The definition of plateful occupy appears plain; indeed, it seems to be contained in the very term. At a minimum, photographic plate address refers to occupy given in their substructures to people with disabilities or diseases. In the United States, home care also refers to a series of programs that are licensed and reimbursed in specific ways and that have been contrasted to nursing-home care as a way of overhaul people with chronic illnesses and functional impairments.
This article identifies several trends that, if allowed to continue, imperfection the definitions of home care and institutional care, change the cast of characters providing both(prenominal) types of care, and even challenge the definition of home. Taken to logical conclusions, this redefinition of home care could result in a sharply divergent conceptualization of both home care and nursing homes. I begin with a discussion of trends for some home care succeedrs to deliver personal assistance services (PAS) in the federation to people who are not home bound, and also to provide home care services to people whose "homes" are flatbed units in assisted living complexes. Next, I discuss features associated with a "home-care model" for long-term care (LTC), and I then routine to factors that facilitate or impede these trends. I conclude with a summary of the challenges to policy makers that stem from the blurring of
Recent developments in state-funded and Medicaid-waiver-funded programs, moreover, have allowed an end run somewhat Medicare definitions of home health care for the senile. For example, most waiver programs accent PAS rather than home health care, and they make eligibility for benefits contingent on measurable functional impairment rather than medically endorsed " exact" for specific services (e.g.
, skilled nursing, physical therapy, speech therapy, occupational therapy, medical social work, and home health aide services, as in the Medicare rules).
Home care and residential care providers whitethorn decide either to welcome this boundary blurring or to advertise to maintain programmatic distinctions. Arguably, widespread confusion about the definition of home and home care could be a positive development, rescue new possibilities to home care providers, reconceptualizing the work done by staff of residential settings, and, most important, bringing new options to change people of all ages. The trends toward clouding distinctions between home care and institutional care particularly promise to improve the lives of elderly disabled people - the largest population in need of care and the people whose care presently is most formula driven, owe to the regulatory and reimbursement provisions in Medicare and in state Medicaid policies.
Weissert, W.G., C.M. Cready, and J.E. Pawelak. 1988. The agone and Future of Home- and Community-based Long-Term Care. Milbank Quarterly 66:
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