Long term care is a variety of services that includes medical and non medical care to seniors or to people who have a chronic illness, disability or memory problem (i.e. Alzheimer’s disease).
Long term care is made up of many different services that helps meet health or personal needs, including help with daily living activities like dressing, bathing, eating, using the bathroom, also called “custodial care”; as well as other undertakings most people do themselves, like taking medications.
Long term care can take place at home, in senior centers, community centers, in special retirement or assisted living facilities, or in nursing homes.
Choosing long term care is an important decision and should be planned ahead of time or before the need arises. It is also important to talk about long term care planning with your family and the kind of care services you think you might need someday. Some financial questions to keep in mind are how much the services would cost and how you would pay for them.
By planning way ahead of time, you will not be rushed into a bad decision and will have the luxury of choosing the best care possible that suits your needs.
Important Things To Consider When Choosing Long Term Care
Long term care service is not only classified as nursing home care. There are many different kinds of long term care. It can take place at home, in senior centers, at community centers, in assisted living or special retirement communities.
The chart below lists some of the kinds of custodial care people often need, like help with daily living activities or care most people do themselves. Some may need help with only one or two of the services listed, like help with eating or bathing. On the other hand, some may need more assistance and care needs, like diabetes monitoring or help with oxygen for those with breathing problems.
Your needs may change overtime so it is important to make a list of the kinds of services you need and revise this list as your needs change. Try to consider whether you or your loved one needs these services now or if you may need them in the future. Check off the services you think you may need.
Will I need help with the following activities of daily living?
___ Using the bathroom, including caring for a catheter or colostomy bag if needed.
___ Moving into or out of a bed, chair, or wheelchair.
___ Preparing meals
___ Housework and laundry
___ Getting to appointments
___ Paying bills and other money matters
___ Home maintenance and repairs
___ Using the telephone
___ Others: ________________________
Will I need help with the following care?
___ Remembering to take medicines
___ Diabetes monitoring
___ Using eye drops
___ Getting oxygen
___ Taking care of colostomy or bladder catheters
___ Others: _______________________
Step 2: Research Financing and Care Choices
There are many types of long term care choices for seniors and a variety of ways to pay for them. It is important to plan ahead, research your long term care choices and determine how you will fund the care you may need.
Learn What Long Term Care Choices are Available in Your Area:
- Talk to your doctor or someone in your doctor’s office. Ask what long term care choices and services are available to help meet your needs, now and in the future.
- Look at the Home Health Compare and Nursing Home Compare databases to locate information about agencies and facilities that are in your area. In some areas, especially rural areas, there may be only one or two kinds of long term care choices. Most areas, however, have more options.
- Visit or call your local social service agency or hospital. Ask to speak to a social worker or care manager who can help you with locating and coordinating different kinds of long term care choices and services.
- Call your Area Agency on Aging or you can also use our Eldercare Locator here. Area Agencies on Aging are local level organizations that coordinate a comprehensive range of services to promote the independence and dignity of Seniors. Seniors and their caregivers can contact their local Area Agency on Aging to receive help in accessing services in their community that include in home supportive services, nutrition services, transportation, elder rights and protection assistance, and caregiver support services.
- Talk with your family and others you trust about your personal and health care needs. Ask them to help you learn about long term care choices and services where you live or where you want to retire.
Talk to your financial advisor about the costs of your current and future long term care needs. Ask what long term care financing options are available to help you pay for your long term care needs.
Options to Fund for Your Long Term Care Need:
Medicare and Long Term Care
Generally, Medicare does not pay for long term care and only pays for medically necessary, skilled nursing facilities or home health care. However, you must meet certain conditions for Medicare to pay for these types of care. Also keep in mind that Medicare does not pay for “custodial care (non skilled care) or activities of daily living.”
Some Medicare Advantage Plans (formerly Medicare + Choice) may offer limited skilled nursing facility and home care (skilled care) coverage if the care is “medically necessary.“ Remember that you may still have to pay some of the out of pocket costs.
Medicaid is a State and Federal Government program that pays for certain health services and nursing home care for older people with low incomes and limited assets. In most states, Medicaid also pays for some long term care services at home and in the community. Who is eligible and what services are covered vary from state to state. However, most often with Medicaid, eligibility is based on your income and personal resources.
Step 3: Find What Is Right For You
Quality care means doing the right thing at the right time, the right way for the right person and producing the best possible results. The Medicare program regulates and enforces rules to ensure that nursing homes, home health agencies, and hospitals comply with federal standards for patient health and safety and quality of care. However, the quality of long term care programs, services, and facilities may vary.
How Long Term Care Programs and Services in Your Area Rate in Quality:
- Ask friends and other people you know who use different kinds of long term care services, if they are happy with the services they get.
- Call your State or local Long Term Care Ombudsman. Ombudsmen visit nursing homes and other long term care facilities regularly to visit residents and take care of complaints. Your local area Ombudsman can also give you information on the most recent State inspection survey for long term care facilities in your area
- Look at the Nursing Home Compare and Home Health Compare. You can also find out if a Continuing Care Retirement Community is accredited from the Commission on Accreditation of Rehabilitation Facilities website.
- Call your State Health Department. Ask if you can get information on the quality of nursing homes and other long term care facilities and services in your area. You can get the telephone number of your State health department by looking in the blue pages of your local telephone book.
Step 4: Visit Your Available Options
Before you make a final decision about long term care, call and ask for information about the program or facility. Visit the places you are interested in. Make an appointment to talk to the program coordinator or care supervisor before you visit.
Tips to help you get ready:
- Talk with your doctor or other health care provider and with your family about what long term care services you need now or may need in the future.
- Go over any information you have already received.
- Write down any questions you still have about how the facility or program will meet your needs.
When you visit, look around carefully. Ask questions about anything you don’t understand. Talk to staff, residents, and family members if you can. Ask them if they are satisfied with the facility or program and its services.
After your visit, ask yourself the following questions:
___ Did they listen to me and make me feel comfortable?
___ Did I get to ask all my questions?
___ Did they give me answers I understood?
___ Are the program staffs respectful and helpful?
___ Does the facility or program meet my needs?
___ Does the facility offer activity programs that I enjoy?
___ Is the facility/setting clean and pleasant?
___What are the facility/program fees?
___Can I afford them?
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