When most people think of long-term care, they think of nursing homes. But long-term care goes far beyond nursing home care. Long-term care is a variety of services that can range from assistance in performing the basic activities of daily living at home (such as bathing, dressing, and eating) to highly skilled nursing home care. Planning for long-term care in advance is important to ensuring your loved ones know your wishes.
Long-Term Care Options
There are many long term care options, depending on the type of care needed.
In-home care may include:
- Personal care assistants who help with household tasks, such as cooking, cleaning, and running errands.
- A home health aide who helps with activities of daily living, including bathing, eating, dressing, toileting, and transferring. Transferring means moving into or out of a bed, chair, or wheelchair.
- Visiting nurses or therapists who may provide skilled care at home for many medical conditions.
Out-of-Home care may include:
- Adult day care centers that provide many social and therapeutic activities during the day.
- Assisted living facility care, where residents can maintain their independence while getting on-site help and support for activities of daily living.
- A nursing home, which provides more advanced levels of skilled care.
- Hospice care provides care at home or in a hospice facility for people nearing the end of life. The goal of hospice care is to make a terminally ill person as comfortable as possible by managing pain and dealing with physical, mental, social, and spiritual needs.
Who Needs Long-Term Care?
There are a number of factors that affect the possibility that long-term care will be needed:
- As we age, our chances of needing long-term care increase.
- Women outlive men by an average of five years. This means women are more likely to live at home alone when they are older, and living alone increases the likelihood that long-term care services will be needed.
- Having an accident or chronic illness may result in the need for long-term care services.
- Chronic conditions, such as diabetes and high blood pressure, may increase the chances of needing long-term care services.
The Cost of Long-Term Care
Long-term care can be some of the most expensive care you will ever need. How much it costs depends largely on where you live. According to Genworth’s 2015 Cost of Care Survey, the annual nursing home costs a median $87,600 for a private room; however, the cost varies by state. Similarly, the national median hourly rate for a home health aide is $20 – or $45,000 per year.
If you’re age 65 or older, Medicare generally pays for routine medical issues, such as doctor visits and appointments, inpatient hospital procedures, and some short-term home health care services. But Medicare does not cover most long-term care needs, such as an extended stay in a nursing home facility. Medicare will pay for some expenses, non-custodial only, for up to 100 days. And Medicaid will typically help only after you have depleted your savings.
Without a plan, families may need to spend their hard-earned savings on a loved one’s care.
Paying for Long-Term Care
In general, there are four ways to pay for long-term care services. A combination of these options may help cover the costs of any long-term care services:
- Your income may be enough to cover long-term care expenses. Or you may use money that you had set aside for retirement expenses.
- Family and friends may be able to help.
- Medicare and Medicaid may contribute toward long-term care expenses. However, there are limitations and requirements to be aware of.
- Long-term care insurance may be an option. There are some life insurance and annuity plans that combine long-term care protection.
Having a plan helps ensure you get the kind of care you need. It will also help to reduce the burden placed on family and friends who have offered to help, and protect your assets from the cost of care.
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