Resources

Where to receive Care

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 daycare service centers
• Transportation services
• 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:

• Bathing
• Dressing
• Using the toilet
• Transferring (to or from bed or chair)
• Caring for incontinence
• Eating

Other common long-term care services and supports are assistance with everyday tasks, sometimes called Instrumental Activities of Daily Living (IADLs) including:

• Housework
• Managing money
• Taking medication
• 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:

Age

The older you are, the more likely you will need long-term care

Gender

Women outlive men by about five years on average, so they are more likely to live at home alone when they are older

Disability

• 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

Health Status

• 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

Living Arrangements

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.

Medicare:

• 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

Medicaid:

• 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.

Health Insurance:

• 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:

• Long-term care insurance
• Reverse mortgages
• Life insurance options
• Annuities