"Long-term care" refers to the type of personal care services you may need if you become unable to care for yourself in the event of a loss of functional capacity or cognitive impairment. It encompasses a broad range of assistance with daily activities that chronically disabled individuals may need for a prolonged period of time. These primarily low-tech services are designed to minimize, rehabilitate, or compensate for loss of independent physical or mental functioning. The services include assistance with basic activities of daily living (ADLs), such as bathing, dressing, eating, or other personal care.
Additional services may also help with instrumental activities of daily living (IADLs), which include household chores like meal preparation and cleaning. Life management chores such as shopping, money management, medication management and transportation are also available. These types of services also provide hands-on, stand-by or supervisory human assistance, assistive devices such as canes and walkers, technology such as computerized medication reminders and emergency alert systems that warn family members and others when an elder with a disability is potentially in danger. Home modifications like building ramps and the installation of grab bars and door handles that are easy to use, are also available.
Long-Term Care Services
Long-term care policies may pay for care in licensed facilities, licensed agencies and a wide variety of non-institutional long-term care settings, ranging from various types of congregate living arrangements, to recipients' own homes. Many policies cover skilled nursing care and personal assistance care in several residential care facilities. The nursing home––or nursing facility, as it is referred to by Medicare and Medicaid––is the major institutional setting for long-term care. In 1996, there were 16,706 certified nursing facilities in the United States with an estimated 1.8 million beds (AARP, 1998a). A small number of people are receiving care in other institutions, such as long-term care hospitals and psychiatric facilities. Many pay for daytime care in adult day care facilities. Some policies also offer other types of coverage, such as hospice care and respite care.
List of Long-term care services:
Nursing home services: Care provided in a licensed nursing facility.
Assisted living services: Care provided in a licensed assisted living facility.
Home health care services: Skilled care or personal assistance in a home. Home health care services must be provided by a licensed home health agency. Covered services may include part-time skilled nursing care, physical therapy, and assistance with activities of daily living (ADL).
Adult day care services: Care in a licensed adult day care facility. These programs provide daytime care to individuals who may not need to reside in a nursing home. Typical benefits include nursing or therapeutic care, social and educational activities, and personal supervision due to lack of "cognitive impairment," such as Alzheimer’s or a similar disease. Daily benefit amounts for home health care and adult day care are usually lower than that of a nursing home.
Respite care: The temporary relief for caregivers and families who care for those with disabilities, chronic or terminal illnesses, or the elderly.
Recovery period benefits: Care provided after a hospital stay.
Home assistance services: Assistance with chores like cleaning and shopping.
Training for family members.
Activities of Daily Living: These are activities considered essential to a normal lifestyle - bathing, continence, dressing, eating and mobility.
Cognitive impairment: A subtle, but measurable memory disorder and loss of intellectual capacity. May be caused by diseases such as Alzheimer’s, senility or accidents.
Long-term care insurance covers state-licensed nursing home health assistance in skilled, intermediate, and custodial facilities. Some long-term care insurance policy features may cover in-home services such as skilled or unskilled nursing assistance, physical therapy, homemakers, and home health aides provided by qualified agencies. Many long-term care insurance policies also cover assisted living or adult daycare for the caregiver.
Skilled long-term care is generally necessary for individuals with medical conditions that require assistance by skilled medical professionals such as registered nurses or professional therapists. The long-term care is usually ordered by a physician, provided 24 hours a day, and involves a treatment plan that is covered by a long-term care insurance policy.
Paying for Long-Term Care Services
The financing of long-term care services is a patchwork of funds that come from private dollars, federal, state, and local levels and the consumer's own pocket. In 1995, approximately $106.5 billion was spent on long-term care. The cost of a nursing home stay could range from $30,000 to more than $50,000 per year. Depending on the services needed and the costs in your area, average daily rates might range from $90 to more than $150 a day.
The cost of home care is even harder to estimate, due to the wide range of skilled and personal assistance services it offers. Skilled services such as nursing or physical therapy generally cost more than homemaker or personal care services. Home care services are normally less expensive than services in a nursing facility.
A significant amount of long-term care expenses are paid for by long-term care insurance, Medicare and individuals. Medicare is a federal program that pays for health care for people over age 65 and for people under age 65 with disabilities. It covers the cost of certain types of skilled care in approved nursing homes or residential homes.
