Long Term & End of Life Care

Long-term care

The World Health Organization describes long-term care as including activities undertaken for persons not fully capable of self care on a long term basis. It includes provision of services such as personal care, life management including medication management, and the use of assistive devices and more advanced technologies. These services are designed to minimize, restore or compensate for the loss of independent physical or mental functioning (Hirschfeld, 2009).

This year in America, about nine million men and women over the age of 65 will need long-term care. By 2020, this number will rise to 12 million older Americans. Most will be cared for at home; family and friends are the sole caregivers for 70 percent of the elderly. According to the U.S. Department of Health and Human Services, people who reach age 65 will likely have a 40 percent chance of entering a nursing home for long term care. About 10 percent of the people who enter a nursing home will stay there five years or more. (http://www.medicare.gov, accessed April 6, 2009)

End of life care

The Center for Disease Control (CDC) has identified the End of Life as an emerging public health priority (http://cdc.gov/aging/EOL.htm). They explain that people are living longer and have increased expectations about health and quality of life. People want to be assured that the last months and years of their lives are lived fully, as pain free as possible and with dignity. Included in the CDC priorities for preparing for end of life are educating the public about hospice and palliative care and educating the public about advanced directives.

Palliative care
"The goal of palliative care is to achieve an optimal quality of life for patients by using a holistic approach that focuses on the alleviation of pain, symptoms, and other unique needs of the patient at any time during their experience with a serious or life threatening disease." (http://cdc.gov/aging/EOL.htm).

Hospice care
"Hospice care is an organized program for delivering palliative care that involves an interdisciplinary team of specially trained health professionals and volunteers. Hospice care is delivered to dying patients in inpatient units, nursing homes, or, most often, in their own homes." (http://cdc.gov/aging/EOL.htm)

End of Life Decisions/Advanced Directives
Advanced directives are end of life preferences identified by the patient and shared with family and health care providers and a health care proxy or surrogate decision-maker for health care. (http://cdc.gov/aging/EOL.htm)