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Editorial: Future of Long-Term Care should
be Home- or Community-Based
"It is estimated that by 2050, 27 million
people in the United States will need
long-term care (home, community or
institutional), an increase from 15 million
in 2000," writes Mitchell H. Katz, M.D.,
then of the San Francisco Department of
Public Health and now of the Los Angeles
County Department of Health Services, in an
accompanying editorial.
"Most of the needed capacity for long-term care
should be home- or community-based care.
Innovative home-care models and
comprehensive care models for the elderly
such as PACE (Program of All-Inclusive Care
for the Elderly) should be supported.
"Since assisted living is less costly than
nursing home placement, Medicaid should pay
for this level of care for those persons who
would otherwise require institutional
placement."
"At the same time, we must demand for our
patients and for our families sufficient
availability of high-quality nursing homes
in the communities where people have lived,"
Dr. Katz concludes.
"Physicians can play a key role in improving
nursing home care. We should advocate for
nursing homes that encourage the
independence and dignity of our patients.
"We need to be more present in nursing homes;
they are excellent sites for teaching and
research and yet are underutilized for both,
at least in part due to the lower prestige
of these institutions compared with acute
care hospitals. This can and must change so
that when people require nursing home care,
we can all feel that it is the best home
possible."