Changing needs of patients and families in long-term care facilities: implications for social work practice

The purpose of this paper is to describe the changing needs of patients in long-term care facilities and their families. The argument will be made that the characteristics of residents have changed significantly with implementation of prospective payment for hospital care of Medicare patients. In addition to the traditional nursing home resident, staff will be expected to respond to the needs of patients who are both more acutely ill and responsive to aggressive rehabilitative efforts as well as to patients who are more critically ill and near death. The implications of these changes for the social work staff of long-term care facilities will be discussed.