It’s best to discuss long-term care early, before medical or personal care is needed. Here’s information to understand, choose and finance long-term care.
Long-term care is a term used to describe home and community-based services for adults who need help caring for themselves.
If you are considering long-term care options for yourself, a parent, or another friend or relative, start your research and discussions early. If you wait, an injury or illness can force the situation and cause you to make a decision that may not be the best in the long run.
Here’s help to familiarize yourself with long-term care options.
Understand types of long-term care
Learning about the various types of long-term care can help you choose the most appropriate options for you or the person you are supporting. Here are some options:
- Home care. Home health aides or personal assistants can help with bathing, dressing, and other personal needs around the home, as well as with housework, meals, and shopping. Home nursing staff provide basic medical care, such as helping with medications. Meal delivery programs can provide hot meals to your home.
- daytime programs. For adults who don’t need 24-hour medical care, day programs offer social interaction, meals, and activities, often including exercise, games, field trips, art, and music. Some programs offer transportation to and from the health care facility, as well as some medical services, such as help taking medications.
- Comprehensive home care programs. The Comprehensive Health Care Program for the Elderly provides comprehensive health care and support services, funded by Medicare and Medicaid, for seniors living at home. Availability of Comprehensive Health Care for the Elderly Program services varies by state.
- Residence for older adults. Many communities offer rental apartments intended for seniors, and rent may be subsidized for some residents. Some nursing homes offer meals, transportation, housekeeping, and activities.
- Protected housing. Staff at these facilities help residents take medications, bathe and dress, as well as eat, get around, do housework, do laundry, and do social activities. Some sheltered living residences have on-site beauty salons and other amenities.
- Continuing Care Retirement Community. These communities offer various levels of health care, such as nursing homes for those who are healthy, sheltered housing for those who need help with daily activities, and 24-hour nursing care for those who are no longer independent. Residents can move between levels of care depending on their needs.
- Home for the elderly and convalescent. Nursing and convalescent homes provide 24-hour nursing care for people recovering from illness or injury, and function as nursing homes for people unable to care for themselves. Nursing and convalescent homes also offer hospice care. Services typically include help with eating, dressing, bathing, and toileting, as well as rehabilitation therapy.
How to choose the right long-term care facility
Selecting a long-term care facility can be overwhelming. Think about the following questions related to you or the person you are helping to make decisions:
- What level of service do you need? Do you need help getting dressed or using the bathroom? What regular medical care do you need? What kind of help do you need with meals or housekeeping? What type of medical care does your doctor recommend?
- What are your personal preferences? Would you prefer a smaller facility or certain arrangements over space, like a single room? Would you rather eat in a community kitchen or in your own room? What are the most important services?
- What are the rules of the institution? Can residents decide the times to get up and go to bed? When are visitors allowed and what social activities are offered? Can residents continue seeing their personal doctors?
- What services are offered at the facility? What types of recreational or social activities are offered? Are there opportunities to participate in religious or cultural events? What types of transportation services are provided?
- How much can you pay? Get details on prices, fees and services. Find out what is included in the monthly rate and what the additional costs are.
- What are the options available near your home? Being close to friends and family can ease the transition to a long-term care facility. If vacancies are a problem, ask about waiting lists.
- What is your first impression? Plan a tour of the facilities. Does the facility appear safe and clean, and are residents treated with respect? Do you see them happy? Do the facilities smell good and have a comfortable temperature? Are there enough caregivers? Make a second visit unannounced to confirm your first impression.
- How are the facilities compared to others? Use tools like Compare Nursing Homes on the Medicare website. Ask a long-term care advocate (an official who investigates complaints against long-term care facilities) about the strengths and weaknesses of the specific facility you’re interested in. To find a local advocate, use the Eldercare Locator, an online service from the US Administration on Aging.
Also, get opinions from family and friends who have experiences with nursing homes and nursing homes. Also, ask your doctor for recommendations and ask if they see patients in nursing homes and convalescent homes. You can get suggestions from social workers, hospital discharge planners, and local agencies on aging.
Pay for long-term care
Long-term care can be expensive. Paying for long-term care usually starts out as an out-of-pocket expense. Other payment options include:
- Medicare, a federal program for people 65 and older and for people with certain disabilities, generally doesn’t cover long-term care. Certain Medicare options cover the health care, prescriptions, and medical devices you need while you’re in a long-term care facility. Medicare covers short-term nursing care in a convalescent and nursing home for needs such as rehabilitation or nursing care after surgery or a hospital stay.
- Medicaid, a joint federal-state program designed for people who meet certain income requirements, could be an option to cover long-term care for adults with little or no resources.
