As a major component of the health care delivery system, long-term care (LTC) has been receiving increasing attention in both developed and developing countries. LTC is closely associated with disabilities emanating from chronic conditions that are mostly related to human aging. Developed countries have seen a steep rise in chronic conditions, and the trend will continue. Thanks to better sanitation, nutrition, and medical care, longevity is increasing in developing countries. A rise in chronic conditions and functional limitations is an unfortunate adjunct of longevity. The social environment in developing countries is also changing. Both men and women are increasingly being drawn into the workforce to improve their standards of living. Hence, there is a growing demand for LTC services in the developing world as well.

Reference

Singh, D. A. (2016). Effective management of long-term care facilities (3rd ed.). Burlington, MA: Jones & Bartlett Learning

Case

Can Mrs. Klausman Stay in Assisted Living?

Contributed by Katie Ehlman, PhD, CHES, HFA; Elizabeth Ramos, MS, RD, CD; Julie McCullough, PhD, RD; and Mary Kay Arvin, OTD, OTR, CHT, College of Nursing and Health Professions, University of Southern Indiana.

Mrs. Klausman is a 92-year-old resident in an assisted living facility. She has mild cognitive impairment and needs help with bathing and medication administration. Because of progressive arthritis, she is having difficulty eating. The silverware slips out of her hands and falls to the floor so that staff members must keep replacing it. Mrs. Klausman becomes visibly frustrated and embarrassed. The food service manager and the administrator decide to meet with Mrs. Klausman’s daughter, and recommend that the family should hire a home care provider to assist Mrs. Klausman at mealtimes. The facility does not have staff resources to feed residents. The resident’s daughter is thinking whether a skilled nursing facility would be more appropriate for her mother.
Questions
1. Identify and evaluate Mrs. Klausman’s deficit in self-feeding from different perspectives on what long-term care consists of.
2. Should Mrs. Klausman be transferred to a skilled nursing facility? Explain.
3. Is hiring a homemaker appropriate? Why or why not? What do you suggest?