What is “Long-Term Health Care”?

Long-term health care, most commonly referred to as long-term care (LTC) is comprised of both medical and non-medical services provided to those who are unable to take care of themselves. Although LTC is most commonly used by the elderly, long term care may also be necessary for people of any age who are either chronically ill or disabled. Many have trouble dressing and bathing themselves, need assistance to use the bathroom or require help preparing regular meals. And with an aging population, LTC is becoming an increasingly important issue.

In 2006, the US Centers for Medicare and Medicaid Services estimated that 6 million Americans needed the assistance of LTC services. This number is expected to increase to 12 million by 2020. According to a study performed by the US Department of Health and Human Services, 40 percent of the population who reach 65 years of age will enter a nursing home at some point in their lives.

There is a wide range of both in-home and out-of-home care services, depending on your particular needs and your budget. They include the following:

Day programs – These offer meals, social interaction and activities outside the home for people who do not need 24-hour care. Some provide round-trip transportation to the care center in addition to minor medical services, such as checking blood pressure or helping with administering medications.
Senior housing – Rental apartments for seniors who do not need much medical care. These facilities may include meals, housekeeping, transportation and activities.
Home care – For help with personal needs at home such as bathing and dressing. Meal preparation, housekeeping and shopping are also sometimes done. Basic medical care can be provided by home health nurses.
Assisted living – Housing facilities for those with disabilities who are not able to live independently, but who do not require 24-hour care. They receive assistance with daily living activities, and some facilities have additional amenities such as on-site beauty shops.
Continuing-care retirement community – Features several care levels in one setting, allowing residents to move from one level to another as their needs change. This includes senior housing for the relatively healthy, assisted living for those who have difficulty with daily activities, and 24-hour nursing care for those who cannot be independent.
Nursing homes – Round-the-clock nursing care for those unable to care for themselves and end-of-life care. Residents receive help eating, dressing, bathing and going to the toilet, as well as basic medical care and physical rehabilitation.

The cost of LTC is not insignificant, and many people are under the mistaken impression that Medicare will pay their LTC costs. In fact, Medicare only pays for short-term skilled services or rehabilitative care that is medically necessary. It does not pay for care in the long-term or for help with activities of daily living, which is what the majority of people actually need. To pay for this, you will likely need a private payment plan such as a reverse mortgage or special long-term care insurance. However, this is not something that can be arranged for at the last minute, so the ability to pay for LTC does require advance planning.