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long-term care (LTC)

Epidemiology: - nearly all long-term care entrants are without severe disability* 4 years before & 2 years after entry * dependence on >= activities of daily living Management: - home modification based on interprofessional evaluation (nurse, occupational therapist, person knowledgeble about home modification) - CAPABLE program provides home visits over the course of 5 months by interprofessional team [1] Notes: - primarily finded by out-of-pocket payment & Medicaid - Medicare part A covers $144/day (2016) for days 21-100 of nursing home - patient is responsible for $185.50 per day for days 21-100 in 2021 but coverage ends at day 100 - Medicaid kicks in when patient spends down assets to a minimum level of worth (varies state by state) [1]

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nursing home

References

  1. Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010 - Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
  2. Kaye HS, Harrington C, LaPlante MP. Long-term care: who gets it, who provides it, who pays, and how much? Health Aff (Millwood). 2010 Jan-Feb;29(1):11-21 PMID: 20048355
  3. Terzakis K, MacKenzie MA. Preparing Family Members for the Death of a Loved One in Long-Term Care. Annals of Long-Term Care. February 2019. https://www.hmpgloballearningnetwork.com/site/altc/articles/preparing-family-members-death-loved-one-long-term-care
  4. Lam K et al. The natural history of disability and caregiving before and after long-term care entry. JAMA Intern Med. 2023;183(12):1295-1303 PMID: 37930717 PMCID: PMC10628843 (available on 2024-11-06) https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2811180