Though this work has briefly touched on the issue of collaborative care, regarding caregivers and family, these structures also need to be expanded to a picture that more broadly develops the idea of holistic care. In general this issue has been dealt with in the literature in the case of specialization, such as follow up care and collaboration between institutions and caregivers from hospital and surgical settings. Yet, the continuity of care issue needs to be addressed in a more formal way. The discussion of the desire of previous care providers, such as hospital staff and physicians having follow up information as well as to influence future care needs to be addressed in the future long-term care setting. The days of LTC being an oasis of its own should end as more and more previous care givers seek to have at least a minimal understanding of the future well being of patients they have treated and families as well as patients tend to seek the same connectivity. Some caregivers are in fact so concerned about this disconnect that they present the idea of creating better outcomes if intermediate care offerings were provided in hospital, rather than in separate LTC facilities. (Raj, Munir, Ball, & Carr, 2007) This call for research on this subject likely has as much to do with the overall disconnect that exists between previous care providers and LTC rehabilitative service provisions as it has to do with the medical community, as well as the public having serious and enduring questions about the quality of care offered in such facilities, i.e. real and fear poor patient outcomes. (Kane, 2001) (Torres et al., 2006)
Reinardy & Kane contend that decisions made about future care are often associated with many factors and autonomy is one of the most important to most. Many often stress the choice of an unregulated assisted living facility, even if they could benefit from more skilled care because they perceive that their privacy as well as their autonomy will be better protected in such as situation. The system of future long-term care must address this issue with regard to autonomy and privacy likely by building on more private room structures and better individualization options for individuals. The days of the stark white institutional flooring and a single hospital bed, arm chair setting may very well be over and for good reasons. Long-term care centers of the future need to integrate the ideation, physical, social and emotional aspects of each cohort, i.e. those who are primarily concerned with rehabilitative care and those who are primarily concerned with privacy and autonomy, to create an environment that would meet the needs of both cohorts, possibly improving physical/medical offerings in assisted living and improving issues of privacy and autonomy in nursing homes. (2003)
Finally, and last but certainly not least LTC facilities of the