Long-Term Care: Aging and Disabled Adults Literature Review

By Larry Polivka (2011), prepared for the Department of Elder Affairs. Long-term Care (LTC) has slowly emerged as a public policy issue over the last several years, but has yet to achieve the level of visibility of issues such as the growing number of medically uninsured, or the fiscal sustainability of Medicare. The aging of […]

The Future of Long-Term Care and the Aging Network

By Larry Polivka and Jung Kwak. Originally published by Generations, the Journal of the American Society on Aging in 2014.  Before concluding that proprietary organizations should provide LTC services, we should analyze the effectiveness of the existing community-based LTC system. Our long-term-care (LTC) system should be an asset in our efforts to build strong local and regional communities […]

The Neoliberal Economy and Erosion of Retirement Security

By Larry Polivka and Baozhen Luo. Originally published by the Gerontological Society of America in 2015. Abstract The origins and trajectory of the crisis in the United States retirement security system have slowly become part of the discussion about the social, political, and economic impacts of population aging. Private sources of retirement security have weakened […]

Neoliberal Long-Term Care: From Community to Corporate Control

By Larry Polivka and Baozhen Luo. Originally published by the Gerontological Society of America in 2017. Abstract Publicly (mainly Medicaid) funded long-term care (LTC) services have evolved from a nursing home dominated system of service to a much more balanced system including home- and community-based services (HCBS) programs over the last 30 years. The HCBS […]

Neoliberalism and the Future of Retirement Security

Originally published by the Annual Review of Gerontology and Geriatrics in 2020 By Larry Polivka Abstract The main questions addressed in this article are: (a) what is the economic status of current retirees and the projected status of future retirees; (b) how does the status of current and future retirees vary by race, gender, socioeconomic […]

Predicting Racial Disparities in Nursing Home Admission: The Role of Discrimination, Stressors, and Neighborhood Context

Originally published by The Sociological Quarterly in 2019 By Lori Gonzalez ABSTRACT Although the overall trend in nursing home use has declined, this has not been the case for racial and ethnic minorities. This article elucidates the role of stressors and neighborhood context in nursing home admission. The analysis fits several regression models to predict […]

Culture Change in Skilled Nursing

Originally published by the Journal of Housing for the Elderly in 2019 By Lori Gonzalez and Lisa Rill Abstract The culture change movement has pushed for reform for more than two decades to align policy, the long-term care industry, and resident preferences with regard to care. Evidence from research indicates that culture change has the […]

Long-Term Care Options in Florida: Their Availability by County Demographics

Originally published by the Journal of Racial and Ethnic Health Disparities By Lori Gonzalez Abstract Older people express a preference for home and community-based care over skilled nursing, realizing that preference, however, is dependent upon having those options available. The present exploratory study uses publicly available data to understand if the geographic availability of long-term […]

Women and the Crisis of Care in the United States

Originally published in 2018 by Gender and Age: A Focus on Women By Larry Polivka Women are much more involved in long- term care (LTC) than men, as caregivers and care recipients. This is true in the formal system of paid care and in an “informal” system that relies upon unpaid caregiving by relatives and […]

The Changing Role of Non-Profit Organizations in the U.S. Long Term Care System

Originally published in 2019 by the Journal of Aging & Social Policy By Larry Polivka and LuMarie Polivka-West Abstract The American long-term care system has changed dramatically over the last several years as the need for care has increased steadily with the aging of the boomer generation. Arguably, the most important change has occurred in […]

An Ethic of Care Needed in Our Long-Term Care System

This article was originally published in 2021 by Generations Today, a publication by the American Society on Aging. By Larry Polivka The COVID-19 pandemic has had a devastating multidimensional impact on the world, especially among older adults, and specifically nursing home residents. More than 130,000 nursing home residents have died and for untold thousands their […]

Failures of Regulation and Policy in Medicaid-Managed Long-Term Care and Medicare Advantage

This article was originally published by the Public Policy & Aging Report in 2021. By Lori Gonzalez, Larry Polivka, and LuMarie Polivka-West We, like many long-term care (LTC) researchers and policy analysts, are concerned about the chronic inadequacy, from a LTC recipient perspective, of the LTC regulatory framework at the federal and state levels. Our […]

Retirement Security

By Lori Gonzalez Introduction Retirement security—being able to transition out of the workforce without severe financial devastation or serious risks to health—was first formed in the U.S. by the New Deal programs enacted in the 1930s which included Social Security and unemployment insurance.  Assistance for older people prior to the New Deal was largely absent save […]