What is Long Term Care?
If you are like most people, when you think of long-term care you probably think of nursing homes! However, the majority of long-term care that takes place is NOT in nursing homes. People can now receive long-term care in a variety of settings other than nursing homes. The most popular setting for long-term care is in your home. Additionally, many people live in beautiful assisted living facilities where they have their own apartment and furniture and require minimal assistance.

Long-term care is defined as needing either assistance or supervision from someone when you are unable to care for yourself as a result of a chronic illness, physical injury, cognitive or mental impairment, or just due to old age and frailty. This type of care is considered custodial care, or non-skilled care. It is NOT acute or rehabilitative care which is known as skilled care. When you need long-term care you usually need help with your activities of daily living. These are items such as bathing, dressing, toileting, continence, eating, ambulating, and transferring. Or, you may be able to do all of your activities of daily living but still need care due to a cognitive impairment. You may be able to dress yourself but you may not remember to take your medications.

Long-term care insurance provides important psychological benefits to purchasers under 65. According to our surveys, buying this insurance makes these purchasers feel more secure about their future and better about the way they plan to secure that future.
“Benefits of Long Term Care Insurance: Enhanced Care For Disabled Elders, Improved Quality of Life for Caregivers and Savings to Medicare & Medicaid.” HIAA. September 2002.

Types of Long Term Care
When people think of long-term care, most people think of skilled nursing facilities. Long-term care can be provided in a variety of other settings. In fact, the majority of long-term care takes place in the home. If you had a choice, wouldn't your rather stay at home? Of course you would! There are two types of long-term care services. There is skilled care and non-skilled care. The long-term care services people need vary depending on their health condition. Long-term care can be provided by skilled and non-skilled caregivers.

An example of a skilled care provider would be a therapist (physical, speech or occupational), a registered nurse or even a medical social worker. An example of a non-skilled care provider would be a family member, nurse’s aide or caregiver. Unlike skilled caregivers, non-skilled caregivers are not required to hold a special license to perform their services. Non-skilled providers can help clients with items like walking, bathing, dressing, shopping, cooking, housekeeping, transporting, paying bills, etc.

Home Health Care
This is part time or "intermittent skilled" nursing services by licensed nursing personnel provided by a home health agency. Home health agencies offer services provided under a physician's plan of treatment to persons who prefer to stay in the familiar surroundings of their own home but still require assistance. Nurses, therapists and home health aides provide medically oriented care in the patient's home, such as physical therapy, giving injections or dressing a wound. While home health care (skilled care) is being provided these people may need help with the activities of daily living such as bathing, eating, toileting, and so on.

Home Care
Home care is different from home health care. Home care consists of "custodial care." An example would be helping someone with their activities of daily living or supervising them due to a cognitive impairment. Home care can also include homemaker services such as housecleaning, meal preparation and laundry. The people that provide home care do not have to be licensed, as this is not considered skilled care.

Adult Day Health Care and Adult Day Care Centers
Adult Day Care programs provide relief to the primary caregiver. The main objective of the Adult Day Care programs is to help keep people out of nursing homes and assisted living facilities. These programs provide care during the day so that caregivers can either work or have a break from the stress of care giving. These programs can include therapeutic, social and health activities for people with physical or cognitive impairments.

Adult Day Care social programs provide social interaction and support services to persons who do not require the full range of services available in an Adult Day Health Care program.

Respite Care
Respite care provides relatives, friends and family members relief when providing care to a loved one on a continuous basis. Respite care provides supervision and care of persons that need long-term care. This care can be provided in the home or in a facility.

Assisted Living Facilities or Residential Care Facilities
An assisted living facility or residential care facility for the elderly provides a residential setting for people in need of personal assistance and custodial care. This is one of the fastest growing types of care because the setting is more like a person's home. These facilities provide room, board, and assistance with activities of daily living, or supervision due to a cognitive impairment. They range in size from small, three to six bed "mom and pop" operations to separate wings within large retirement communities.

Skilled Nursing Facilities
Nursing facilities are licensed by the state. They provide both skilled and custodial care. Residents that are receiving skilled care are usually getting rehabilitative care after a serious illness or surgery. Often they are getting rehabilitation- for example, they may need physical therapy after a stroke or hip replacement.

The most common type of care in nursing homes is custodial care. This is care like bathing and dressing. Many times the residents that receive custodial care are just frail elderly people, or have a cognitive impairment and can't care for themselves.

Hospice Services
Hospice services are designed to provide palliative care, alleviate the physical, emotional, social and spiritual discomforts of an individual who is experiencing the last phases of life. Hospice services also provide supportive care to the primary caregiver and the family.

Who Pays for Long Term Care?
The majority of long-term care costs are paid by Medicaid. After you have spent down your assets and meet strict income criteria. After Medicaid, the next largest payer of long-term care is the individual that pays for long-term care out of their personal assets.

Health insurance, HMO's, Medicare, and Medicare Supplement policies pay for very little, if any, long-term care. These types of insurance pay for skilled care of an acute medical nature and for some rehabilitation, as long as there is continual improvement in your condition. These types of coverage usually do not pay for personal aides, homemakers, adult day care, assisted living centers, or skilled nursing home care for chronic conditions.

The Costs of Long Term Care
According to a recent American Council of Life Insurers (ACLI) study the costs of long-term care services will more than quadruple by 2030! Additionally they have listed the current and 2030 projected costs.

Click for Average Costs Charts

Who Needs Long Term Care?
All ages can need long-term care! However, usually when people think of long-term care they tend to think of it as care for the elderly. This is not the case. In fact, 43% of the people that need long-term care are under the age of 65. An example of this is Christopher Reeves who needed years of long-term care due to his horseback riding accident. You've probably known of younger people in your community that need long-term care because of things like strokes, car accidents, skiing accidents, multiple sclerosis or a variety of other disabling diseases. We are living longer than we ever used to due to medical technology, increased longevity and the fact that we take better care of ourselves now then ever before. Therefore, as our society ages, even more people will need long-term care.

Women are more likely to need long-term care than men. Women tend to have more chronic conditions, like arthritis and osteoporosis. Men tend to have more acute types of health conditions that lead quickly to death, like a heart attack. Also, women are more likely to need long-term care services than men because they have a longer life expectancy.

Many times women marry men that are older than them. With the life expectancy being longer for women and their husbands being older it is very common for women to care for their older husbands at home. After they pass away the women are left alone and their care is more likely to be provided by their children, or in a nursing home.

The Odds of Needing Long Term Care
The odds of needing long-term care are great. According to Health Insurance Association of America / Life Plans, the general public believes the risk to be only 25%. However the actual risk is greater than 50%! There is more of a demand for long-term care now than there was in the past. We are living longer now and the family dynamics have changed. Families are not as available to provide care now as they were in the past. The longer we live, the odds are higher that we will need long-term care.

Many times people wrongly assume that just because no one in their family ever needed long-term care, or that they are in such great health they won't need long-term care. This couldn't be further from the truth! Despite your great health, you could get in a car accident and need long-term care!

How Long Do People Need Long Term Care?

Unfortunately, there is really no way to accurately predict how long you could need long-term care. There are a lot of factors that would determine this. For example if you were in your 80's and had cancer you may not need long-term care as long as if you were 54 and had a stroke. It is not wise to assume that if someone in your family needed long-term care for only two years that you would also only need long-term care for two years.

Statistics tell us that the majority of the long-term care is for less than 5 years. The disadvantage is not knowing if you are in the minority and would need it for more than 5 years!

Would you like specific information about the long-term care costs in your area? Contact us to get current information.