Long-Term Care Service Choices

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There are a variety of long-term care services that can be offered. The kind of care required will help in making the decision on what type of arrangements should be made.

• Home health care usually includes medical services provided by professionals such as nurses, therapists, home care aides and social workers in a home setting. Home health care is available from nonprofit and for-profit health-care agencies and public health departments. Home health aides help with activities of daily living such as bathing, eating or dressing. They may also help prepare meals, run errands and do light housekeeping.
• Respite care provides a break for family members who are the primary caregivers for a disabled individual at home. Care can range from a few hours each day to several weeks. A respite caregiver usually comes to the home. Respite care may be provided by volunteers.
• Adult day care is usually at a center that provides both health-care and social services for individuals who cannot be left alone during the day. Hospitals, local governments or nonprofit agencies operate centers which usually offer some basic health services as well as social and recreational opportunities. Costs may be adjusted according to one's ability to pay.
• Hospice care helps the terminally ill and their families cope with physical, emotional and spiritual aspects of dying. Care may be provided in a hospice facility or in the home. Costs may vary.
• Assisted living care is a combination of housing, personalized support services and health care. It is designed to meet the needs of individuals who need some help with activities of daily living but do not require the skilled care of a nursing home. Assisted living facilities may be independent facilities, combined with nursing homes or part of a continuing care retirement community. Most costs are paid by the resident or the resident's family. Most long-term care policies currently offer assisted living coverage. In some states, depending on your situation, Medicaid may pay for some services.
• Continuing Care Retirement Communities (CCRCs) offer an innovative option to meeting long-term care needs. These retirement communities combine independent housing units or apartments with living facilities and nursing home care, usually all at the same location. Many offer a broad range of services and levels of care as well as recreational, social and educational opportunities. Carefully review any CCRC contract with your attorney or financial planning professional.
• Nursing home care provides skilled nursing care and rehabilitation services for individuals with physical or mental disabilities. Many patients require long-term care and will never recover or stabilize to the point where they can care for themselves. Costs may vary and Medicare may pay for a limited number of days following a hospital stay.

Three Levels Of Care

Skilled Care is needed for individuals with medical conditions that require continuous care by medical personnel. This may include physical, occupational, respiratory and speech therapy from a licensed professional.

• Daily care is usually 24 hours.
• Physician must order care.

Intermediate Care is for less complicated medical conditions. Intermediate care provides rehabilitation for individuals to regain independence following an illness.

• Requires the attention of a registered nurse or professional therapist.
• Does not require 24-hour supervision.

Custodial Care is for individuals who need assistance with simple daily tasks such as bathing, eating or dressing.

• Requires less attention than skilled care.
• Care may be provided in a home rather than a nursing home facility.