When his mother-in-law died suddenly and his seriously ill father-in-law was left with no one to care for him, the author and his wife were thrust into the complex and overwhelming world of long-term care. Just months later his own father fell sick, and the couple struggled to help care for him too—from 1000 miles away. Over the next year-and-a-half, this ordinary family faced one crisis after another, as each day brought new struggle and pain, but also surprising rewards. They were among the 44 million Americans who are caring for elderly parents or relatives or friends with disabilities. Someone you love will almost certainly need long-term care services before they die. Nearly 70 percent of our parents will receive such help sometime during their old age—usually at home, though often in a nursing home. It will last for an average of three years, though one in five will need this assistance for five years or more. This book tells the sometimes painful, sometimes uplifting, and always compelling stories of the families who struggle every day with the care needs of their loved ones. The costs are crushing: and the weight of 77 million aging Baby Boomers will devastate our nation's already fragile system for funding this critical day-to-day assistance. How can we repair the tattered safety net that is so essential to our aged and disabled?

"Population aging is challenging countries around the globe to adapt their public policy responses to the new world. Long-term care is a relevant topic today both because of the rapid growth in long-term care needs in every country and the lack of responses from governments. The Future of Long-term Care explores some issues related to the implementation of long-term care responses in different countries. Looking at six different cases, the book highlights the need to foster an urgent debate in the area, as well as emphasizing the need for action in the coming years. The examples analyzed show common problems faced by countries trying to respond to their people's needs, as well as the dissimilar stages, contexts, and paths followed by each one in the endeavour for providing long-term care services to the population. Whether the analysis is carried out in countries with well-established long-term care systems or in places where the debate is just starting, the book proves that this is an area in which many challenges remain. Learning lessons from others is important but providing a space for countries to frame their problems and propose their solutions is crucial. This book contributes to fill this gap and contribute to a debate that is just starting in many places around the world"--

A NATIONAL BESTSELLER SHORTLISTED FOR THE BALSILLIE PRIZE FOR PUBLIC POLICY It took the coronavirus pandemic to open our eyes to the deplorable state of so many of the nation's long-term care homes: the inhumane conditions, overworked and underpaid staff, and lack of oversight. In this timely new book, esteemed health reporter André Picard reveals the full extent of the crisis in eldercare, and offers an urgently needed prescription to fix a broken system. When COVID-19 spread through seniors' residences across Canada, the impact was horrific. Along with widespread illness and a devastating death toll, the situation exposed a decades-old crisis: the shocking systemic neglect towards our elders. Called in to provide emergency care in some of the hardest-hit facilities in Ontario and Quebec, the military issued damning reports of what they encountered. And yet, the failings that were exposed--unappetizing meals, infrequent baths, overmedication, physical abuse and inadequate personal care--have persisted for years in these institutions. In Neglected No More, André Picard takes a hard look at how we came to embrace mass institutionalization, and lays out what can and must be done to improve the state of care for our elders, a highly vulnerable population with complex needs and little ability to advocate for themselves. Picard shows that the entire eldercare system--fragmented, underfunded and unsupported--is long overdue for a fundamental rethink. We need to find ways to ensure seniors can age gracefully in the community for longer, with supportive home care and respite for family caregivers, and ensure that long-term care homes are not warehouses of isolation and neglect. Our elders deserve nothing less.

How can we plan, organize, distribute, and offer care in ways that treat both those who need it and those who provide it with dignity and respect? Using the example of residential services, Troubling Care: Critical Perspectives on Research and Practices investigates the fractures in our care systems and challenges how caring work is understood in social policy, in academic theory, and among health care providers. In this era defined by government cutbacks and a narrowing sense of collective responsibility, long-term residential care for the elderly and disabled is being undervalued and undermined. A result of a seven-year interdisciplinary research project-in-progress, this book draws together the work of fourteen leading health researchers, including sociologists, medical practitioners, social workers, policy researchers, cultural theorists, and historians. Using a feminist political economy lens, these scholars explore and challenge the theories, work organization, practices, and state-society relations that have come to shape long-term care. Troubling Care offers critical perspectives on the often disquieting arena of care provision and proposes alternatives for thinking about and meeting the needs of some of our most vulnerable citizens in ways that go beyond residential care. This book seeks to bridge not only the gaps between disciplines, but also those between theory and practice. Features: takes an interdisciplinary approach, making this work appropriate for courses in a variety of disciplines including sociology, medicine, social work, health policy, cultural studies, and political economy includes the work of fourteen leading health researchers, including sociologists, medical practitioners, social workers, policy researchers, cultural theorists, and historians bridges the gap between theory and practice by incorporating both theoretical research and specific case examples

Sexuality in residents of long-term care facilities is a topic rarely addressed except in cases of inappropriate behavior. After distinguishing between sexuality and intimacy, Doll (Center on Aging, Kansas State U.) examines societal, older adult, and staff attitudes toward sexual expression in seniors; the effects of aging on sexuality; family influences; spaces and policies for balancing public and private spaces; and the needs of lesbian, gay, bisexual, and transgendered residents. The text includes case studies, assessment forms, exercises, discussion questions, and annotated further references.

The number of elderly and disabled adults who require assistance with day-to-day activities is expected to double over the next twenty-five years. As a result, direct care workers such as home care aides and certified nursing assistants (CNAs) will become essential to many more families. Yet these workers tend to be low-paid, poorly trained, and receive little respect. Is such a workforce capable of addressing the needs of our aging population? In Who Will Care for Us? economist Paul Osterman assesses the challenges facing the long-term care industry. He presents an innovative policy agenda that reconceives direct care workers’ work roles and would improve both the quality of their jobs and the quality of elder care. Using national surveys, administrative data, and nearly 120 original interviews with workers, employers, advocates, and policymakers, Osterman finds that direct care workers are marginalized and often invisible in the health care system. While doctors and families alike agree that good home care aides and CNAs are crucial to the well-being of their patients, the workers report poverty-level wages, erratic schedules, exclusion from care teams, and frequent incidences of physical injury on the job. Direct care workers are also highly constrained by policies that specify what they are allowed to do on the job, and in some states are even prevented from simple tasks such as administering eye drops. Osterman concludes that broadening the scope of care workers’ duties will simultaneously boost the quality of care for patients and lead to better jobs and higher wages. He proposes integrating home care aides and CNAs into larger medical teams and training them as “health coaches” who educate patients on concerns such as managing chronic conditions and transitioning out of hospitals. Osterman shows that restructuring direct care workers’ jobs, and providing the appropriate training, could lower health spending in the long term by reducing unnecessary emergency room and hospital visits, limiting the use of nursing homes, and lowering the rate of turnover among care workers. As the Baby Boom generation ages, Who Will Care for Us? demonstrates the importance of restructuring the long-term care industry and establishing a new relationship between direct care workers, patients, and the medical system.