Changing settings of care and the need for a new long term care workforce

Susan A. Chapman, PhD, RN, Center for the Health Professions, University of California, San Francisco, 3333 California Street, Suite 410, San Francisco, CA 94901, (415) 502-4419, Email and Charlene Harrington, PhD, Disability Statistics Center, Institute for Health & Aging, University of California, San Francisco, 3333 California Street, Room 340, San Francisco, CA 94118.

Long term care for the elderly is increasingly being provided in non-nursing home environments including assisted living and home and community based settings. Surveys find that the elderly prefer care in less restrictive settings. The recent Supreme Court decision in the Olmstead case mandates that states provide options for long term care in less restrictive settings. In our study of the demand for and supply of long term care services, we found nearly flat growth in nursing home facilities (1% from 1990 to 2002) and a 57% growth in assisted living facilities. There are currently nearly two million professional and non-professional workers in long term care settings and a projected need for more than a million new workers by the end of this decade. State recruitment and training funds have largely been directed to institutional settings. More resources should be directed for workforce development in assisted living and home and community based settings where more care will be delivered in the future.

Learning Objectives:

* Describe 3 major settings of long term care for the elderly.
* Describe the long term care workforce and their role in various settings of care.
* Define workforce shortages and identify policy options to address them.