Hundreds of thousands of older adults and younger people with disabilities are living in nursing homes only because that is where Medicaid drives them. They have no clinical need for skilled nursing care, and, if better options were available, many could be living in other settings, including their own homes. Medicaid—the joint state/federal health care program for the very poor—sends [...]
Likely Democratic presidential nominee Joe Biden has proposed a major new initiative to encourage state Medicaid programs to expand home and community-based care for low-income older adults and younger people with disabilities. While the proposal is ambitious, it addresses the long-term care needs of the Medicaid population in an especially complicated way. It still leaves huge gaps in Medicaid-based care [...]
The headlines are eye-opening: On Friday, the Kaiser Family Foundation reported that, as of as of April 23, there were more than 10,000 reported deaths from COVID-19 in long-term care facilities—in just the 23 states that publicly report this information. That may be shocking. But it should not be surprising. COVID-19 has exposed and amplified our profoundly flawed system of [...]
Nursing homes and other senior living facilities are not the only places where COVID-19 is creating a health care crisis for frail older adults and their care providers. The other setting at risk: private homes, where the vast majority of older adults get both personal and post-acute care. And the pandemic is creating enormous challenges for those seniors, their families, [...]
It is a terrifying time to be caring for an aging parent or other family member who needs assistance with physical or cognitive limitations. You are unable to visit your loved ones in care facilities. It is a struggle to find aides to care for them at home. You worry about them contracting the potentially deadly coronavirus. You worry about [...]
The coronavirus pandemic and the fast-moving federal response to it is upending long-standing rules and practices for caring for older adults. Some changes will be incredibly disruptive, while others may increase support for vulnerable seniors. Here are some of the ways they are affecting how we care for our parents. No more nursing home visits. Just a week ago, the [...]
No, PDGM is not a new disease. It is, instead, the way Medicare now pays for home health care. Shorthand for The Patient-Driven Groupings Model, PDGM is the Trump Administration’s latest effort to reduce Medicare costs. And it appears to be making it much harder for some patients living at home to receive occupational, physical, and speech therapy. PDGM is [...]
Family members and friends are the bedrock of our system of personal care for frail older adults and younger people with disabilities. Without their support, the nation’s hospitals and nursing homes would be filled to the rafters with very sick, frail seniors. And many of those older adults would die before their time. Those family caregivers often provide assistance with [...]
Democratic presidential hopeful Pete Buttigieg has proposed an ambitious plan to reform long-term care finance and delivery in the US. It includes a public catastrophic long-term care benefit, enhancements to the private long-term care insurance market, reform to Medicaid long-term services and supports (LTSS), and higher wages and benefits for direct care workers. Buttigieg, who says he learned about the [...]
The growing shortage of paid caregivers has become increasingly apparent over the past several months. Now, we are seeing evidence of the most direct consequence of that scarcity: The cost of care, especially for those living at home, is rising faster than it has in years. According to the newly released Genworth cost of care survey, the cost of homemaking [...]