These imbalances need correction. Personal care is the bedrock of long-term care services. It needs to be available around the clock every day of the week. The biggest deficit in long-term care in America is the lack of a dependable capability for personal care services across the country. The good LTC system has options.
Consumer choice is an empty slogan if there is no menu to choose from.
These options should include a wide range of ways to get services in one's own home and a wide range of residential settings where services can be efficiently received. Consumer direction is important regardless of where the consumer lives and whether the consumer is receiving care from an agency or an independently employed worker. Some form of care coordination seems to be a necessary component of a LTC system. This care coordination is meant to serve the individual consumer's interests and respond to the system's interest, which include increasing the supply of high-quality services, keeping price as low as is consistent with good care, and allocating the services fairly. People who need LTC also need acute care often and in substantial amounts.