Types of Long-Term Health Care for Older Adults

Many older adults will eventually need long-term health care (LTC). There are several types of long-term care. Nursing home care, home health care, or adult day care all qualify as “long-term care.” There are also insurance, caregiver programs, and other services designed to help older adults with the basic activities of daily living. The right choice depends on your loved one’s health, independence, and safety. Many people prefer to remain at home as long as possible.

This article explains long-term care for older adults and the different options that may be available for your loved one.

These conversations are never easy and can be emotional, overwhelming, and stressful. An elder law attorney near you can help you prepare for these conversations by explaining your options, reviewing facility contracts, and navigating Medicaid eligibility. You don’t have to make these decisions alone.

Long-Term Care Basics

Long-term care services provide older adults with a way to stay healthy, active, and meet their basic living requirements. The need for long-term care may be temporary, such as during recovery from illness or injury. It can also be ongoing due to a persistent physical condition or dementia.

Proper long-term care planning and knowing what services are available may include help with the following activities:

• Walking
• Eating
• Grooming
• Personal care services
• Bathing
• Dressing
• Toileting
• Assistance with medical therapy
• Drug administration
• Meal preparation
• Money management
• Shopping
• Transportation
• Bill paying
• Running errands
• Minor repairs
• Pain management
• Housework

Having a plan when things start to get difficult can take pressure off loved ones and caregivers. It can also allow older adults to live in their own homes longer or have greater independence for as long as possible.

Who Needs LTC?

There are no set criteria for those who may require long-term care. It is most often needed by adults over 65 but is also available to younger adults.

People under age 65 may have a chronic illness, disability, or other health condition. Young adults may require assistance with basic daily living tasks.

Factors that may increase or decrease your chances of requiring LTC include:

• Age
• Gender, due to women generally living longer than men and needing LTC assistance more often
• Marital status, as single people often require more help than a married person
• Lifestyle
• Eating habits
• Exercising
• Smoking, drinking, or drug use
• Health history
• Chronic health diseases

Preparing for Long-Term Health Care

It’s important to know how to prepare for the cost of long-term health care. Most typical health insurance plans do not cover long-term health care. As a result, many people who need long-term care struggle to decide the level of care required and to pay for long-term care costs.

Some people prepare for the cost of long-term health care by buying a long-term care insurance policy. Programs like Medicare usually only pay for long-term health care costs after the patient has paid as much as possible. This can include selling property assets to pay for services such as an extended stay in a nursing home facility or assisted living facility.

Social Security and other public benefits can provide crucial funds for elder care. Many states have Medicaid programs that can help with the cost of long-term care for older adults below the federal poverty line.

Keep in mind that there are specific eligibility requirements for government benefits like Medicaid and Medicare. Veterans and their loved ones may also get veteran’s benefits, including the pension benefit, to help cover long-term care expenses.

Planning ahead for your long-term care can help alleviate stress and uncertainty for your loved ones and family. Find local legal help.

Types of Long-Term Health Care

Generally, there are four types of long-term health care:

• In-home care options or “homemaker services” (such as a home health aide)
• Residential care facilities (assisted living communities or nursing homes)
• Adult day care center
• Rehabilitation facilities

These types of long-term care aim to preserve an older adult’s activities of daily living (ADL) as much as possible. Generally, older adults prefer to stay in their own homes or have partial days at a center. Still, in some cases, full-time residential or rehabilitation facilities are the safest option.

In-Home Services

In-home services are a good option for people whose homes can accommodate the older adult’s special needs.

A family member may be able to provide in-home services. Another option is to hire a nurse or licensed in-home care provider. Some people need aid and 24-hour supervision. Others only need in-home support during the day to help with daily chores to age in place for as long as possible.

Residential Facilities: Assisted Living or Nursing Homes

Residential facilities offer several different arrangements catering to the person’s specific needs. Assisted living homes help people with daily activities in a home-like environment. Skilled nursing facilities offer specialized support and medical care for health conditions.

Nursing homes can include skilled nursing, intermediate care, and custodial care.

If your loved one is incapacitated and needs 24/7 care, then a residential facility is likely your best option.

You may be able to find a continuing care retirement community (CCRC). These communities offer a spectrum of care, from independent living to assisted living to skilled nursing to memory care. This allows your loved one to stay in the same community as their care needs change.

Adult Day Care

Adult day care facilities offer social and educational activities during the day. Many older people add adult day care to their long-term care plans to improve their quality of life.

Long-Term Health Care: Rehabilitation Facilities

Rehabilitation facilities offer extended care to help adults regain lost abilities after illnesses or injuries. If someone in assisted living gets hurt or sick, they might have to go to these facilities for special care and therapy. The purpose of rehabilitation is to provide a supportive environment where people can work with health care professionals to improve their strength and mobility. These facilities aim to enhance the quality of life for older people by helping them recover as much as possible.

Paying for Long-Term Care

Most people with long-term care needs receive unpaid help from family and friends. This includes multigenerational care from adult children or even grandchildren. Family caregivers are sometimes forced to leave their work to help care for an aging parent or grandparent.

Medicare pays for long-term care in many settings, including a nursing home or home care.

Other means of paying for long-term care may include:

• Personal savings
• Medicaid
• Veteran’s benefits
• Reverse mortgages
• The Programs of All-inclusive Care for the Elderly (PACE)

Caregiver Support

Family and friends often provide unpaid in-home care to help with the cost of home health care. While Medicare covers some caregiver costs, alternative funding sources include personal savings, Medicaid, and Veterans’ benefits.

Medicaid’s Programs of All-inclusive Care for the Elderly (PACE) offers additional support. Recognizing the cost of caregivers is important in planning for the cost of long-term care.

Long-Term Care Insurance

Long-term care insurance can sometimes help pay for health care over a certain time. However, health insurance policies often have certain eligibility requirements and are generally limited to people between 50 and 84. The premiums can also make insurance a difficult option.

If their terms better fit your situation, there are also short-term care insurance options like Aetna, Medico, or MedAmerica.

Get Legal Help With Long-Term Care Planning

If you’re dealing with end-of-life decisions or need help with Medicaid planning and the probate process, contact the law office of an elder law attorney. They can help you navigate long-term care planning or review a nursing home agreement before you sign. They can also provide legal advice on important matters including:

• Estate planning
• Asset protection
• Durable power of attorney
• Advance directives
• Living wills

FindLaw’s directory of elder law attorneys can get you started. Enter your city or ZIP code for a list of qualified legal professionals near you. Because your state’s laws are relevant, your attorney should be licensed in your state. Your search results will also show important details about prospective attorneys, like ratings and whether they offer free case evaluations.