Improving Quality of Long-Term Care: It is Time for Collaboration

Abstract

NC Med J March/April 2010, Volume 71, Number 2 Long-term care is a critical and necessary part of the health care continuum. Whether in a facility, in the community, or at home, how our society designs and delivers quality, accessible, and affordable long-term care for our oldest and sickest citizens is a huge challenge for families and policymakers. Many of us have experienced the task of determining the right level of care for our loved ones and then searching for high quality, affordable options to meet those needs. Historically, there has been conflict over what quality means and how to achieve it. And let’s face it, many of us have heard about or experienced a quality issue in residential and home care situations. In some cases the complaints are overblown or not factual. But clearly, in other cases, the abuse or negligence is proven, and the public confidence in our long-term care system is shaken. Over the years, a strong influential corps of state agency and non-governmental advocates has developed in North Carolina and they are working on behalf of family members and the general public to improve the quality of care in our communities. At the same time, the facilities and community care industries have strengthened their own cadre of advocates to address quality issues. Both sides have worked hard to impact policies, legislation, and public perception by encouraging legislation; providing input in the rule-making process; serving on task forces, commissions, and work groups; and mounting public awareness campaigns. Advocacy manifests itself differently across a variety of groups. Organizations like AARP, the Senior Tarheel Legislature, the Governor’s Advisory on Aging, the North Carolina Coalition on Aging, and Friends of Residents in LongTerm Care represent individuals, families, and the broad community by pushing for stronger consumer protections, more transparency, safer living and care environments, standards and requirements for training of care workers, and more funding from federal, state, and local entities. Staff and volunteers with these organizations frequently work together to craft priorities and campaigns designed to impact legislation and regulations and to educate the public with a wide range of informative booklets and guides. On the provider side, organizations like the North Carolina Health Care Facilities Association, the North