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Many elderly and dis­abled Amer­i­cans may face extended hos­pital stays or long term care in nursing homes. But, many could be receiving high quality care that keeps them healthier, longer in their own homes.

Alice Bonner, of North­eastern Uni­ver­sity, and Robert J. Master, of the Com­mon­wealth Care Alliance, look at how the long-​​term care land­scape is changing — and what the future may hold.

Alice Bonner, PhD, RN, is an asso­ciate pro­fessor of nursing at North­eastern Uni­ver­sity. Pre­vi­ously, she served as director of the divi­sion of nursing homes at the Cen­ters for Medicare and Med­icaid Services.

What does home mean to you?

It may be a house in the sub­urbs or a high-​​rise apart­ment in the city. A trailer in the country or some type of shelter or group home. At the end of life, or for those with severe dis­abil­i­ties, it often means a nursing home.

Roughly 12 mil­lion Amer­i­cans with func­tional impair­ments today rely on “long-​​term ser­vices and sup­ports” (LTSS). LTSS refers to assis­tance for people who need help per­forming rou­tine daily activ­i­ties: get­ting dressed, taking a bath, eating, going to the bath­room. Most people receiving LTSS are elderly, but 44 per­cent are under 65.

Long-​​term ser­vices and sup­ports are costly. On average, nursing homes cost about $70,000 a year per person, although cost varies con­sid­er­ably from state to state. Assisted living facil­i­ties gen­er­ally cost about half that. How­ever, the vast majority of people receive LTSS deliv­ered by unpaid care­givers in the com­mu­nity. Esti­mates are that unpaid care­giving may rep­re­sent up to $200 bil­lion in health care costs that are not cap­tured in Medicare, Med­icaid and pri­vate spending projections.

Read the article at WBUR →