Long-Term Care Cycle

Over a century the long-term care system has gone through five cycles of changes that are woven together. Professors David Smith and Zhanlian Feng describe the changes that have occurred and the challenges long-term care faces in hopes to educate policymakers to learn from the past and not remake the negative effects. Extended over approximately 20 years a piece, these five cycles start in 1910 to present day (Smith & Feng, 2010, p. 28). Access to quality of long-term care has become strained by economic division. From 1910-1930 the focus was on controlling the cost of care by using a form of indoor relief. Volunteer rescue facilities relieved many elderly inhabitants of the poorhouses and proposed a pension for the elderly. During the Great Depression the numbers needing indoor relief rose to a number that could not be provided for. The next cycle of change from 1930-1950 enacted the Old Age Security Age which provided for seniors that were not located in the poorhouses. Medical services, for chronic health concerns, were not available for these seniors. The need for medical services brought about the Medicare and Medicaid legislation, and Social Security
The influx of people needing long-term services, the quality, and the availability of those services will become very strained. Without an appropriate reform, there is the possibility of resorting back to economic separation of persons-low and middle income fighting for placement in facilities and the monetarily fit being able to afford community care. Economic struggles can cause staffing challenges and closure of long-term care facilities, lessening bed space for Medicaid receivers. Learning from the past cyclic events can lead to a better future for these next seniors entering care if policymakers can reduce the economic challenges to them, as well the struggles of