Opportunities and Challenges for Long Term Care in the Future


Discussions of health care and its funding are no longer confined to insurance board rooms and the halls of government.    They are now a part of everyday conversations.

This awareness has made individual Americans increasingly conscious about what will happen to them when they are older.  We are an aging population.  That’s not news; but, the rate of aging is a call to action for both governments and long term care providers and suppliers.

In 2013 people over the age of 65 were 14% of the population.

By 2040 that number is expected to increase to 22%.

A 2016 survey of people who are now over 40, conducted by the Associated Press-NORC Center for Public Affairs Research, indicates two important expectations and preferences for long term care:

  1. Most people expect some, or even complete, support from Medicaid for their long term care, and,
  2. 76% want to be cared for in their own homes.

Both these results present major challenges to policy makers and to the long term care and nursing home industries.  Yet, they can also spark creative solutions for lower cost and more patient centered equipment, supplies and programming.

While policy makers wrestle with the financing issues, long term care providers are cutting costs and increasing patient comfort with innovative programs and materials.

A recent case study

An excellent model involves the non-so glamorous issue of constipation.  Parkview Manor in Ontario, Canada, became concerned with the repeated use of medication to relieve their patients of this uncomfortable and unhealthy condition.  In search of a better solution, they carefully documented the daily routines of their residents.

A wide ranging review of the material pointed to diet and inactivity as a potential cause of the problem.  They engaged experts in diet and exercise, and, the patients, themselves, to devise individual and group programs to improve nutrition and include appropriate level exercises.  Even bed-ridden patients can do some exercise if they are on a sleeping surface which breathes and allows for comfortable movement.

This innovative approach means the staff now relies on drugs only as a last resort.  It also has unexpected benefits.

According to Teresa Tibbo RPN, Quality Co-ordinator,

It has empowered staff to take an active role in ensuring our residents are given the nutritional supplements and exercise plans that will help them avoid pharmacological interventions, and has enhanced the collaboration and communication between departments.

Ancillary benefits

While Parkview Manor’s findings may not seem particularly revolutionary, the true breakthrough is that staff chose to try to improve what might be considered a minor issue, and, found a solution which not only lowered cost, and improved patient comfort; but, provided the added benefit of patient and staff engagement.  It show that if long term care providers and suppliers pay attention to the details, there are enormous potential advantages.

What can we look forward to?

Some policy  makers, for instance, are studying what it will mean to their business if seniors get their preference and receive care at home.  Institutional care will still be necessary for some seniors; but, do the institutions expand to provide an outreach division, or,  do they regard home care providers as their major business competitors?

The at-home approach

On the other hand, forward thinking suppliers and long term care equipment producers are also looking at the future of the home care market.  The challenge and the opportunity will be to provide medically supportive materials, medical mattresses and equipment which fit as seamlessly as possible into a residential setting.  No one feels at home when a hospital bed replaces the couch.

Still, mostly mobile, stay-at-home seniors will require everything from lower and safer cooking surfaces to easy entry beds and baths to user-friendly work stations so they can stay productive and connected.  Manufacturers have made several advances in items like:

  • ♦ the induction cooking surface which heats only the pots and pans which belong on it, yet is cool if you put your hand on it,
  • ♦ mattresses which respond well to your every toss and turn &
  • ♦ various versions of step-in baths.

Talk-to television even overcomes fumbling with the remote.

But what about the basics?

Where the opportunities and challenges still lie are in basic medical apparatus, like mobility support equipment and oxygen delivery systems that are a permanent part of the resident’s life.  Both their use and their appearance in a home setting may require a new approach.

Success in this new market will depend on an awareness of the issues and a creative approach to solutions.