Divine inspiration for the coming spring.

Has the daily Social Security reform debate, the ongoing Medicare prescription drug benefit battle, or the staggering Medicaid budget tussles all over the country left you feeling lost and befuddled? You re not alone.

The new year has already developed a break-neck pace, and it's barely a quarter of the way through. It's exhilarating, but how will the debate keep from spinning out of control.

Perhaps the answer could be found in some old-time religion. Call it divine inspiration, our cover story this month came about after a happenstance conversation I had on one of the shuttle busses leaving the conference site during the American Association of Housing and Services for the Aging (AAHSA) this past fall.

The concept of spirituality is nothing new to long term care facilities, where residents understand that they could be living in their final place they can call home. Yet, for many residents the spiritual element of their lives can be downplayed at a time that it might matter most.

I don't think anyone doubts that quality care is the most important consideration when having to choose where a loved one will live. But how that person lives and what are the immutable truths that govern one's remaining years clearly play important roles.

Our national telephone survey of more than 1,000 consumers discovered some interesting views regarding how Americans value the faith-based aspect of long term care operators and health care facilities. Done in conjunction with our sister publication, The NonProfit Times, we asked about choice, donations and the design of a place to worship.

Still, whether a facility is a for-profit entity or holds a nonprofit mission, business decisions must be made. That's one of the reasons we included a design question among the three survey questions.

As America ages, several other questions will need to be addressed, and the long term care field is already preparing. In the first of a two-part series, Jim Moore takes a look at the aging-in-place debate, and whether IL facilities and CCRCs are ready for one possible future.

As Jim wrote, the issue is easy to define but difficult to address: How much assistance can you afford to provide to the IL residents of your community?