Abstract:

Most services for the elderly are structured by a medical service model, focusing on diagnosis & treatment of ailments, which is predominant because it is the basis for reimbursement under Medicaid. In contrast, an alternative social model is proposed that considers all the needs of the aging person, including mobility, independent living skills, & other nonmedical needs. Assuming that the medical model is associated with institution-based care & the social with home-based care, some estimates of the costs of each can be made. While the medical model can employ economies of scale, it does not have a clear cost advantage because true costs depend on clients' needs & quality of life. A transition to the social model with an enhanced role for social workers in long-term care case management is recommended.