Texas State Health Plan: 1985, Appendix A Page: 1
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CHAPTER 6
SUBCHAPTER III: LONG TERM INSTITUTIONAL CARE AND ALTERNATIVES
Summary of Analysis Results
Modern technology has tended to produce increased life expenctancy at birth and
thus a high proportion of older persons in our population. Unfortunately,
improved life expectancy has not ensured freedom from disease, impairment and
disability, a part of the aging process. The knowledge of how to prolong life
regretably has not brought with it the know-how to ensure personal independence
for older persons.
Data has shown that the number of elderly and frail elderly (75 years and
older), the primary users of long term care are increasing more rapidly than
that of the population as a whole. As the elderly grow older, the progression
of chronic disease and the aging process itself cause a decrease in abilities in
the daily activities of living. Throughout this process, services and living
arrangements should be available to the elderly to assist in maintaining optimal
functions ability, in adjustment to chronic conditions and in maintaining per-
sonal dignity. The more appropriately the living environment supports the capa-
bilities and needs of older individuals, the longer they will be able to
maintain autonomous lives, and the higher quality these lives will be.
As elderly individuals lose the ability to care for themselves, the need for
assistance from others increases. However, social changes such as more wonen in
the work force, families with fewer children and family morbidity are reducing
the amount of informal support care provided by the family. An increasing
demand for formal support provided by paid employees of social services and
health care organizations has developed and is expected to continue to increase.
Therefore, a continuum of services which meet the needs of the elderly and
disabled should be available. Services should provide these individuals with
the needed care while allowing them as much freedom as possible to reduce the
likelihood of premature placement in an institution.
For many years the major concern within long term care was the provision of
medically oriented institutional services. In recent years the shift has been
toward the development of a broad range of services which met varying degrees
and types of needs of individuals and to reduce the premature admission of indi-
viduals into institutions. While the family continues to be the primary source
of care for the elderly and disabled, various publicly funded services are being
developed to provide for the social, personal and medical needs of the semi-
dependent elderly and disabled. Such programs allow these individuals to avoid
early placement in institutions and to remain within a less restrictive home and
community setting.
In recent years, efforts to reduce the high cost of institutionalization have
resulted in (1) the discontinuation of Intermediate Care Level II (custcdial)
care from the Medicaid program and (2) the development of several alternatives
designed to assist the elderly and disabled to remain in their homes and com-
munity. The range of long term sevices includes in-home services, community-1
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Texas. Statewide Health Coordinating Council. Texas State Health Plan: 1985, Appendix A, report, 1985; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1586722/m1/57/: accessed July 16, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.