For many, the phrase ‘long-term care’ may conjure images of patients recovering in the quiet hallways of a nursing facility.  In fact, this coverage category applies to a variety of services that may be provided at inpatient or outpatient settings—and even in the comfort of your own home.

What is Long-Term Care?

Simply put, long-term care is help that is provided when you are unable to manage your activities of daily living on your own. Activities of daily living, also called ADLs, are all the things that need to be done on any given day, such as:

• Eating
• Dressing
• Bathing
• Using the toilet
• Getting out of bed

Long-term care may be needed after an injury, recovering from surgery or after a serious health incident. Care needs may increase as you or your loved one gets older, or an illness creates more strain on your body. On average, women live longer than men, which means they may require longer-term care. People who live alone tend to need paid care as they age. Your current state of diet, exercise and health history will impact your level of need for long-term care.

Long-Term Care Planning

You may like to think you will never need long-term care and don’t want to plan for it. Planning in advance will help you make the best decision if/when the time comes.

If you or a loved one has been diagnosed with a degenerative disease such as Alzheimer’s disease, now is the right time to start your long-term care plan.

Related: Caregiver 101: Caring for Aging Parents

Types of Long-Term Care

There are two forms of long-term care that you may need.

Personal Care

Personal care is care that does not need to be provided by a trained medical professional. This can include:

• Help with dressing, bathing, grooming and transfers
• Assistance with preparing meals, grocery shopping, housework and laundry
• Companion visits and transportation

Skilled Care

Skilled care is provided by or overseen by a trained medical professional. This may be after an injury or illness, while recovering from surgery or as a disease progresses. Care may include:

• Monitoring vital signs
• Administering medication
• Wound care
• Managing IV treatments or feedings
• Occupational, physical or speech therapy

Long-Term Care at Home

Staying at home is important for many people as they age. Long-term care provided at home can take many forms. 

Personal care

While living at home you could benefit from assistance with your daily activities of living even if you don’t need medical care. Personal care covers bathing, dressing, grooming, toileting, feeding, assistance with transfers and transportation.

Homemaker services

A homemaker can assist with the tasks of managing a home. This can include pet care, housecleaning, preparing meals, laundry, shopping, transportation and companionship.

Home health care

Standard medical care and monitoring can also be provided in-home by a home health aide. This care may involve personal care as well as monitoring vital signs, medications, IV treatments, and wound care.

Nurse care

Specialized medical care by a trained professional such as a nurse or a therapist may be needed during illness or recovery. This assistance includes skilled nursing care, diabetes management, physical, speech and occupational therapy. 

Hospice care

Hospice refers to care that focuses on quality of life and pain management instead of recovery. This care can include doctor and nurse visits, medical equipment, prescription drugs and counseling.

Community-Based Care for Seniors

The spectrum of care can be quite broad. Community-based care often provides a smaller amount of care that can be accessed as needed.

Adult Daycare

An adult daycare program can offer caregivers a break while providing supervision, meals and regular group activities.

Respite Care

Respite care is meant to alleviate the strain on a caregiver, whether it is for an afternoon or a week. Care can be offered in-home or at a facility. 

Transportation Services

Losing the ability to drive can hamper independence. Transportation services such as community buses or vans can be a viable option for a senior who cannot drive.

Facility / Community Long-Term Care

A senior may benefit from a move out of their home into a residential facility. These facilities are staffed 24/7 and have regularly scheduled activities for residents. The care given will depend on the type of facility chosen.

Assisted Living Community

A senior who needs assistance with activities of daily life but still wants to maintain their independence may choose an assisted living community. These communities provide supervision and help with personal care tasks, meals, assistance with medication and transportation. Maintenance and housekeeping are also included.

Related: Medicare Benefits for Assisted Living

Retirement Community

A retirement community often covers the independent living of an assisted living facility while offering access to more advanced care as needed. A retirement community may also provide amenities such as community clubs, therapy, medical care and even shopping.

Nursing Home

A nursing home provides 24/7 medical monitoring and care for someone who can no longer manage on their own. This can include help with activities of daily living, meals and laundry while also providing skilled nursing care.

How To Decide it’s Time for Long-Term Care

Knowing when long-term care is needed can be difficult. You or your loved one may fear that it signals a loss of independence. Long-term care can actually alleviate the stress of living alone and provide a higher quality of life.

Some of the signs you might notice that show a need for more assistance are:

A loss of personal care

You might notice a change in hygiene and appearance. Your loved one may be unable to shower, brush their teeth or wear clean clothes. They may be losing weight and struggling with balance or a loss of energy.

Difficulty with home management

When you take a look around the house, you could find garbage, clutter, burn marks or damage that is indicating it is becoming harder to maintain a home.

Struggles with daily life

The regular tasks of daily life such as taking medications, getting around the house and keeping up with bills may become too much. You might notice more falls, confusion and even depression.

You can benefit from talking with your loved ones about long-term care options before, or as soon as, you notice these signs developing.

How Much Does Long-Term Care Cost?

Long-term care can vary widely in regard to cost. To determine what you will be paying you will want to look at:

• Services provided
• Hours of care you require 
• Geographic location
• Comparison of providers 

The Genworth’s Cost of Care Survey lists average costs ranging from $4,957 a month for homemaking services to $9,034 a month for a private room in a nursing home.

Does Medicare Advantage Cover Long-Term Care?

Original Medicare will cover some of the medical care costs associated with hospital stays, doctor visits, home health care and hospice care. Medicare Advantage does not cover assisted living or long-term care.

The decision to pursue long-term care can feel overwhelming at the beginning. Starting the discussion now will help you to feel more prepared to make this important decision.