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Long Term Care report from KPMG

by Louis on February 3, 2014

Thanks to my friend, colleague, sometime mentor Laurie Orlov of Aging in Place Technology Watch for pointing out this report from KPMG. An Uncertain Age: Re-imagining long term care in the 21st century speaks clearly to many issues on my mind. I copy a few highlights below.

From the Executive Summary:

Three findings stand out as being critical and relevant to every society, regardless of where they have progressed in their journey:

Firstly, the debate over finance threatens to obscure the scale and gravity of the overall challenge. Nevertheless, funding is a critical issue, as most governments are cash-strapped and the next generation may be unable or unwilling to foot the bill for care. Increasingly innovative new mixes of public and private finance are needed, along with new ways to allow older people to save more for retirement.

Secondly, care should be redesigned to break down organizational boundaries through greater integration. The medical model has to change in favor of a new philosophy and practical methods that pay more attention to people’s needs and aspirations, rather than to the treatment of disease.

And finally, given the societal impact of elderly care, the discussion should take center stage and involve government, private and non-governmental bodies and providers, as well as the wider public. Only through such wide scale involvement is it possible to address the critical issues of public policy, models of care, housing and personal preparation for old age.

From Section:2 Shaping tomorrow’s long term care systems

Many long term care recipients have complex and multiple chronic conditions, yet the various services they receive tend to be poorly coordinated and fragmented, with visits from numerous professionals and conflicting advice. Providers are often paid for the hours of nursing care they deliver, rather than on outcomes, with a strong bias towards acute treatment.

As with other areas of health and social care, there is a growing interest in integrating care by bringing together family doctors, geriatricians, community nurses, occupational therapists, physiotherapists, speech therapists, dieticians, pharmacists, social workers and mental health workers. Over time this approach should mature to offer seamless services, with common IT systems that allow data sharing, common care pathways and accountable managers with single budgets coordinating multidisciplinary teams, leading to greater efficiency and better outcomes.

Sidebar quotes from some of the experts interviewed to prepare the report:

“Integration is essential and this is currently a real problem. Plans are not coordinated, health and social care are not integrated and housing is not incorporated. There is a need for integrated budgets and services.”

Baroness Sally Greengross, Commissioner, Equality and Human Rights Commission, UK

“Multidisciplinary or interdisciplinary teamwork should form the backbone of the long term care system. Building the most effective interpersonal and inter-organizational long term care models among and between professionals, paraprofessionals, agencies and institutions should be a priority.”

Dr. Dennis Kodner, International Visiting Fellow The King’s Fund, Canada

“The whole ‘personal budgets’ approach can be difficult to communicate as it is hard to make people accept that care recipients will make sensible decisions about what is important to them.”

Carolyn Denne, Head of Service Quality Social Care Institute for Excellence, UK

This is a really good report. I encourage you to read the whole thing.

{ 2 comments… read them below or add one }

Shoshan Shacham February 3, 2014 at 11:24 pm

Dear Louis , Hi
Needless to say the KPMG document is truly a very j high quality report !
However , to my humble view , once again it demonstrates that it is almost “Misson Impossible” to address the sustainable challange
Of addresses the Needs & Wants of EACH individuale aged 70 +,who wish , to live in dignity, meaningful life ,at affordable cost, at home,within the community ,connected to freinds and multigenerational family.
This is what Homage for Life is all about!
All the Best
Shoshan Shacham


Dr. Gene Loeb February 4, 2014 at 1:46 am

This as a thorough, well-written report that is a call to action. Various points in the report allow individuals or organizations to use as a place to initiate action. It is useful for persons of different experience to work together and work hard. I look forward to other reports from persons carrying out or following through from these recommendations.


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