Question

Prepare a 3-4 page paper discussing the changes in demographics, today’s aging population and the impact on the long-term care system. Using the criterion for a high reliability system described in your book, include the goals needed for the optimal long-term care system. This assignment should utilize your assigned readings as well as a minimum of 3 citations.

Outline for your paper:

1. Introduction
2. Changing demographics and description of today’s aging population
3. Description of the various segments of the long-term care industry
4. Goals/criteria for the optimal long-term care system
5. Critique of the strengths and weaknesses of the current long-term care system
6. Describe one priority for improvement in the current long-term care system
7. Conclusion

Answer 1

Demographic Changes

As the U.S. population becomes more racially and ethnically diverse, Americans have mixed views about how the country might change when blacks, Hispanics, Asians and other minorities make up a majority of the population. While more say this change will be good for the country than say it will be bad, the predominant view is that it will be neither.

At the same time, when asked about projections by the U.S. Census Bureau that a majority of the U.S. population will be nonwhite by the year 2050, about half of Americans say this shift will lead to more conflicts between racial and ethnic groups. And about four-in-ten predict that a majority nonwhite population will weaken American customs and values, larger than the shares who say it will strengthen them (30%) or will not have much of an impact (31%).

Opinions about the growth in interracial marriage are, on balance, positive or neutral. About half say more people of different races marrying each other than in the past is a somewhat or very good thing for the country, while about one-in-ten say it’s a somewhat or very bad thing, and four-in-ten see this as neither good nor bad. On this question, as well as the questions about the impact of having a majority nonwhite population, Democrats and those who lean Democratic express far more positive views than Republicans and Republican leaners.

The survey also asked about trends related to marriage and divorce. About half of Americans (53%) predict that in 30 years people will be less likely to get married than they are now; just 7% say people will be more likely to get married, and 39% say people will be about as likely to marry. About six-in-ten expect the divorce rate to remain about the same, but 29% say people who are married will be more likely to get divorced than people are now; 12% say married people will be less likely to divorce.

Americans have a more negative view of another demographic trend: the aging of the U.S. population. According to the U.S. Census Bureau, by the year 2050, people who are 65 and older will outnumber those younger than 18, and 56% of Americans say this will have a negative impact on the country.

Many think people will be less likely to have children

More than four-in-ten Americans (46%) expect that, by 2050, people will be less likely to have children than they are now. A similar share (43%) think people will be about as likely to have children, while just one-in-ten expect people to be more likely to have children in the future.

While a minority across all age groups expect that people in 2050 will be more likely to have children, young adults are more likely than older Americans to say this is the case. About one-in-five adults younger than 30 (18%) say they expect that people in 2050 will be more likely to have children, compared with 9% of adults 30 to 49, 8% of adults 50 to 64 and 5% of those 65 and older.

A majority of Americans say population aging will have a negative impact

The U.S. Census Bureau estimates that, by 2050, the number of people who are 65 and older will outnumber those younger than 18. A majority of the public (56%) say this transformation will be a somewhat or very bad thing for the country, 17% say it will be good and 26% say it will be neither good nor bad.

Adults with more education are more likely than those with less formal schooling to see population aging negatively. About two-thirds of those with a bachelor’s degree or more education (67%) say this will have an adverse impact on the country, compared with 56% of those with some college and 48% of high school graduates and those with less education.

Views about the impact of population aging also vary considerably by gender. Men are far more likely than women to say this change will be bad for the country (64% vs. 49%), while 20% of women – vs. 13% of men – say this trend will have a positive impact. Views don’t vary considerably by age, race and ethnicity, or party identification.

Description of ageing population

Today, 125 million people are aged 80 years or older.

Key facts

• Between 2015 and 2050, the proportion of the world's population over 60 years will nearly double from 12% to 22%.
• By 2020, the number of people aged 60 years and older will outnumber children younger than 5 years.
• In 2050, 80% of older people will be living in low- and middle-income countries.
• The pace of population ageing is much faster than in the past.
• All countries face major challenges to ensure that their health and social systems are ready to make the most of this demographic shift.

Common health conditions associated with ageing

Common conditions in older age include hearing loss, cataracts and refractive errors, back and neck pain and osteoarthritis, chronic obstructive pulmonary disease, diabetes, depression, and dementia. Furthermore, as people age, they are more likely to experience several conditions at the same time.

Older age is also characterized by the emergence of several complex health states that tend to occur only later in life and that do not fall into discrete disease categories. These are commonly called geriatric syndromes. They are often the consequence of multiple underlying factors and include frailty, urinary incontinence, falls, delirium and pressure ulcers.

Factors influencing Healthy Ageing

Although some of the variations in older people’s health are genetic, much is due to people’s physical and social environments – including their homes, neighbourhoods, and communities, as well as their personal characteristics – such as their sex, ethnicity, or socioeconomic status.

These factors start to influence the ageing process at an early stage. The environments that people live in as children – or even as developing foetuses – combined with their personal characteristics, have long-term effects on how they age.

Environments also have an important influence on the development and maintenance of healthy behaviours. Maintaining healthy behaviours throughout life, particularly eating a balanced diet, engaging in regular physical activity, and refraining from tobacco use all contribute to reducing the risk of non-communicable diseases and improving physical and mental capacity.

Behaviours also remain important in older age. Strength training to maintain muscle mass and good nutrition can both help to preserve cognitive function, delay care dependency, and reverse frailty.

Supportive environments enable people to do what is important to them, despite losses in capacity. The availability of safe and accessible public buildings and transport, and environments that are easy to walk around are examples of supportive environments.

Various segments of long term system

"Long-term care" means helping people of any age with their medical needs or daily activities over a long period of time.

Home care can be given in your own home by family members, friends, volunteers, and/or paid professionals. This type of care can range from help with shopping to nursing care. Some short-term, skilled home care (provided by a nurse or therapist) is covered by Medicare and is called "home health care." Another type of care that can be given at home is hospice care for terminally ill people.

Community services are support services that can include adult day care, meal programs, senior centers, transportation, and other services. These can help people who are cared for at home-and their families. For example, adult day care services provide a variety of health, social, and related support services in a protective setting during the day. This can help adults with impairments-such as Alzheimer's disease-continue to live in the community. And it can give family or friend caregivers a needed "break."

Supportive housing programs offer low-cost housing to older people with low to moderate incomes. The Federal Department of Housing and Urban Development (HUD) and State or local governments often develop such housing programs. A number of these facilities offer help with meals and tasks such as housekeeping, shopping, and laundry. Residents generally live in their own apartments.

Assisted living provides 24-hour supervision, assistance, meals, and health care services in a home-like setting. Services include help with eating, bathing, dressing, toileting, taking medicine, transportation, laundry, and housekeeping. Social and recreational activities also are provided.

Continuing care retirement communities (CCRCs) provide a full range of services and care based on what each resident needs over time. Care usually is provided in one of three main stages: independent living, assisted living, and skilled nursing.

Nursing homes offer care to people who cannot be cared for at home or in the community. They provide skilled nursing care, rehabilitation services, meals, activities, help with daily living, and supervision. Many nursing homes also offer temporary or periodic care. This can be instead of hospital care, after hospital care, or to give family or friend caregivers some time off ("respite care").

Another type of long-term care takes place in home-like settings called Intermediate Care Facilities for the Mentally Retarded. They provide a wide variety of services to mentally retarded and developmentally disabled people from youth to old age. Services include treatment to help residents become as independent as possible, as well as health care services.

Strength and weakness of current long term care system

Strengths
1.The Long-Term care system responds great to changing needs. Diseases and symptoms are ever changing. Facilities in the Long-Term health care system have to be on their toes at all times and ready to change according to the needs of the consumer and forms of treatment. I think if Long-Term health care wasn’t efficient in this matter there would be no need for them due to the fact that Health Care is ever changing.

2. America is unique and there is a vast amount of people who share different ethnics, location, economics, etc. To bring all these different types of people together to live in semi-close corridors could create a problem. That is why Long-Care facilities have their own form of government which makes individuals be able to vote for what they want and ultimately gives them personal responsibility.

3. This part I think could be both a strength and a weakness for Long-Term health care, and that is the dedication of the caregivers. For the most part the caregivers do what they do because they love their job. Although in my opinion and from what I have read and seen on the news some of the caregivers abuse and steal from the residents.

4. Customer Service is everywhere. Even in Long-Term care facilities. Making your residents are happy is and should be the number one priority. Such examples I can come up with as to make the residents happy would be activities and comfortable atmosphere.

5. Tending to each individual needs is definitely a strength. Depending on the age and condition of the resident will depend on how much attention and or care the resident needs.

6. One strength that is still being worked on is integration efforts. Some places have found a solution and some have failed.

Weaknesses

1. Money is a big problem. Long-Term care facilities are looking to do things that will allow reimbursements and avoid doing things that will not be reimbursed.

2. Long-Term facilities often turn away people who need them. When this happens it most likely has something to do with money.

3. Being unincorporated is a big issue. When money is being paid but from numerous sources that could cause a problem.

4. There are several services Long-Term facilities offer, housing, meals and transportation. Most residents are not categorized by their disease, but their needs.

5. The fact that a resident can enter the facility leave and come back is a problem. Long-Term means long-term and I think they should once “checked in” have to stay and if for some reason they leave it should be for an emergency.

6. Residents in Long-Term care facilities have decreased. Because of the new technology and all the procedures hospitals can perform most people choose to stay out of Long-Term care facilities.

7. Poor public image, such as what I discussed earlier. Accusations of abuse and theft.

8. There should be some type of class that family members of residents at Long-Term care facilities could take. This would better help them understand what is going on and what they need to do.

9. Long-Term care facilities use confusing systems. To experts this is even confusing could you imagine using it at an entry level?

Priority for improvement need for the current long term care

The staffing shortages in the health care workforce.

The demand for long-term care is predicted to exceed the supply of trained professionals who are qualified to deliver the needed services, which will lead to severe workforce shortages of 30 percent or more. This shortage of health care professionals has already begun in some areas of the country, as there are not enough qualified applicants to fill open positions for direct caregivers to the elderly. Historically, long-term care workers have been paid less than workers in acute health care settings, and this is a factor in the shortage of workers in the long-term care system. The rapid employee turnover that is common in some long-term care settings also contributes to less than adequate staffing levels and compromises quality of care. Nurses and other long-term care professional staff members need a more competitive wage, opportunities for continuing education, and better working conditions than they have been receiving if the significant rate of turnover is to be reduced.

Conclusion

In this article i have discussed about the changing demographics and description about the ageing population, Today, 125 million people are aged 80 years or older. By 2050, there will be almost this many (120 million) living in China alone, and 434 million people in this age group worldwide. I discussed about the various segments of long term care such as supportive housing programs, Assisted living, continuing care retirement communities etc. And at the end I have discussed about the strength and weakness of current long term care facilities and the improvement needed for the current long term care system.

Citations

1. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health

2. http://as230382.blogspot.com/2009/09/strengths-and-weaknesses-in-long-term.html

3. https://www.webmd.com/healthy-aging/guide/choosing-long-term-care#2