Long-Term Care Services and Supports Needed for Successful Aging-in-Place: A Critical Review

We summarize the state of the evidence on the long-term services and supports infrastructure to support aging-in-place. We find an extensive literature describing the importance of affordable medical and social services delivered in the home, support for family caregivers, and the role of technology for improving communication among patients, caregivers, and health care teams to support aging-in-place. We identify gaps in access to affordable services and an inadequate workforce prepared to support aging-in-place, raising concerns about meeting the future needs of our aging population. Interventions have been directed primarily at the individual level rather than at the system or policy level. Those systems-level interventions that do exist have been primarily within the health care sector: Little attention has been directed at developing holistic interventions that address multiple sectors, which reflects the lack of a cohesive public health delivery system for long-term services and supports nationally. Our findings collectively highlight the multifaceted nature of supports to enable aging-in-place and the necessity for future research to focus on drawing connections across domains of health services infrastructure.