. Introduction
Americans are living longer today than have previous generations. Indeed, the aging of the Baby Boom generation is causing a rapid increase in the number of older Americans. This means that there will be increases in demand for long-term care services, or what has more recently become known as long-term services and supports. Long-term services and supports (LTSS) involve the provision of medical, social and personal care services on an on-going basis to people with chronic physical and mental disorders. These services can be delivered in a broad array of settings, including institutions, private residences and assisted-living environments. In 2010 it was estimated that nearly 10 million Americans required ongoing help with their functional impairments through LTSS. By 2020, this number is expected to increase to 15 million. Over 80% of these individuals receive that help informally from friends and relatives. The rest receive “formal” or paid services at home, in other community settings, or in institutions.