Time flies.

Even government long-term care (LTC) services rating programs developed by patient advocates often tend to assume that the patients will be helpless invalids who have to depend on others to monitor, evaluate and manage their care.

These days, however, many of the elderly people and disabled people who are moving into LTC facilities or using home-based LTC services have computers, Internet connections, and Web-based message board and rating service accounts.

Some LTC users can lash out with a 1-star rating or an angry essay when care fails to meet their expectations, and the number of users with Web communication access is growing.

Health Affairs — a traditional academic journal that focuses on health care finance and health care delivery systems — is highlighting the power of the care user’s own voice in shaping care this month by publishing an essay on care by Martin Bayne, an author and former journalist who lives in an assisted living facility in Center Valley, Pa.

Bayne says the facility is clean and well-run and has good, plentiful food, but that, from a patient’s perspective, it has many shortcomings, such as sinks that are inaccessible to patients who are in wheelchairs and a lack of a wheel-chair-accessible exercise room.

Bayne reports that, at the facility he was in before, the administrators seemed to have little interest in the views of residents and no understanding of the concept that residents might regard the facility as being their home.

Another way to measure the coming influence of digital consumerism on LTC services and related products and services — including private long-term care insurance (LTCI) is to search Google for Yelp LTC facility and services reviews posted by the residents themselves. The number of resident-posted reviews seems to be small but growing.

The residents’ desire to have a say could collide with the cold reality that the resources being stashed away for the cold, hard LTC winter seem likely to be small compared with the need. In 20 or 30 years, society may be too desperate to find ways to keep frail, elderly Americans who did not buy adequate private LTCI warm, dry and fed to devote much effort to making LTC responsive to residents’ concerns. 

But it seems as if people like Bayne, and the hundreds of LTC users posting lower-profile comments and ratings on the Web, may influence the future of LTC by changing the way non-LTC users who come across the reactions think about the topic.

You can’t change what you can’t measure, and you can’t measure something if you’ve never thought about it. Bayne and others like him may be giving non-LTC users the words and concepts to think entirely new LTC thoughts.