From Nursing Homes to Home CarePainos 1

Older people who would prefer to stay in their homes and states whose funds are being depleted by the rising costs of Medicaid payments to nursing homes find the current system of long-term care unsatisfactory. From Nursing Homes to Home Care arms educators, policymakers, public health professionals, gerontologists, and advocacy groups with the information they need to participate knowledgeably in the debate about aging and long-term care needs. The book shows readers where things are, where they are going, and where they need to be in changing the system of long-term care. From Nursing Homes to Home Care evaluates future needs for long-term care by analyzing on-going systems and assessing key features of proposed long term programs in the context of population aging. Readers gain a thoughtful analysis of the complex dimensions of making future long-term care policy and program decisions as they read about:

• patterns of demographic aging, disability, and health needs
• intersections of formal and informal care including intergenerational equity issues
• long-term care services needs and accessibility
• planning for funding, quality assurance, and range of services
• implications of shifts from the current system to a system of home and community-based services Chapters in From Nursing Homes to Home Care express the collective thinking of leaders in long-term care policy and research. Contributors address implications for changing the current system in relation to the emerging needs of the aging population and use this as a basis for examining alternative decisions. Information in the book helps readers determine how to best blend formal and informal services, how to assure quality of care and quality of life in long-term care policy, how to finance devised programs, which health needs to address, and whether to use regulatory or competitive approaches. Professionals, educators and students, and policymakers at all levels learn about factors to consider in policy planning and decision making, including features of aging baby boomers; trends in the growth of the aged population; newly emerging trends in morbidity, disability, and mortality and their effect on the demand for long-term care in the short and long term; access issues from the perspective of the historical evolution of publicly funded long-term care services, the distribution of formal and informal systems of care; utilization patterns of the minority and poor; how to pay for care, how to design an appropriate mix of services, how to maintain quality with efficiency, and how to mesh services with social and family values. From Nursing Homes to Home Care is an invaluable resource in evaluating and advocating policy changes and decisions for an improved long-term care system.