In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant portion of their funding.
A nursing home is a facility for the residential care of older people, senior citizens, or disabled people. Nursing homes may also be referred to as care homes, skilled nursing facilities (SNF) or long-term care facilities. Often, these terms have slightly different meanings to indicate whether the institutions are public or private, and whether they provide mostly assisted living, or nursing care and emergency medical care. Nursing homes are used by people who do not need to be in a hospital, but cannot be cared for at home. The nursing home facility nurses have the responsibilities of caring for the patients' medical needs and also the responsibility of being in charge of other employees, depending on their ranks. Most nursing homes have nursing aides and skilled nurses on hand 24 hours a day.
An assisted living residence or assisted living facility (ALF) is a housing facility for people with disabilities or for adults who cannot or who choose not to live independently. The term is popular in the United States. Still, the setting is similar to a retirement home, in the sense that facilities provide a group living environment and typically cater to an older adult population. There is also Caribbean assisted living, which offers a similar service in a resort-like environment.
Elderly care, or simply eldercare, serves the needs of old adults. It encompasses assisted living, adult daycare, long-term care, nursing homes, hospice care, and home care.
Long-term care (LTC) is a variety of services which help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods. Long-term care is focused on individualized and coordinated services that promote independence, maximize patients' quality of life, and meet patients' needs over a period of time.
A retirement community is a residential community or housing complex designed for older adults who are generally able to care for themselves. Assistance from home care agencies is allowed in some communities, and activities and socialization opportunities are often provided. Some of the characteristics typically are: the community must be age-restricted or age-qualified, residents must be partially or fully retired, and the community offers shared services or amenities.
The American Health Care Association (AHCA) is a non-profit federation of affiliated state health organizations that represents more than 14,000 non-profit and for-profit nursing homes, assisted living communities, and facilities for individuals with disabilities. The organization's president and CEO is Mark Parkinson, a former governor of Kansas. The National Center for Assisted Living (NCAL) is a part of the AHCA.
A group home, congregate living facility, care home, adult family home, etc., is a structured and supervised residence model that provides assisted living and medical care for those with complex health needs. Traditionally, the model has been used for children or young people who cannot live with their families or afford their own homes, people with chronic disabilities who may be adults or seniors, or people with dementia and related aged illnesses. Typically, there are no more than six residents, and there is at least one trained caregiver there 24 hours a day. In some early "model programs", a house manager, night manager, weekend activity coordinator, and four part-time skill teachers were reported. Originally, the term group home referred to homes of 8 to 16 individuals, which was a state-mandated size during deinstitutionalization. Residential nursing facilities, also included in this article, may be as large as 100 individuals in 2015, which is no longer the case in fields such as intellectual and developmental disabilities. Depending on the severity of the condition requiring one to need to live in a group home, some clients are able to attend day programs and most clients are able to live normal lifestyles.
Program of All-inclusive Care for the Elderly (PACE) are programs within the United States that provide comprehensive health services for individuals age 55 and over who are sufficiently frail to be categorized as "nursing home eligible" by their state's Medicaid program. The ultimate goal of PACE programs is to keep eligible older adults out of nursing homes and within their communities for as long as possible. Services include primary and specialty medical care, nursing, nutrition, social services, therapies, pharmaceuticals, day health center services, home care, health-related transportation, minor modification to the home to accommodate disabilities, and anything else the program determines is medically necessary to maximize a member's health. If you or a loved one are eligible for nursing home level care but prefer to continue living at home, a PACE program can provide expansive health care and social opportunities during the day while you retain the comfort and familiarity of your home outside of day hours.
William H. Thomas, also known as Bill Thomas, is an American author, performer and authority on geriatric medicine and eldercare from New York State. In 2014, Thomas organized a 25-city "non-fiction" theatrical tour to launch his book and to promote the documentary film Alive Inside. He is the founder of The Eden Alternative, a philosophy and program that de-institutionalized nursing homes in all 50 states and worldwide over the past 20 years. A self-described “Nursing Home Abolitionist,” he is also creator of Green House Project, a long-term care approach where nursing homes are torn down and replaced with small, home-like environments. In 2005, the Robert Wood Johnson Foundation announced a five-year $10 million grant that would result in the creation of Green House projects in all fifty states. As a professor at The Erickson School at UMBC, Thomas led development of the nation's first emergency department designed for older adults.
Total care is where long-term care facilities for residents are responsible for meeting all the needs of a resident. While some residents receiving so-called total care may be able to independently meet all or some of their needs for their activities of daily living without the assistance of a caregiver, the facility and its staff have the duty of monitoring the resident to be sure s/he is having those needs met.
Brookdale Senior Living Solutions owns and operates retirement homes across the United States. The company was established in 1978 and is based in Brentwood, Tennessee. It is the largest operator of senior housing in the United States, with over 60,000 residents.
A continuing care retirement community (CCRC), sometimes known as a life plan community, is a type of retirement community in the U.S. where a continuum of aging care needs—from independent living, assisted living, and skilled nursing care—can all be met within the community. These various levels of shelter and care may be housed on different floors or wings of a single high-rise building or in physically adjacent buildings, such as garden apartments, cottages, duplexes, mid- and low-rise buildings, or spread out in a campus setting. The emphasis of the CCRC model is to enable residents to avoid having to move, except to another level of care within the community, if their needs change.
Nursing home residents' rights are the legal and moral rights of the residents of a nursing home. Legislation exists in various jurisdictions to protect such rights. An early example of a statute protecting such rights is Florida statute 400.022, enacted in 1980, and commonly known as the Residents' Rights Act.
ReachOut Healthcare America (RHA) is a dental management services company with its headquarters in Farmington Hills, Michigan. It is a part of the private equity portfolio of Morgan Stanley. The company operates in 22 U.S. states. In 2011 the company coordinated dental care at 8,700 schools and coordinated the processing of 488,000 children in those schools. As of May 2012 the company has coordinated the processing of 1.5 million patients. ReachOut seeks to coordinate treatment for underserved children on Medicaid.
De Hogeweyk, operated by nursing home Hogewey, is a gated model village in Weesp, Netherlands. It has been designed specifically as a pioneering care facility for elderly people with dementia. The benefit of using all-day reminiscence therapy at Hogewey, compared to traditional nursing homes, is that the residents with dementia are more active and require less medication.
As of 2017, approximately 1.4 million Americans live in a nursing home, two-thirds of whom rely on Medicaid to pay for their care. Residential nursing facilities receive Medicaid federal funding and approvals through a state health department. These facilities may be overseen by various types of state agency.
Granny dumping (informal) is a form of modern senicide. The term was introduced in the early 1980s by professionals in the medical and social work fields. Granny dumping is defined by the Oxford English Dictionary as "the abandonment of an elderly person in a public place such as a hospital or nursing home, especially by a relative". It may be carried out by family members who are unable or unwilling to continue providing care due to financial problems, burnout, lack of resources, or stress. However, instances of institutional granny dumping, by hospitals and care facilities, has also been known to occur. The "dumping" may involve the literal abandonment of an elderly person, who is taken to a location such as hospital waiting area or emergency room and then left, or in the refusal to return to collect an elderly person after the person is discharged from a hospital visit or hotel stay. While leaving an elderly person in a hospital or nursing facility is a common form of the practice, there have been incidences of elderly people being "dumped" in other locations, such as the side of a public street.
Virginia H. Fraser was an American activist for human rights, women's rights, and elder rights. She was the Long-Term Care Ombudsman for the state of Colorado for more than two decades. She co-wrote several works on nursing home care and eldercare. She was inducted into the Colorado Women's Hall of Fame in 2002.
The COVID-19 pandemic has impacted long-term care facilities and nursing homes around the world. Thousands of residents of these facilities, who are a high-risk group, have died of the disease.
