A new long-term care manifesto.

Area of Science:

• Gerontology
• Healthcare Policy
• Public Health

Background:

• Current long-term care (LTC) models for older persons are often costly and undesirable.
• Policy debates focus on cost, neglecting the need for societal support and re-branding of LTC.
• Existing LTC often fails to integrate personal care, housing, and healthcare effectively.

Purpose of the Study:

• To propose a re-imagined framework for long-term care (LTC) delivery for older adults.
• To advocate for re-inventing and re-branding LTC to build societal support.
• To outline components and delivery models for improved LTC.

Main Methods:

• Conceptual analysis of existing LTC components and delivery models.
• Proposal of a tripartite framework: personal care, housing, and healthcare.
• Discussion of policy and payment incentive adjustments for improved LTC.

Main Results:

• LTC integrates personal care (competent, compassionate), housing (amenities, autonomy), and healthcare (proactive chronic disease management).
• Innovative LTC requires flexible, integrated approaches, potentially including clustered housing.
• Payment incentives and regulations should prioritize quality of care, quality of life, and slowing decline.

Conclusions:

• A tripartite LTC framework can foster innovative, flexible, desirable, and affordable care models for frail older persons.
• Re-branding and re-inventing LTC is essential for societal acceptance and value.
• Policy changes, including payment parity and regulatory adjustments, are needed to support improved LTC.