What is Long-Term Care and Who Provides It?
Entrusted Legacy Law
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Mar 31, 2023
Pennsylvania - Greater Pittsburgh Area
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Long-term care is the care you need if you can’t perform
daily activities on your own for an extended period of time. There are a number
of different ways that long-term care can be provided.
Most long-term care involves assisting with basic personal
needs rather than providing medical care. You are usually determined to need
long-term care if you need help with two or more “activities of daily living”
(such as bathing, dressing, eating, and going to the bathroom). Family
members usually provide long-term care to start, but as an illness escalates
paid care may become necessary.
The following are the types of long-term care:
- Home
care from family member. The most basic form of long-term care is when
a family member becomes the caregiver. It can involve simple tasks like
buying groceries or more complicated ones like bathing and dressing.
Sometimes family members can be paid for their work.
- Home
care aide. Home care aides provide companionship and socialization and
assist with meal preparation, housecleaning, laundry, shopping, and
errands. They are also called homemaker or chore aides.
- Home
health care aide. Health care aides provide personal care (bathing,
grooming, etc.), assist with range-of-motion exercises, provide some
medically-related care (empty colostomy bags, dress dry wounds, check
blood pressure, etc.), and provide assistance with housekeeping and
errands. They are often referred to as personal care assistants
- Adult
day care. Adult day care allows family members to get a respite from
caregiving. In general, there are three types of centers: those that focus
on social interaction, those that focus on health care, and special
Alzheimer's care centers.
- Assisted
living facility. Assisted living facilities are a housing option for
people who can still live independently but who need some assistance.
Depending on the facility, that assistance may include help with meal
preparation, housekeeping, medication management, bathing, dressing,
transportation and some nursing care. Residents usually live on their own,
in small apartments. Despite the emphasis on independence, supportive
services are available 24 hours a day in order to provide different levels
of help with activities of daily living. The level of medical supervision
depends on the facility.
- Nursing
home. Nursing homes are the highest level of long-term care. They
provide 24-hour care to residents. Staff provide help with daily
activities such as feeding, dressing, and bathing along with medical care
and physical, occupational, and speech therapy.
Costs for care can vary widely, from a few hundred dollars a
week to pay for coverage when family members are at work to $300,000 or more a
year for around-the-clock home care or care in the most expensive nursing
homes, perhaps with private aides hired on the side.
Long-term care costs, whether at home, in assisted living or in a nursing home, are paid primarily from three sources: out-of-pocket, Medicaid, and long-term care insurance. Medicare, the health insurance for people over age 65, only pays for up to 100 days of skilled nursing facility care following a hospitalization, and only for so long as the patient is deemed to need skilled care. It will also pay for skilled care at home -- in theory indefinitely, but this may take some advocacy.
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