The LTC system is sometimes referred to as the , which means the full range of long-term care services that increase in the level of acuity and complexity from one end to the other—from informal and community-based services at one end of the continuum to the institutional system at the other end. Hence, the long-term care continuum has three major subsystems: • The informal system • The community-based system • The institutional system Reference Singh, D. A. (2016). (3rded.). Burlington, MA: Jones & Bartlett Learning
The long-term care (LTC) system is a complex and multifaceted network of services that caters to individuals with chronic illnesses, disabilities, or the aging population who require assistance with daily activities and medical care over an extended period of time. It is often referred to as a continuum, which implies that it encompasses a wide range of services that increase in level of acuity and complexity from one end to the other.
The LTC continuum is comprised of three major subsystems: the informal system, the community-based system, and the institutional system. These subsystems collaborate and interact with one another to provide a holistic and comprehensive approach to long-term care.
The first subsystem, the informal system, refers to the care provided by family members, friends, and other unpaid individuals within the individual’s social network. It is often the starting point for long-term care, as individuals may rely on their loved ones for assistance with activities of daily living (ADLs) such as bathing, dressing, eating, and mobility. Informal care can also encompass emotional support and companionship. However, the availability and sustainability of informal care can be limited by various factors such as distance, availability of caregivers, and caregiver burnout.
The second subsystem, the community-based system, comprises a variety of services and programs that are accessible to individuals in their own homes or within the community. These services are designed to support individuals in maintaining their independence and quality of life while receiving the necessary care and support. Examples of community-based services include home health care, home-delivered meals, adult day care centers, and transportation assistance. The community-based system often involves a multidisciplinary team of healthcare professionals, including nurses, social workers, therapists, and case managers, who work together to develop personalized care plans for each individual.
The third and final subsystem, the institutional system, refers to long-term care facilities that provide 24-hour supervision and medical care for individuals who require a higher level of support and assistance. This includes nursing homes, assisted living facilities, and specialized care units for individuals with specific conditions such as dementia. These institutional settings are equipped with trained staff, medical equipment, and resources to address the complex needs of residents. Institutional care is typically recommended when individuals have significant physical or cognitive impairments that cannot be adequately managed in a community-based setting.
It is important to note that the LTC continuum is not a linear progression from one subsystem to the next. Instead, individuals may access services from different subsystems simultaneously or transition between subsystems based on their changing needs and preferences. For example, an individual may receive informal care from family members and also utilize community-based services to supplement their care. As their condition progresses, they may eventually require institutional care for more intensive support.
In conclusion, the LTC continuum encompasses a range of services that provide long-term care for individuals with chronic illnesses, disabilities, or the aging population. The informal, community-based, and institutional systems work together to ensure that individuals receive the appropriate level of care and support based on their needs and preferences. By understanding the different subsystems within the LTC continuum, healthcare professionals and policymakers can develop strategies to improve the delivery and accessibility of long-term care services.