Quality of long term care (LTC) continues to be a major problem in the US, especially in nursing homes and in residential care. Literally dozens of studies by researchers, the US General Accounting Office, the US Inspector General and others have documented the persistent quality problems in a sizable subset of the nation’s nursing homes over the past 30 years. Although not studied as much, residential care and assisted living facilities have also had documented quality problems. Quality problems in the home are more difficult to observe but reports of poor reliability, lack of timeliness of care, poor attitudes, theft, neglect, and abuse by some providers are not uncommon.
LTC quality rests entirely in the hands of nurses, nursing assistants, home care workers, personal assistants, and other caregivers who deliver formal care and assistance. LTC is labor intensive and requires education, experience, and compassion. The processes of care include assistance with activities of daily living (such as bathing and dressing) and special nursing services such as wound care, nutrition and incontinence management, medication and behavioral management, chronic disease management, and other complex care processes.
