Long term care for the elderly and disabled in the US should focus on community services

Spending on long term care for elderly and disabled US citizens should shift from providing mainly institutional care to expanding community based services, specialists argued at a forum in Washington DC this week.

H Stephen Kaye, associate adjunct professor in health and aging at the University of California in San Francisco, has reported that in the United States 10.9 million people living in the community and 1.8 million nursing home residents need long term care (Health Affairs 2010; 29: 11-21). He noted, however, that estimates for the number of disabled people needing long term care range from three million to 11 million, because of the lack of broadly accepted definitions of disability and fragmented services.

His analysis of five national surveys showed that half of disabled people living …