Planning for the future of long-term care: consumers, providers, and purchasers.

The number of consumers needing long-term care services, including nursing home care, will more than triple during the next 30 years, and their characteristics will change dramatically. Providers will be in short supply, and an increasing variety of professionals will participate in meeting the long-term care needs of the older population. Purchasers will make decisions about providing services based on the health-related outcomes and value of these services. While an integrated delivery system that incorporates a range of alternatives to the nursing home is the ideal, the demands and preferences of consumers, the availability of providers, and purchasers' mostly financially driven decisions will influence the achievement of such a system. The challenge to the nursing profession will be to continue to serve as an advocate for the patient as the system evolves and to provide data for wise policy decision-making.