Choosing Your Care

What is long-term care?

Long-term care is a variety of services and supports to meet health or personal care needs over an extended period of time. Most long-term care is non-skilled personal care assistance, such as help performing everyday Activities of Daily Living (ADLs), which are bathing, dressing, using the toilet, transferring (to or from bed or chair) caring for incontinence and eating

The goal of long-term care services is to help you maximize your independence and functioning at a time when you are unable to be fully independent.

Who needs long-term care?

Long-term care is needed when you have a chronic illness or disability that causes you to need assistance with Activities of Daily Living. Your illness or disability could include a problem with memory loss, confusion, or disorientation. (This is called Cognitive Impairment and can result from conditions such as Alzheimer’s disease.)

This year, about 9 million Americans over the age of 65 will need long-term care services. By 2020, that number will increase to 12 million. While most people who need long-term care are age 65 or older, a person can need long-term care services at any age. Forty (40) percent of people currently receiving long-term care are adults 18 to 64 years old.

How much care might I need?

It is difficult to predict how much or what type of care any one person might need. On average, someone age 65 today will need some long-term care services for three years. Service and support needs vary from one person to the next and often change over time. Women need care for longer (on average 3.7 years) than do men (on average 2.2 years). While about one-third of today's 65-year-olds may never need long-term care services, 20 percent of them will need care for more than five years.

If you need long-term care, you may need one or more of the following:

  • Care or assistance with activities of daily living in your home from an unpaid caregiver who can be a family member or friend;
  • Services at your home from a nurse, home health/home care aide, therapist, or homemaker;
  • Care in the community; and/or
  • Care in any of a variety of long-term facilities.

Generally, services provided by caregivers who are family or friends are unpaid. This is sometimes called informal care. Paid services are sometimes referred to as formal services. Paid services often supplement the services provided by family and friends.

What is a continuum of care?

A continuum of care, allows residents to remain in their apartments when health needs change and additional services are needed. As residents age in place, they can avoid a move to a new residence by using Enriched Living or Assisted Living services.

Why should you plan ahead?

Planning ahead for long-term care is important because there is a good chance you will need some long-term care services if you live beyond the age of 65. About 70 percent of people over age 65 require some services, and the likelihood of needing care increases as you age.

Planning ahead helps you understand what service options are available in your community, what special conditions may apply for receiving services, for example, age or other eligibility criteria, what services cost, and what payment options – public and private – apply. Having this information helps ensure you will have a range of options when you need long-term care, and makes it more likely that you will have more choice and control over where and how you receive services.

Planning ahead is important because the cost of long-term care services often exceeds what the average person can pay from income and other resources. By planning ahead, you may be able to save your assets and income for uses other than long-term care, including preserving the quality of life for your spouse or other loved ones. With planning, there is a greater likelihood of being able to leave an estate to your heirs, because you are less likely to use up your financial resources paying for care.

Planning ahead also means less emotional and financial stress on you and your family. It can provide a way to involve your family in decisions without depending on them to bear the entire burden alone.

Finally, for many people, one of the most important advantages of planning ahead is to ensure greater independence should you need care. Your choices for receiving care outside of a facility and being able to stay at home or receive services in the community for as long as possible are greater if you have planned ahead.

How to have that difficult conversation:

Click here to learn about how to have that difficult conversation with your loved one

Types of care

From the Mayo Clinic

Home care: Personal or home health aides may help with bathing, dressing and other personal needs at home, as well as housekeeping, meals and shopping. The home health nurses provide basic medical care at home

Day Program: Day programs for adults offer social interaction, meals and activities – often including exercise, games field trips, art and music – for adults who don’t need round-the-clock care. Some programs provide transportation to and from the care center as well as certain medical services such as help taking medications or checking blood pressure

Community Services: Support services that can include adult day care, meal programs, senior centers, transportation and other services. These can help people who care cared for at home and their families. For example, adult day care services provide a variety of health, social and related support services in a protective setting during the day. This can help adults with impairments such as Alzheimer’s disease continue to live in the community. It can also give a family or friend caregiver a needed respite.

Senior Housing: Many communities offer rental apartments intended for older adults. Some senior housing facilities offer meals, transportation, housekeeping and activities.

Assisted Living: Assisted living facilities offer 24-hour supervision. Staff members to help with medications, bathing, dressing and basic medical care – as well as meals, transportation, housekeeping and activities. Some assisted living facilities have on-site beauty shops and other amenities.

Nursing Home: Offer 24-hour nursing care for those recover from illness or injury. Nursing homes also offer end-of-life care. Services may include help bathing, dressing and toileting, wound care, rehabilitative therapy and help with respirators or ventilators

Continuing-care community: Continuing-care retirement communities offer several levels of care in on setting – such as senior housing for those who are healthy, assisted living for those who need help with daily activities, and round-the-clock nursing care for those are no longer independent. Residents can move among the various levels of care depending on their needs.

How to choose a level of care

From the Mayo Clinic

  1. Figure out if you or your loved one needs help with activities of daily living like bathing, toileting and dressing. Consult your doctor to find out what kind of care you may need
  2. Think about your personal preferences. Do you want a larger or smaller facility? Do you prefer a single room? What amenities are available? Are there social activities?
  3. Determine what you can afford. What are the prices, fees for extra services and know what’s included in the monthly fee.
  4. Research what’s available close to home. Being close to family and friends can east the transition to long term care.
  5. Schedule a tour of the facility and note if it’s safe, smells ok, how residents are treated and if those residing in the facility are happy.
  6. Compare the facility to others. What have you heard? Call the Better Business Bureau to check whether any complaints have been filed against the facility. Ask an ombudsman- an official who investigates complaints against long term care facilities.
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