Long-Term Care Administration Long-term care refers to the wide range of medical activities designed to assist the needs of people living with chronic health issues. Debates concerning hospital quality, and nursing care often occur independently to one another. The activities that ensure adequate performance of hospital nursing play a role in quality improvement, and realization of effective control of hospital costs. In addition, the nursing homes practitioners are critical to the provision of quality and efficient care. Facilities that adopt front-line staff motivated performance improvement approaches, such as Transforming care at the bed-side demonstrate how practitioners (Needleman, 2009), driven by effective leadership can play a role in improving both the quality and efficiency of hospital care.

The healthcare organization may adopt strategies, or approaches that will improve the provision of quality care. Organizations should lay emphasis on the engagement of front-line staff as a strategy to achieving quality care. A typical model that nursing homes should embrace is the Transforming Care at the Bedside whose primary objective was to engage front-line staff and nursing leadership to improve the quality and safety of care. It was to achieve this by creating a setting of high quality work, which would attract and retain nurses, who will in turn improve the experience of patient care and their families. Numerous organizations, which have utilized the TCAB program was successful in engaging front-line staff, and subsequently initiated changes that improved unit processes, in turn improving the quality of care (Needleman, 2009).

On the other hand, Care Transitions Coordinator (CTC) program allowed physician engagement for homecare and hospice healthcare facilities. Physician engagement provides for patient follow up with their physician within one week of discharge, in a regular manner. In addition, this practice helps in reducing re-hospitalizations a step towards improving the quality of care. This program is a relationship-based, which the CTC serves as the funnel for sharing information among all the people engaged with the patient. However, this program requires cooperation among physicians and other healthcare practitioners for it to achieve the desired objectives of improved care. Research suggests that the primary outcome of this program was the decrease in re-hospitalization rates. In addition, it enhances the relationship between physicians and patients, a move that saw to improved quality of care (Fleming, 2013).

Notably, there is a similarity between the discussed programs, CTC and TCAB, in that they play a role in staff management. Although they are not the only models, with the capacity of increasing staff engagement, they have proved to offer substantial help in improving the quality of care, in nursing homes and homecare facilities. Scholars have attempted to understand how policies influence the quality of care in nursing and homecare, the government has a role to play when it comes to financing long-term care. This will work well for the retiring elderly, and the less fortunate people in a given society (Fleming, 2013). In addition, the states must continue to incorporate acute and long-term care services for the elderly, this will help to contain spending.

The financing of long-term care remains the cheapest and most appropriate policy, because the government, for instance, in U.S., Medicaid offers low payment rate when compared to private insurances. Additionally, the hospitals will have a role to play in implementing the policies, which work well with utilizing the discussed programs. When hospitals integrate their work to improve the quality of care, this will increase efficiency in provision of care. Therefore, the organization, nurses and other key stakeholders must embrace such policies. The organization will also need to value their contributions, and shift their visions from being a cost center to a critical service line (Fleming, 2013).

Question 2

The prevalence of chronic issues in healthcare is likely to increase dramatically with the aging population. Conversely, the need for quality long-term care is also likely to increase in the years to come. On the other hand, the aging population will lead to an increased demand for aged care services over the next 20 years (Joseph, 2006). This situation is likely to happen owing to reductions in chronic and profound...

In addition, this will also alter the current care delivery settings, services and the financial mechanisms. While the future demand for these services appears to be more heterogeneous, the degree to, which aged care providers can handle such cases is an important determinant of the care mixes they develop and their contribution to foster the well-being of the aging population.
A major concern in the long-term care field is the financial burden it will place on the society and the state. The challenge will be to ensure that there are adequate resources and effective service system are available for twenty years (Knickman and Snell, 2002). There are different financial burdens associated with an aging population: increase in social security payments, increase in medical care insurance costs, challenges in uncovered medical expenses and long-term care expenses will grow (Knickman and Snell, 2002). Owing to this, it is important for the state to make appropriate policies, which will work towards relieving the elderly the financial burden. Therefore, it should opt for tax reductions for private insurance, provision of long-term care and mandatory savings at younger ages for private insurance.

On the other hand, there will be a demand of services to cater for the needs of the aging population. Similarly, these services along with prescription drugs will have the fastest growing expenses. Long-term care includes a wide range continuum of services, which will address the needs of disabled and require assistance with the daily basic activities (Knickman and Snell, 2002). The services may vary from the informal care delivered by families to the formal services offered in a nursing, homecare or assisted living. However, over the next 20 years, some of the services will change reflecting the alternating pattern of disease associated with an increase in the incidence of co-morbidities. By the year 2030, millions of individuals will have a chronic condition.

It is vital, therefore, to evaluate the different ways to design the care settings to handle the well-being of the aging population. Currently, the care facilities align to a medical approach, characterized by nursing stations, shared bathrooms and rooms. In such settings, the patients have few or no choices because the setting is central to treatment rather than the individual in care. However, this is likely to change in the next 20 years, where the individual receiving the care will have a choice. In order to improve care and safety the healthcare setting will comprise a unit layout, supportive aspects, reduced noise, and access to doors, improved sleep, better orientation and increased interaction (Joseph, 2006). In addition, for the communities to be successful in caring for the aging populations, they will have to make changes to the housing and human services.

Question 3

Ethical issues have always have been part of the healthcare field for some time now. In the recent past, there has been an examination of ethical issues in the long-term care setting. In the nursing homes, the practitioners have to deal with the patients, some who are Alzheimer patients. They do this by instituting ethical decision making because they have to stay in the facility for a long period. Unlike a hospital setting, in the long-term care facility, the practitioners deal with a variety of patients, who suffer from severe cases (Goldsmith, 1993).

For instance, many of the residents suffer a reduced mental capacity, therefore, decisions concerning autonomy and other issues must consider individual differences and not central to simple categorizations of the residents as having or not having adequate mental capacity (Goldsmith, 1993). The practitioners put much effort to offer as much involvement in care-related decisions; they often differ with the preferences of a patient. Patients are to comply with the treatment plan even in absence of a care practitioner. The plan may require the patient to adhere to restrictive diet because some foods may be harmful, but getting the patients to comply on the plan, making them refrain from foods they desire is difficult (Pratt, 1999).

Denial is another issue significant to long-term care. Patients show reluctance in accepting they are terminally ill, and this becomes an ethical issue because it relates to the manner in, which the practitioner will address, the impending death and the decision to accept long-term care (Pratt, 1999). Notably, there is a great difference in access to long-term care services from state to state, or urban to rural settings, and even within regions. To the degree that access to proper care, is a right, which qualifies it as an ethical issue. When a long-term care staff suspects that a patient is not safe in their homes, owing to neglect or abuse, this becomes an ethical issue.

The staff should look out for the welfare of the patient, but in such case they cannot make founded accusations; if their accusations have grounds, they have an ethical obligation to report the matter to the authorities (Pratt, 1999). The nursing homes have to cope with emphasizing ethical decision-making, and they…