Most long-term care is provided at home. Other kinds of long-term care services and supports are provided by community service organizations and inlong-term care facilities.
Examples of home care services include:
An unpaid caregiver who may be a family member or friend
A nurse, home health or home care aide, and/or therapist who comes to the home
Community support services include:
Adult day care service centers
Home care agencies that provide services on a daily basis or as needed
Often these services supplement the care you receive at home or provide time off for your family caregivers.
Outside the home, a variety of facility-based programs offer more options:
Nursing homes provide the most comprehensive range of services, including nursing care and 24-hour supervision
Other facility-based choices include assisted living, board and care homes, and continuing care retirement communities. With these providers, the level of choice over who delivers your care varies by the type of facility. You may not get to choose who will deliver services, and you may have limited say in when they arrive.
What is Long-Term Care?
Long-term care is a range of services and supports you may need to meet your personal careneeds. Most long-term care is not medical care, but rather assistance with the basic personal tasks of everyday life, sometimes called Activities of Daily Living (ADLs), such as:
Using the toilet
Transferring (to or from bed or chair)
Caring for incontinence
Other common long-term care services and supports are assistance with everyday tasks, sometimes called Instrumental Activities of Daily Living (IADLs) including:
Preparing and cleaning up after meals
Shopping for groceries or clothes
Using the telephone or other communication devices
Caring for pets
Responding to emergency alerts such as fire alarms
Who Needs Care?
70% of people turning age 65 can expect to use some form of long-term care during their lives. There are a number of factors that affect the possibility that you will need care:
The older you are, the more likely you will need long-term care
Women outlive men by about five years on average, so they are more likely to live at home alone when they are older
Having an accident or chronic illness that causes a disability is another reason for needing long-term care
Between ages 40 and 50, on average, eight percent of people have a disability that could require long-term care services
69 percent of people age 90 or more have a disability
Chronic conditions such as diabetes and high blood pressure make you more likely to need care
Your family history such as whether your parents or grandparents had chronic conditions, may increase your likelihood
Poor diet and exercise habits increase your chances of needing long-term care
If you live alone, you’re more likely to need paid care than if you’re married, or single, and living with a partner
How Much Care Will You Need?
The duration and level of long-term care will vary from person to person and often change over time. Here are some statistics (all are “on average”) you should consider:
Someone turning age 65 today has almost a 70% chance of needing some type of long-term care services and supports in their remaining years
Women need care longer (3.7 years) than men (2.2 years)
One-third of today’s 65 year-olds may never need long-term care support, but 20 percent will need it for longer than 5 years
Who Pays for Long-Term Care?
The facts may surprise you.
Consumer surveys reveal common misunderstandings about which public programs pay for long-term care services. It is important to clearly understand what is and isn’t covered.
Only pays for long-term care if you require skilled services or rehabilitative care:
In a nursing home for a maximum of 100 days, however, the averageMedicare covered stay is much shorter (22 days).
At home if you are also receiving skilled home health or other skilled in-home services. Generally, long-term care services are provided only for a short period of time.
Does not pay for non-skilled assistance with Activities of Daily Living (ADL), which make up the majority of long-term care services
You will have to pay for long-term care services that are not covered by a public or private insurance program
Does pay for the largest share of long-term care services, but to qualify, your income must be below a certain level and you must meet minimum state eligibility requirements
Such requirements are based on the amount of assistance you need with ADL
Other federal programs such as the Older Americans Act and the Department of Veterans Affairs pay for long-term care services, but only for specific populations and in certain circumstances
Like public programs, private sources of payment have their own rules, eligibility requirements, copayments, and premiums for the services they cover.
Most employer-sponsored or private health insurance, including health insurance plans,cover only the same kinds of limited services as Medicare
If they do cover long-term care, it is typically only for skilled, short-term, medically necessary care
There are an increasing number of private payment options including: