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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

Improving Dementia Long-Term Care: A Policy Blueprint

Jun 23, 2014

As millions of Americans struggle to help loved ones with dementia, policymakers should consider more ways to improve long-term services and supports for the soaring number of people with the debilitating condition and their caregivers.
Report

Improving Support for Military and Veteran Caregivers: A Research Blueprint

Jun 14, 2017

Millions of Americans provide informal care and support to current and former U.S. service members. A new research blueprint could help inform efforts to improve support for these “hidden heroes.”

Explore Long-Term Care

Journal Article

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

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

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
Journal Article

Journal Article

Expanding Home-Based Primary Care to American Indian Reservations and Other Rural Communities: An Observational Study

Expanding home- based primary care to American Indian Reservations and other rural communities increased access to long term care and enrollment for health care benefits; outcomes were similar for Indian Health Service and non-Indian Health Service populations.

Apr 20, 2018
Journal Article

Journal Article

Changing Structures and Processes to Support Family Caregivers of Seriously Ill Patients

Fundamental changes are needed in the way we identify, assess, and support family caregivers of seriously ill relatives.

Dec 15, 2017
News Release

News Release

Average American's Risk of Needing Nursing Home Care Is Higher Than Previously Estimated

The average American's lifetime risk of using a nursing home is substantially greater than previous research has suggested. Among persons age 57 to 61, 56 percent will stay in a nursing home at least one night during their lifetime.

Aug 28, 2017
Testimony

Dementia Long-Term Care Policy Options for Family Caregivers and Medicare

The total cost of caring for people in the United States with dementia in 2010 was estimated to be between $159 billion and $215 billion. As the nation's population ages, these costs will soar. Lawmakers could consider policy changes that support family caregivers and expand Medicaid eligibility.

Jul 13, 2016
Journal Article

Journal Article

Cost-effectiveness of Nutrition Intervention in Long-Term Care

This study aims to determine the cost-effectiveness of two nutrition interventions on food, beverage, and supplement intake and body weight.

Nov 11, 2015
Journal Article

Informal Caregiving for Dementia in the U.S.

Family members play a critical role in caring for older adults with and without dementia. In 2010, 5.5 million U.S. adults age 70 and older received informal care, including 3.6 million with cognitive impairment or dementia.

Oct 20, 2015
Commentary

Demographics Add Urgency for Action on Dementia Long-Term Care

Dementia takes a huge toll on those afflicted with it but also has major consequences for those who must care for them. More than 15 million Americans provide care for loved ones with dementia—tending to their daily, routine needs and ensuring their medical needs are met.

Jul 28, 2014
Report

Hidden Heroes: America's Military Caregivers

There are 5.5 million military caregivers across the United States, with nearly 20 percent caring for someone who served since the terrorist attacks of Sept. 11, 2001. Military caregivers experience more health problems, face greater strains in family relationships, and have more workplace issues than noncaregivers. Changes are needed to both provide assistance to caregivers and to help them make plans for the future.

Mar 31, 2014
Journal Article

Journal Article

Transforming Nurse Home Culture: Evidence for Practice and Policy

The nursing home culture change movement aims to improve resident quality of life and quality of care by emphasizing the deinstitutionalization of nursing home culture and focusing on person-centered care.

Feb 1, 2014
Journal Article

Journal Article

What Does the Evidence Really Say About Culture Change in Nursing Homes?

Nursing home culture change remains an evolving field. Although culture change has clear face validity, the current evidence does not give providers sufficient information for selecting interventions based on the expectation of improving outcomes.

Feb 1, 2014
Journal Article

Cost of Informal Caregiving for U.S. Elderly Is $522 Billion Annually

The price tag for informal caregiving of elderly people by friends and relatives in the U.S. comes to $522 billion a year. Replacing that care with unskilled paid care at minimum wage would cost $221 billion, while replacing it with skilled nursing care would cost $642 billion.

Jan 1, 2014
Journal Article

Cost of Dementia Tops $159 Billion Annually in the United States

The monetary cost of dementia in the United States ranges from $159 billion to $215 billion annually, making the disease more costly to the nation than either heart disease or cancer. The greatest cost is associated with providing institutional and home-based long-term care rather than medical services.

Apr 1, 2013
Journal Article

Refining Assessments of Elderly Patients

Significant changes to the Minimum Data Set (MDS), a standardized assessment of nursing home residents, aim to improve the tool's clinical utility.

Sep 1, 2012
Journal Article

Journal Article

Increasing Influenza Immunization for Long-Term Care Facility Staff Using Quality Improvement

Based on the insights learned about effective changes, the project developed a change package for use by other long-term care facilities.

Dec 31, 2006

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