Agenda - 09-06-1983 - Laserfiche WebLink

Browse Search

There is substantial evidence that many elderly persons have been unnecessarily placed in institutional care facilities* According to a 1977 Congressional Budget Office survey, some 10 to 20 percent of the individuals in killed nursing facilities and 20 to 45 percent of those in intermediate care facilities were receiving unnecessarily high levels of care. (7) 1 The effect of this unnecessary institutional placement on rates of institutional utilization are unclear. In many places there are waiting lists fOr these facilities so those placed there unnecessarily might have their places filled by others, with a resulting maintenance of the overall rate of institutionalization among the aging. However. most individual J1 prefer to remain in their own homes or to live with family or friends. There is evidence that unnecessary institutional placement reducels the capacity of an individual to remain independent. Persons institutionalized for longer than six months often have depleted their slayings and lost their residences, and many have experienced a deOine in their ability to meet their own basic needs or experienced mental deterioration because of lack of independence and self—determination. Because North Carolina placed a cap on the expansion of nursing home beds in 1981, it is possible that the state's current rate of inappropriate institutional placement is low. However, the growth in North Carolina'slolder population, particularly among those over 85 and living alone, will likely require some future expansion of both skilled nursing and intermediate care facilities. Any expansion should be regulated to insure that inappropriate placements do not occur. that the emphasis is en the most severely impaired, and that options for community based services are available. There has recently been increased utilization of home care services. AlthoUgh federal programs currently provide or pay for some home health services, there is wide—spread interest in expanding the availability and coverage of this care. This interest was evident in the 1981 White House Conference on Aging, in several congressional hearings on the Subject, and in congressional legislative proposals, and is partly the result of a perception that expanding these services could reduce the use and costs of institutional long—term care services. Additional community—based services are also seen as improving the health, sense of well—being, and independence of the chronically ill elderly by providing a continuum of services more appropriate to their care needs and more responsive to their wishes. Itit-neelLEMALOWINUIRLDE-GABg IbiAlmnod-f2c_EximadssUottiamt_Stritigirs Five major 4derel programs currently fund most of the delivery of in—home services—rModicarer Medicaid, Title XX of the Social Security Act, Title III of the Older Americans Act and the Veterans 5