Elderly care

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Elderly care or elder care is a broad term encompassing such services as assisted living, adult day care, long term care, nursing homes, hospice care, and Alzheimer's care.

The form of elder care provided varies greatly between and within countries, and is changing rapidly. Traditionally the responsibility of families and provided within the extended family home, in modern societies elder care is frequently and increasingly provided by state or charitable institutions. The reasons for this change include decreasing family size (particularly the sharp decreased at the demographic transition), the greater life expectancy of elderly people, the geographical dispersion of families, and the tendency for women to be educated and work outside the home. Although this change affected European and North American countries first, it is now increasingly affecting Asian countries also.

In most western countries, the majority of elderly care facilities are freestanding, but they may also be part of a continuing-care retirement community, seniors apartment complex, or wing or floor of a nursing home. Ownership and operations vary, too. In the United States, most of the largest multi-facility providers are publicly held and managed as for-profit businesses. There are exceptions; the largest operator in the US is the Evangelical Lutheran Good Samaritan Society, a not-for-profit organization that manages 6,531 beds in 22 states, according to a 1995 study by the American Health Care Association.

A distinction is generally made between medical and social care, and the latter is much less likely to be covered by insurance or public funds. In the US, 86% of the one million or so residents in assisted living facilities pay for care out of their own funds. The rest get help from family and friends and from state agencies. Medicare does not pay unless skilled-nursing care is needed and given in certified skilled nursing facilities. Assisted living facilities usually do not meet Medicare's requirements. However, Medicare does pay for some skilled care if your relative meets the requirements for the Medicare home health benefit. Thirty-two states pay for care in assisted living facilities through their Medicaid wavier programs. Similarly, in the United Kingdom the National Health Service provides medical care for the elderly, as for all, free at the point of use, but social care is only paid for by public authorities when a person has exhausted their private resources.

Elderly care emphasizes the social and personal requirements of senior citizens who need some assistance with daily activities and health care, but who desire and deserve to age with dignity. It is an important distinction, in that the design of housing, services, activities, employee training and such should be truly customer-centered.

However, Elderly Care is focused on satisfying the expectations of two tiers of customers: the resident customer and the purchasing customer, who are often not identical, since relatives or public authorities rather than the resident may be meeting the cost of care. Where residents are confused or have communication difficulties, it may be very difficult for relatives or other concerned parties to be sure of the standard of care being given, and the possibility of elder abuse is a continuing source of concern.