Innovations in Long-Term Care

Chronic illness poses a, if not the, principal challenge to the United States’ health care system. Chronic illnesses (also called “chronic conditions”) are long-lasting and often life-long, are typically not curable, place a potentially heavy burden on the life of the person with the illness and family members, and are characterized by a progressive onset with multiple and oftentimes misunderstood causes. Long-term care: is an array of informal and formal community-based and residential services offered to those with chronic conditions over time. Long-term care use is potentially nonlinear, dynamic, and subject to interactions between both the services received and the environment (both physical and social) in which such services are delivered. In addition to examining definitions of long-term care, this chapter briefly explores the historical context of long-term care in the United States and this history has influenced the current state of long-term care science, practice, and policy. Following this contextual overview, this chapter identifies several “innovations” that have emerged over the past several decades: this core of the chapter will examine innovative models and clinical practices that have aimed to transform and optimize long-term care.