I chose the webinar on the cost- effectiveness of home and community based services. This webinar is from 2011, and was an hour and a half long. There were 4 different speakers, and they eached talked about different aspects of how home and community based services are cost effective. Though it is a bit old, I feel like the struggles of long term care will always be relevant because times are always changing, and new ways of caring for the older generation come and go. This subject isn’t exactly relative to me in my professional career, or personally right now, but I thought it would be interesting to learn more about home and community based services as opposed to nursing homes. When I think about living in a nursing home I always think about a hospital like building, or even a place where people get abused, or not treated to the standard that they should be treated, so I feel like community based living, and living from home could be an ideal option for some people.

     The webinar argues that community and home based living do not increase long term care spending, and are cost effective on an individual and program level. Home care expenditures increased, as well as long term care, and it seems like the home care cost increase caused the long term care increase, but it is not true. They found that 87% of the time the community and home based care cost less than $3500 a month, while 92% of the time nursing home cost more than $3500 a month (Kaye 2011). But this is on an individual level, as opposed to on a program basis where many of the critics say it is not cost effective.

     When just nursing homes are offered they don’t get as many people to apply, but when they offer more services such as community and home based services they get more applicants. One study found that 14% more people applied for long term care. With that was a 49% increase in community and home based care costs, but an 88% decrease in nursing care costs so in the end they ended up spending 15% less total (Kaye 2011). They found that the cost of community and home based services cost does go up for a few years at first, but they blame this on the start up costs, because after a few years it goes back down a bit and then stays pretty level. Even though there were increases seen, the nursing home costs went down as the home care costs went up. So in the end the costs stayed even, or they went down (Kaye 2011).

     This subject relates to Chapter 5 in the textbook when it talks about where people live, and how their environment affects them. Many people want to stay in their home because they have become attached to it, and don’t want to have to acclimate to a new setting at their age. People become attached to their homes to the point where leaving makes them feel like they are losing a part of their identity (Cavanough 2011). Funding community and home based services helps out the people who are maybe too weak, or too poor to be up and moved into a nursing home. Things such as assisted living houses, adult day cares, or congregate housing are more cost effective for people than a nursing home, so for medicaid to sometimes fund those types of lifestyles can really help an individual (Cavanough 2011).

     Nursing home care is very expensive, and when it is the only option for some you will see a decline in applications. Nursing homes are typically lived in by women, who have some kind of impairment, who do not want to be home owners any longer, or have recently been widowed or divorced (Cavanough 2011). The rates of mental and cognitive impairment among nursing home residents is high at 30% to 50% being clinically depressed (Cavanough 2011). With these impairments it makes it difficult for family members to want to put their parents, or siblings in a nursing home. Many times nursing homes are the last resort option.

      Because of this I believe community and home based services should stay funded, and continue to be an outlet families can set their loved ones up with. Throughout the webinar I did get lost in the graphs and the terminology every once in awhile, but in the end it was clear that home and community based services were cost effective. Though there were spikes in expenditures, they always came back down, and the cost of nursing homes always seemed to level the amount of money that was spent total. If one went up, the other went down. I want to be able to have at home care for as long as possible before I am to be placed in a nursing home.