What are the major challenges that have faced the long-term care system in recent years?

The field of long-term care has gone through and is still experiencing, a time of great change. It has been, as such times tend to be, both trying and exciting. It has presented challenges to providers, consumers, payers, and regulators alike. Some of these challenges have been met, at least in part. Others have not. The desire of consumers to receive care in the most appropriate setting and the desire for a high quality of life have led to development of more and better alternative services such as hospice and adult day care. They have also stimulated more home- and community-based care. This has improved access to care for many.

Reference

Pratt, J. R. (2010). Long-term care: Managing across the continuum (3rd ed.). Sudbury, MA: Jones and Bartlett

What are the major challenges that have faced the long-term care system in recent years?

What are the most likely ethical challenges to be faced in the near future?