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Long term care is becoming a crucial part of health care due to more chronic health problems as well as an increase in the number of aged persons. Long term care (LTC) is a service that helps people to meet non-medical and medical needs of people with disability or chronic illness. LTC provides non-skilled and custodial care like assisting with normal duties, such as use of the bathroom, bathing or dressing. LTC requires skilled practitioners experts to address multiple chronic associated with older populations. The service is provided in nursing homes, assisted living facilities, in communities and at home.

Long term care offers continuous care for ninety days to people having chronic and acute conditions. Long term needs are measured by individual abilities. There are two standard measure assessing functions which include Instrumental Activities of Daily Living (IADLs) and Activities of Daily Living (ADLs). ADLs functions offer most basic tasks required to function independently. IADLs functions offer skills, which are required to perform household chores and social tasks to maintain great self-sufficiency. Long term care services are provided informally or formally. LTC services provide accommodation for people in the facilities as well as for those who require on site care. These formal services include housekeeping, laundry, meals, personal care and health services. LTC provided in homes incorporate clinical services such as physical therapy, drug therapy, nursing and physical construction of kitchens, bathrooms and lifts. The cost of the services depends on nature of the health care system and the country. Informal LTC services are support and care provided by family members (Barton, 2007).

Due to rise in life expectancy, there are more people in the age which needs care. There is a need for health care systems and countries to find sustainable and innovative ways to cope with the shift. Change in social patterns such as increased female labor and residential patterns among others increase the need for paid care to the elderly people. In most countries health care is provides by volunteers or family members. In the United States more than 20 million people require LTC services and the figure is expected to rise in the next few years. However, half of this population is disabled, hence needs more attention. 6.6 million people in United States are of the age of 65 and above and are the beneficiaries of Medicare. Likewise, they are entitled to LTC coverage of skilled nursing care and home care.

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Home health care services provide services in their homes and have been available in the United States health service system. These services keep individuals out of costly facilities. Provision of LTC services expanded to Omnibus Budget Reconciliation Act (OBRA) and community based services from nursing home care and home health care. Nursing homes provide LTC and nursing care services on residential basis to all patients with impairment and disabilities. According to Office of Program Policy Analysis and Government Accountability, 2009 statistics taken in 1999, 1.6 million people in the United States resided in nursing homes while 600,000 lived in other LTC services.

There are designed nursing homes for military veterans which are supported by department of veterans’ affairs (VA). In the 2000s, intermediate care facilities for mentally retarded were established. This is a result of being disowned in nursing homes and by family members. Medicaid has programs which provide services to people with disabilities and are not ICFMRs residents. LTC service has an elderly program for the elderly which monitors on their health and day care which ensures they obtain all the services needed. Social Health Maintenance Organizations (SHMOs) determine whether health programs maintain elderly people fairly well in their communities or homes. This avoids the need for institutionalization as well as determining the medicate LTC feasibility increase.

Services provided by LTC are not obtained by all people. Home health services are provided to people at all ages who have insurance services. However, most of home care clients are beneficiaries. In Home Care Community Services it is difficult to obtain information, since Medicare programs vary in operation and reimburse. Long term care is financed by public payers In the United States health services system. Medicare pays nursing home care, which is 60% of nursing home residents, mostly the elderly. Currently, the monthly charges for nursing home are $3900 or more. However, the services offered vary in different states. The estimated number of Americans who need LTC services is more than 12 million. However, not everyone receives the services due to financial barriers. There are two types of policies surrounding LTC. One of the policies is Taxed Qualified policy. The person who requires this policy must require care for 90 days and should be unable to perform two or more daily activities such as bathing, eating and dressing among others. The benefit for this policy is that these services are non-taxable. The second policy is Non-tax qualified policy. This policy requires the person to own a doctor where the policy pays for the services. This policy requires the person to be unable to perform one or more activities. The policy is cancelled only due to lack of payment.

In conclusion, LTC is a service that helps people to meet nonmedical and medical needs of those with disability or chronic illness. LTC offers a continuous care for a period of ninety days for chronic and acute conditions. LTC needs are measured on individual abilities. Two standard measure assess functions include Instrumental Activities of Daily Living (IADLs) and Activities of Daily Living (ADLs). LTC provided in homes incorporate clinical services. Change in social patterns, such as increased female labor and residential patterns among others increase the need for paid care to the elderly people. 

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