long term health care for the elderly. The following discussion provides an overview of the problem, while the concluding discussion describes the proposed intervention.
It has been widely reported and acknowledged that the fastest growing segment of the domestic economy of the United States (US) since the mid 1960s has been and, in the mid 1980s, continues to be the health care sector (Joint Economic Committee [JEC], 1985; Patricelli, 1984; Tratford & Work, 1983). Beginning in the late 1970s, government and private health care funders, as well as the general public, began to express public concerns over the rising costs associated with health care (Council of Economic Advisers [CEA], 1984; "As inevitable" (1983). The provision of health care for the elderly segment of the population is one of the most critical of the health care funding issues facing the country.
The problems associated with the delivery of health care services to the elderly are an end result of developments in several areas. These developments are (1) a lengthening lifespan, (2) an increase in both the numbers of elderly persons and of their proportion in the total population of the country, (3) technological advancements in health care, which makes its delivery more expensive, (4) a burgeoning federal budget deficit, and (5) a change in the governmental perspective towards the delivery of social services. The combined result of these factors is a continuing evolvement of an elderly segment of the population, which requires (1) a growing proportion of the nation's total health care services output, (2) an increasing level of health care services on a per capita basis, and (3) new types of health care services.
On a national basis, approximately $105 billion was spent in the US in 1984 on the provision of health care services for the elderly (Public, 1987). In that same year, there were approximately 32.3 million persons aged 65 or older ...