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Long-Term Care

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More than 12 million Americans depend on long-term care for help with everyday activities such as bathing or dressing. This group includes veterans and people with disabilities, but it is primarily comprised of seniors. Thus, the number will likely soar as the baby boom generation ages. RAND research on long-term care can help health providers and policymakers meet the growing demand for high-quality, affordable care.

Report

Family Caregivers Should Be Integrated into the Health Care Team

Jan 5, 2021

The pandemic has produced changes in health care practices, such as shorter hospital stays and more frequent management of chronic illnesses at home. This has shifted the responsibility for many medical tasks to family caregivers. Caregivers have become frontline workers and should be treated as members of the health care team.
Report

Long-Term Care Policy: Who Should Be at the Table?

Feb 2, 2021

The COVID-19 pandemic has underscored that long-term care residents, their families, and staff have limited representation when it comes to facility policies. Recognizing them as stakeholders with perspectives to include in decisionmaking could improve infection control practices and also address residents' health-related quality of life.

Explore Long-Term Care

Journal Article

Perceived Impacts of a Medicaid Rebalancing Initiative to Increase Home- and Community-Based Services

Stakeholders reported that BIP participation had a range of impacts on the HCBS ecosystem, often beyond the structural reforms. Our findings highlight BIP impacts to monitor over the long term and to consider in evaluations of future rebalancing efforts.

Jul 16, 2021
Blog

RAND Art + Data, 'Gray Market Care,' Supply Chains and Cyberattacks: RAND Weekly Recap

This weekly recap focuses on RAND's new artist residency program, Art + Data; the prevalence of “gray market care” in the United States; supply chains' cyber problem; and more.

Jun 25, 2021
News Release

Nearly a Third of Americans Use Gray Market When Hiring Caregivers for the Elderly and Those with Dementia

Nearly a third of Americans who arranged for paid care for an older person or someone with dementia employed workers who were not hired through a regulated agency.

Jun 21, 2021
Commentary

The Informal Carers Who Help People with MS Need Support More Than Ever

The trend within health care services toward remote care and self-management for people with multiple sclerosis has not included adequate support to carers. Greater investment to support the needs of carers could support the informal care they provide, as well as the carer as an individual.

May 28, 2021
Commentary

Rescue Plan Help for Family Caregivers Is a First Step

Unpaid caregivers have been a critical part of the functioning U.S. economy, serving as the backbone of the health system, since long before the pandemic started. Adding them to the American Rescue Plan was an important step, but even after the pandemic is over, their financial security will need long-term protection.

Apr 5, 2021
Essay

Giving Family Caregivers a Voice

One in every five American adults is caring for a loved one in need. Too often, they have to fight to make their voices heard in a health care system that doesn't always see them as the partners in care they can be. More could be done to integrate them into patients' health care teams.

Mar 10, 2021
Report

Home Care Workers Are Essential Yet Undervalued

Home health and personal care aides are socially isolated and at heightened risk during the COVID-19 pandemic. Journaling is a promising way to give them a voice and reduce stress and anxiety. But policy-level changes are needed to address the issues of low wages and minimal benefits.

Feb 3, 2021
Journal Article

Do Income Supplemental Programs for Older Adults' Help Reduce Primary Caregiver Burden? Evidence from Mexico

This article analyzes the effects of a supplemental income program for older adults on primary caregiver burden, in Yucatan, Mexico.

Dec 15, 2020
Journal Article

Comparative Effectiveness of Long-Term Acute Care Hospital Versus Skilled Nursing Facility Transfer

We conducted a retrospective cohort study of patients hospitalized on a medicine service in a high-LTACH use region and discharged to either an LTACH or SNF and followed for one year.

Nov 17, 2020
News Release

Efforts Needed to Expand Ability of Family Members to Integrate into Formal Health Care Teams

Integrating family caregivers into a patient's health care team can help improve care quality and the quality of life for both patients and their families, yet family caregivers face significant barriers coordinating their efforts with the formal health care team.

Nov 10, 2020
Report

Family Caregivers Should Be Included in Health Care Teams

About 53 million family and friends provide care and assistance to loved ones in the United States, but they are often overlooked by health care systems. Integrating them into a patient's health care team can help improve care quality and the quality of life for patients and their families.

Nov 10, 2020
Journal Article

Factors Explaining State Differences in Applying for a Recent Long-Term Care Program That Promotes Aging in Place: Perspectives of Medicaid Administrators

This article examines the reasons underlying states' decisions regarding their applications to the Balancing Incentive Program.

Aug 4, 2020
Blog

COVID-19's Effects on Mental Health, Food Access, and Education: RAND Weekly Recap

This weekly recap focuses on COVID-19 and mental health, food security challenges during the pandemic, supporting children while schools are closed, and more.

Apr 3, 2020
Commentary

Should You Consider Taking a Loved One Out of a Long-Term Care Facility?

As modern living is changing during this pandemic, so is assisted living. Already, many of us are facing difficult decisions about whether someone we know should stay in an assisted living facility or be taken out due to the coronavirus crisis. If you're in the position to bring someone to hunker down with you, is it even a good idea?

Mar 30, 2020
Journal Article

Engagement of Providers and Advocates in a Rebalancing Initiative to Increase HCBS Access for Medicaid Beneficiaries

Rebalancing long-term services and supports toward increased home- and community-based services will engage and affect multiple stakeholder groups, including governmental and nongovernmental stakeholders. This study describes stakeholder engagement in a LTSS rebalancing initiative.

Jan 29, 2020
Commentary

Recognizing Family Caregivers as Part of the Health Care Team

Recent shifts in health care practices have left family caregivers increasingly responsible for medical tasks. Given family caregivers' central role in medical care, there are efforts underway to improve family caregiver integration into the health care team, but there are barriers to effective integration and engagement.

Nov 18, 2019
Dissertation

Understanding Home and Community-Based Long-Term Services and Supports: An Evaluation of Medicaid's Balancing Incentive Program

Explores home and community-based services as a way to curb long-term services and supports spending growth through an evaluation of Medicaid's most recent rebalancing effort -- the Balancing Incentive Program.

Sep 24, 2019
Brochure

Struggling with Dementia

The costs of dementia -- economic and personal -- are staggering. A recent RAND analysis quantifies the scope of the problem in the United States and serves as a wake-up call to policymakers everywhere.

Sep 9, 2019

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