What is Long-Term Care?

Long-term care (LTC) is medical and nonmedical assistance for people who have an illness or disability and can no longer care for themselves.  LTC helps people remain in their own home or where they are currently living and as independent as possible.

Long-term care is so much more than just getting care in a nursing home. It may be provided at home, in the community, in assisted living facilities or nursing homes and includes activities of daily living, such as dressing, bathing, toileting, eating, preparing meals, or housekeeping.

When to Decide if You Need Long-Term Care

The time to explore LTC options is before they are needed. It could be too late to wait until you or a loved one experience problems caring for yourselves. Poor decisions are often made in a crisis or a rush to obtain care when there may be fewer options available.

Numerous options exist for LTC. A complete assessment of the individual’s and his or her caregiver’s needs are necessary to develop the best plan. The best outcomes occur when LTC professionals (such as CICOA), the individual and caregivers work together to develop a plan.

Determining Long-Term Care Needs

Because there are many options to long-term care, a complete assessment of short- and long-term needs is required.  The assessment should be centered on the individual, his or her abilities, wants and needs.  This assessment serves as a guide for planning and decision-making to meet the needs of the individual and caregiver.

The individual, caregivers and the primary care physician must be involved in developing a plan. It would be helpful to talk with family members, neighbors, friends, financial and legal advisors, and insurance carriers.

Paying for Long-Term Care

The following are various means by which people pay for LTC:

  • Bank accounts and investments (stocks, bonds, annuities, mutual funds, etc.)
  • Family resources
  • Home equity loan
  • Insurance, such as long-term care, supplemental, accelerated death benefits and life settlements
  • Personal savings
  • Personal loans
  • Private insurance
  • Reverse mortgage
  • Selling the home
  • Social security, pensions, or other retirement funds

You may become eligible for assistance from one or more of the following state or federal programs:

  • Medicare
  • Veterans benefits
  • Medicaid
  • Other state or federally funded programs

It is wise to consult a trusted professional, such as an elder law attorney, CICOA’s Aging & Disability Resource Center (ADRC), a financial advisor, etc., when considering how to pay for long-term care.

Long-Term Care Options

Long-term care can be provided by a spouse, children or live-in caregiver, or at a skilled nursing care facility, with multiple options in between.  This guide will define some choices.    

Home and community options include a wide range of personal and health services to help individuals stay at home and live as independently as possible.  These services often are provided by family caregivers but also can be provided by others, including:

  • Adult day service programs
  • Case managers or geriatric care managers
  • Emergency response systems
  • Friendly visitor and companion services
  • In-home health care providers
  • Homemaker or home chore services
  • Home modifications, maintenance and repairs
  • Meals programs
  • Respite care (caregiver time off)
  • Senior centers
  • Transportation services

Facility or institutional options are personal and health services provided in a residential facility. This may include housekeeping services, medication management, assistance with personal care, oversight supervision, special programs for people with dementia, or 24-hour nursing care.

Facilities options include:

  • Adult daycare
  • Residential and group care homes
  • Assisted living
  • Continuing care retirement communities (CCRCs)
  • Nursing homes

Your next step is choosing the best LTC option to meet your needs with the resources available to you and your family.

Choosing a Long-Term Care Provider

Choosing long-term care is a process of matching personal needs to service providers to available funding. Be sure to talk with service providers, visit facilities of interest, and have a talk with staff, residents and other caregivers.

Take notes on the following:

  • Did I like the people and the place?
  • Was my interaction comfortable?
  • Were my questions answered to my satisfaction?
  • Did I feel understood?
  • Was the program staff respectful and helpful?
  • Does the facility or program meet my needs?
  • Does the facility or service offer enjoyable activities or programs?
  • Is the facility clean and pleasant?
  • Do the costs fit my budget?

Review your notes and observations with someone you trust to help you make a decision that is right for you.