Social Security Act (1935)
With a dramatic increase in life expectancy and decreases in mortality rates, many old
People live their later lives with chronic illnesses and disabilities. As a result, long-term care is becoming an important part of service to the elderly population. The US General Accounting
Office (1994) reports that more than 12 million Americans need long-term care and 55% of them
are people aged 65 or older (Binstock, Cluff, & Mering, 1996). ...view middle of the document...
In 1994, more than $100 billion was spent on long-term care in the US in 1994, 72% of which went to nursing home care (Binstock, Cluff, & Mering, 1996). It was not until recently, however, that long-term care of the elderly received attention from the government and the health care sector. Throughout most of American history, the long term care of the elderly has been considered
a responsibility of family households, especially a daughter of the person, rather than the society and its health system (Holstein & Cole, 1996). Now, public attention has increased due to the growing elderly population and their political influence, the economic and psychological burden of the family and caregiver is still substantial. According to 1994 statistics, it is estimated that individuals and their families pay out of pocket costs equaling 44% of the total amount of long-term care expenses. Private insurance pays 1% and federal, state, local government pay the balance (Binstock, Cluff, & Mering, 1996). Consequently, many elderly who cannot afford care and are also not eligible for public assistance are neglected and suffering chronic illnesses. In this paper, I will examine the history of the development of long-term care services, its current status, its strengths and weaknesses, and the emerging issues in the field.