This article presents information about group settings that provide residential long-term care for older adults, focusing on nursing homes and residential care/assisted living communities. It provides an overview of both settings and describes their scope of services, funding, and clientele. The section “Issues in Residential Long-Term Care” addresses issues of special relevance to social workers: dementia and other psychosocial care needs; quality of life and quality of care; access to and disparities in care; end-of-life care; family involvement; and abuse and neglect. The article ends with a section on the role of the social worker in residential long-term care.
Rosalie A. Kane and Mingyang Zheng
Jun Li and Edward C. Norton
Pay-for-performance programs have become a prominent supply-side intervention to improve quality and decrease spending in health care, touching upon long-term care, acute care, and outpatient care. Pay-for-performance directly targets long-term care, with programs in nursing homes and home health. Indirectly, pay-for-performance programs targeting acute care settings affect clinical practice for long-term care providers through incentives for collaboration across settings. As a whole, pay-for-performance programs entail the identification of problems it seeks to solve, measurement of the dimensions it seeks to incentivize, methods to combine and translate performance to incentives, and application of the incentives to reward performance. For the long-term care population, pay-for-performance programs must also heed the unique challenges specific to the sector, such as patients with complex health needs and distinct health trajectories, and be structured to recognize the challenges of incentivizing performance improvement when there are multiple providers and payers involved in the care delivery. Although empirical results indicate modest effectiveness of pay-for-performance in long-term care on improving targeted measures, some research has provided more clarity on the role of pay-for-performance design on the output of the programs, highlighting room for future research. Further, because health care is interconnected, the indirect effects of pay-for-performance programs on long-term care is an underexplored topic. As the scope of pay-for-performance in long-term care expands, both within the United States and internationally, pay-for-performance offers ample opportunities for future research.
The term survivor has been applied to people who have endured diverse traumatic or life-threatening experiences ranging from sexual abuse to airplane crashes and wars. In the past 25 years, the term has also been applied to those diagnosed with cancer, an illness that once claimed the lives of most who were diagnosed with it, but which many now survive because of treatment advances. This entry addresses the social-work profession’s involvement with cancer survivorship as one example of survivorship. Social workers encounter cancer survivors in every practice arena, including hospitals and palliative-care programs as well as schools, correctional facilities, and mental-health clinics. They conduct research and provide education about the psychosocial impact of cancer and also provide counseling and advocacy. With their focus on strengths and resilience and their range of skills and knowledge about the biopsychosocial impact of life-threatening and traumatic experiences, social workers are uniquely positioned to assist survivors in adjustment to survivorship and in restoring well-being through micro, mezzo, and macro systems interventions.