Concept of Home-Care

among home care, institutional care, and other

long-term-care services.

Citation: The Milbank Quarterly, Summer 1995 v73 n2 p161(26)

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Institutional care_Research

Nursing home care_Research

Long-term care of the sick_Research

Long-term care facilities_Research

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Author's Abstract: COPYRIGHT Milbank Memorial Fund 1995

Distinctions between home care and residentially based care are blurring because of two trends: home care providers are offering services, including personal assistance, outside of the private, self-contained family home ot apartment; and a market-driven movement is underway to develop group residential settings where long-term-care (LTC) consumers with substantial disability receive personal care and nursing in their own, fully equipped, apartments where they largely control the schedule. For the customers, such boundary blurring can lead to experiences of greater power and normality in their everyday lives. State regulations will help determine the extent to which new, "residentially" oriented models of LTC are feasible. Home care providers are challenged to develop flexible and creative paradigms for service tha

. . .
-home care. Obviously that break-even point is more likely to be reached if the home care client has high levels of disability, has little or no family help, and lives in a home that is inaccessible or difficult to maintain. It is less often recognized that people with substantial disabilities will be likely to receive care at home under the break-even point if nursing-home reimbursement rates are relatively high, if home care rates are relatively low, if plans for home care are relatively parsimonious, and if home care providers can organize their services to achieve economies of scale. Such an eventuality can be achieved by eliminating requirements for minimum hours of service and by assigning workers or teams to particular buildings and geographic areas where many clients reside. Nursing homes are billed as 24-hour care. In a typical scenario, a doctor explains to a family that the discharge planner will look for a nursing home because their mother needs 24-hour care. In reality, these prescribed settings provide remarkably little nursing care. A recent study of a large sample of nursing homes and nursing-home residents in six states uncovered the following facts: about 39 percent of the sample received no care from a regist
. . .

Some common words found in the essay are:
Kane Wilson, Cready Pawelak, Memorial Fund, Eckert Lyon, Nurse Delegation, Kane Caplan, Services Home, Medicare Medicaid, Accounting Office, Falik Ginsburg, home care, assisted living, nursing homes, home health, long-term care, health care, nursing-home care, nursing home, disabled people, care homes, home care providers, board care homes, home health care, assisted living settings, home care agencies,
Approximate Word count = 9594
Approximate Pages = 38 (250 words per page)

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