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The Long Term Care Crisis
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The Long Term Care Crisis
Elders Trapped in the No-Care Zone

  • Carroll L. Estes - School of Medicine, University of California, San Francisco, University of California, San Francisco, USA
  • James H. Swan - Wichita State University, USA

© 1999 | 351 pages | SAGE Publications, Inc
Recipient of Choice Magazine's 1994 Outstanding Academic Book Award What happens when efforts to contain spiraling costs collide with health and social services delivery in a competitive market? The unintended results can be alarming. Carroll L. Estes, James H. Swan, and Associates uncover the insidious relationship between recent transformations in hospital care financing and the manner in which older Americans now receive--or, more accurately, do not receive--health and social services in the community. The distinguished authors of The Long Term Care Crisis scrutinize the surprising and pervasive consequences of competition in the health care arena tempered by government attempts to correct an out-of-control system. The authors provide a rich and incisive analysis of the complex events and policies leading to the current crisis in long term care and suggest options to simultaneously revitalize the system and empower older Americans. For all who question the current state of the U.S. health care system, skyrocketing health care costs, and disappearing personal resources, The Long Term Care Crisis is a professional library must. Students, researchers, and professionals in the areas of aging sociology, social work, nursing, policy studies, health administration, communication, and policy will find The Long Term Care Crisis a revealing and exciting resource. "A forceful analysis of the inequities of the U.S. healthcare system, which particularly affect women and people of color." --Lou Glasse, President, Older Women's League "Beyond perceptive analysis of the problem of providing long term care, the authors present policy options that empower the elderly and provide equitable, compassionate care for Americans of all ages." --Maggie Kuhn, Founder and National Convener, Gray Panthers "Once again, Carroll Estes, our great medical sociologist, has given us a painful and invaluable portrait of old age in America in the no-care zone." --Robert N. Butler, M.D., Chairman, Department of Geriatrics, Mount Sinai Medical Center, New York "The absence of rational social policy on long term care is the greatest impediment to reform of the U.S. health care system. This volume documents the further deterioration of access to long term care, resulting from efforts to contain escalating costs of acute care, and points to the policy changes needed to meet national needs in the 21st Century." --Linda H. Aiken, Ph.D., Trustee Professor of Nursing, Professor of Sociology, Director, Center for Health Services and Policy Research University of Pennsylvania "A critically important emphasis in this volume is the goal of maintaining independence and empowerment of older persons. As the book carefully documents, we must recognize how the policy decisions of the past decade have eroded the social, community-based supports needed to maintain elders' independence, and move to correct these lacks." --T. Franklin Williams, M.D. Professor of Medicine Emeritus and of Community & Preventive Medicine University of Rochester Medical Center "This is an excellent, but dense work. . . . Its moral and social dimensions present a chilling scenario for the future. . . . An important book for a wide range of readers." --Choice "Carroll L. Estes is the premiere authority on the political economy of aging, and past writings have had a profound influence on the sociology and economics of aging. The Long Term Care Crisis is another in a long string of significant contributions to the macro understanding of social problems and aging. . . . [This book] is an excellent piece of scholarly literature. I would strongly recommend it for professors of gerontology and health care policy, students, academic and hospital libraries, C.E.O.'s who are responsible for hospitals, nursing homes, health care programs, adult day care programs, and senior center programs." --Clinical Gerontologist "The results of this ambitious study are presented in fifteen chapters divided into five sections and are a 'must-read' for anyone interested in planning community services for elderly people. The arguments also have more general applicability to other populations as well. . . . As a single text, this is an excellent resource." --Canadian Journal of Urban Research
 
Introduction
 
PART ONE: OVERVIEW
 
Prospective Payment Revolution and Long Term Care
 
Restructuring of the Nonprofit Sector
 
PART TWO: FROM HOSPITAL TO COMMUNITY
 
Discharge Planners as Gatekeepers to Community Care
 
Does Out of the Hospital Mean Out of Luck?
 
Service Paradox
 
PART THREE: HOME HEALTH AND NURSING HOME CARE
 
Metamorphosis of Home Health Care
 
Nursing Homes Under Prospective Payment
 
Access to Nursing Home and Home Health Services
 
PART FOUR: ELDER CARE AND THE COMMUNITY
 
Informalization and Community Care
 
Access in Peril
 
Community Variation in Policy Implementation
 
Waves of Change
 
PART FIVE: THE FUTURE
 
Policy Elites and Fiscal Crisis
 
Empowerment Imperative
 
No-Care Zone and Social Policy

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ISBN: 9780803939936
$68.00