older people’s health issues
Settings for Care for Older People
Post acute and long term care
Post-acute care is care immediately after hospital discharge for people who need more care than they can get at home but do not clearly need long-term care. Post-acute care facilities provide a variety of health services including skilled nursing care and physical and occupational rehabilitation to help people regain their strength and function. Most people ultimately return to their home. However, some do not recover all of their function and may require long-term care. The prospect of needing long-term care services concerns many older people. The likelihood of needing long-term care increases greatly as people age because older people are more likely to develop chronic disorders and to have problems functioning. How long care is needed varies from weeks to years to indefinitely. Long-term care is focused on helping people maintain function. It helps them do the activities necessary to care for themselves and to live as independently as possible. These activities include basic daily activities (such as eating, dressing, bathing, grooming, and walking) and other activities (such as shopping, balancing a checkbook, doing laundry, and housecleaning). Long-term care includes help with health care such as taking vital signs, monitoring weight, and giving medicine. Most long-term care facilities also provide social and recreational activities. Many people have their first experience with post-acute and long-term care after a hospital stay. During an illness or after an injury, many older people lose some or all of the ability to care for themselves. Thus, although they may be well enough to leave the hospital, they may need to go to a post-acute and long-term care facility for rehabilitation and recovery. This move can be physically and psychologically demanding. People have to adjust to many new faces and to new routines for sleeping, bathing, dressing, eating, and other daily activities. The move happens quickly, with little time to adjust. Most people associate long-term care with a change in residence: To the home of a family member To a Retirement Communities None To an Assisted–Living Communities None To a Board-and-Care Facilities None To a Life-Care Communities None To a Nursing Homes None Older people may be particularly concerned about moving to an institution. People live in institutions for a variety of social and economic reasons. The most common reasons are physical problems and/or problems with mental function (cognition) plus lack of adequate social support. What type of arrangement is possible depends partly on a person's needs (medical, functional, social, and emotional), preferences, and financial and social resources such as long-term care insurance, availability of state waiver programs, and family members’ willingness and ability to help. One person may be able to live at home with the help of a spouse. Another person with similar problems but without family support may need to go to a nursing home. Learning about the many types of long-term care facilities can help people choose the right time and place for long-term care. Each type of long-term care facility provides different services and levels of health care. After the type of arrangement is determined, a particular facility must be carefully chosen. Even within each type, facilities differ considerably in environment, services (including health care), activities, living arrangements, and rules. Sometimes the difference is simply a matter of what people can afford, but even within a price range, quality varies. The idea of going to a long-term care facility, particularly a nursing home, does not appeal to most people. The following problems are common reasons for entering a long-term care facility. However, sometimes problems can be solved, and the need for a long-term care facility can be delayed or avoided. Urinary Incontinence in Adults : Problems with doing daily activities:Certain devices can help people function better. A physical or occupational therapist or a home health nurse can observe people in their home and can sometimes help them choose and learn how to use appropriate devices that will enable them to continue to function safely at home. Dementia : Avoiding Caregiver Burnout : Financial issues:People can buy long-term care insurance that covers care in the home. This care typically involves helping people with personal care, such as bathing, grooming, and eating. Such insurance may enable people to postpone going to a long-term care facility. 