Long term care refers to a variety of services designed to meet health or personal care needs over an extended period of time. Long term care can be provided at home, in the community, or in various types of facilities, including nursing homes and assisted living facilities.
The goal of long term care is to promote an individual’s quality of life through assistance with daily activities and health needs. This type of care is not medical care but rather assistance with basic personal tasks of everyday life, also known as activities of daily living (ADLs). Examples of ADLs include bathing, dressing, eating, using the bathroom, and moving around inside one’s place of residence.
Long term care and long term services and supports differ from medical care covered by Medicare or private insurance. Medical care is meant to cure an ailment or injury, while long term care is assistance provided to those who need ongoing help to manage chronic illnesses or disabilities. It is a long-lasting service that reflects how much hands-on help a person needs and how much caregiving is required.
Types of Long Term Care
There are a variety of long term care options depending on a person’s specific needs, circumstances, preferences, and available resources. Common types of long term care include:
Home and community-based services: These are services that allow individuals to remain living in their own home instead of relocating to an assisted living or nursing home facility. Services may include home health aides, personal care aides, meals on wheels, adult day services, transportation, homemaker services, and respite care.
Assisted living facilities: These facilities provide private living spaces and personal care assistance with activities like bathing, dressing, eating, taking medications, housekeeping and laundry. They aim to promote independence while providing some medical and health-related services.
Nursing homes: Also known as skilled nursing facilities, these residential healthcare centers provide 24-hour nursing care and are designed for those needing assistance with severe disabilities or medical conditions. They offer services like assistance with all activities of daily living, rehabilitation therapies, medication management and skilled nursing care.
Continuing care retirement communities (CCRCs): These are retirement communities that provide a combination of housing, assisted living and nursing home services, allowing residents to move between levels of care as needs change over time. CCRCs require an entry fee and monthly service fees.
Hospice care: This is a program centered around managing pain and symptoms for those in the final stages of a terminal illness. Hospice focuses on comfort, quality of life and emotional/spiritual support for individuals and their families. It can be provided at home, in hospitals, nursing homes or stand-alone hospice facilities.
Why Long Term Care Matters
The need for long term care in the US is vast and growing considering Americans are living longer lives with illnesses like Alzheimer’s, cancer or chronic conditions requiring ongoing support. Some key points about long term care needs include:
– About 70% of Americans over age 65 will require some type of long term care assistance at some point in their life according to government estimates.
– Those turning 65 today have almost a 70% chance of needing long-term services and supports (LTSS) in their remaining years. Average duration of LTSS is about 3 years but 20% of people face support needs lasting 5 or more years.
– Women need long term care more than men due to living longer on average. Nearly two-thirds of nursing home residents are women.
– Caregiving demands already strain millions of unpaid family caregivers annually, with an estimated economic value of $470 billion or more per year to the nation. Factors like dual careers and geographic distance have reduced family caregiving capacity.
– Public spending on long term care services totaled $200 billion in 2016 through programs like Medicaid and is projected to increase dramatically due to aging baby boomers requiring ongoing assistance. Private long term care insurance helps offset financial risks but remains underutilized.
Paying for Long Term Care
Paying for long term care services can be a major financial burden, especially for unforeseen or chronic conditions requiring care over an extended period of time. Typical payment options include:
– Private pay directly from personal savings and investments
– Long term care insurance to cover costs of care not covered by health insurance like Medicare. Policies differ in covered services, daily benefit amounts, and duration of benefits. Premiums are based on age when first purchased.
– Medicaid as a public assistance program. To qualify an individual must meet strict income and asset eligibility limits through spending down their own funds before qualifying for means-tested coverage.
– Veterans benefits through the Department of Veterans Affairs for eligible veterans and surviving spouses needing skilled nursing or custodial home care.
– Reverse mortgages allow homeowners 62+ to convert home equity into tax-free cash that can then be used to pay for long term care in the home or facility. No repayment as long as one continues living in the home.
Planning for Future Long Term Care Needs
Given most will require some assistance later in life but costs are largely uninsured, planning is key. Steps to consider include assessing risk factors and family needs, researching available options in one’s area, and determining how to pay costs publicly or privately through Medicaid eligibility and planning, private LTC insurance, annuities or life insurance riders. Consulting elder law attorneys, financial planners, insurance professionals and geriatric case managers can aid the planning process. For most, long term care needs will arise, making advance preparation an important process to potentially manage risks and expenses through available programs and resources.
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1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it