Updated August 18, 2013.

What Is Long-Term Care?

Long term care is a type of service or support to help you meet your health or personal care needs over an extended period of time and to help you be as independent as possible. You may need long-term care if you have a chronic illness or had a serious injury that prevents you from taking care of yourself over a long period of time.

Most long-term care services are provided by personal care assistants to help you with activities of daily living, such as:

• eating
• bathing
• dressing
• using the toilet
• getting out of bed or a chair
• caring for incontinence

Who Needs Long-Term Care?

According to the U.S. Administration on Aging, at least 70% of people over age 65 will require some long-term care services at some point in their lives. The older you are, the more likely it is that you will need long-term care. For example, a growing problem among the elderly is a cognitive impairment (memory loss, confusion, or disorientation) that can result from Alzheimer’s disease.

Although Americans age 65 and older use the most long-term care services, a young or middle-aged person who has been in an accident or suffers from debilitating illness might also need long-term care.

You may never need long-term care, but you should be aware of the following facts from the federal government:

• 40% of people who are currently receiving long-term care are between the ages of 18 and 64.
• People age 65 have at least a 40% risk of entering a nursing home during their lifetime.
• More than 50% of people age 85 or older have an impairment that requires long-term care.

Where Is Long-Term Care Provided?

There are many options for long-term care depending on your health care needs, support from your family or other personal caretakers, and available services in your community. Some examples of the more common types of long-term care providers and services include:

Nursing Homes
Nursing homes, also known as Skilled Nursing Facilities (SNFs), provide residents with skilled nursing care 24 hours a day, along with assistance with Activities of Daily Living, and rehabilitation services such as physical and occupational therapy.

Some people need the services of a nursing home for a short period of time for recovery or rehabilitation after a serious illness or operation (such as a knee or hip replacement), while others need to stay for a longer period of time because of a chronic health or cognitive condition (such as Alzheimer’s disease) that requires constant supervision.

Adult Day Care Programs
Located in many communities, adult day care centers provide daytime supervision for adults with mental and physical problems who need supervision while their family or other personal caretakers are at work or otherwise not available. These programs offer a range of health-related services along with social support in a protective and supervised environment.

Adult day care centers are usually available during regular business hours. Although some adult day care programs have evening and weekend hours, they do not provide 24-hour care.

Home Health Care, Home Care, and Homemaker Services
These services, all provided in your home, differ in the level of skill required to meet your needs:

• Home health care usually is a short-term service such as nursing, physical or another therapy ordered by your doctor for a specific condition – such as rehabilitation following a hip replacement.
• Home care services typically include assistance with Activities of Daily Living.
• Homemaker services are to help you with general household activities such as cooking, cleaning, laundry, and shoveling snow.

Assisted Living Facilities
An assisted living facility is for people who need some health-related support services and want to live in a community setting. Most assisted living facilities offer residents an apartment or private room along with social and recreational programs, a communal dining room, and onsite staff for security and emergencies. Health-related services may include assistance with activities of daily living and help with medications.

What Is the Cost of Long-Term Care?

Long-term care is very expensive. How much you pay for long-term care support varies greatly depending on the level of care you need, how long you need care, who provides the care, and where you live.

For example, the average cost for one year of care in a nursing home in 2009 was more than $66,000 for a semi-private room. However, if you live in Iowa that semi-private room would cost you $45,900 each year, while in Massachusetts you would pay almost $102,000!

An assisted living facility that includes rent, food and some “hands-on” assistance with activities of daily living has an average cost of more than $2,800 per month. This figure is based on the cost of a private one bedroom unit in 2009. Again, these costs vary from state to state.

For example, in Missouri the monthly cost for an assisted living facility is $1,775, while in Maryland the cost would be $3,250 each month.

Home care is a less expensive option, but can still add up based on how many hours of assistance you need each week. At an average cost between $20 and $45 per hour, six hours of care each week could cost you from $480 each month to more than $1000 each month. And, this amount can go up quickly with more hours and additional services.

How Will I Pay for Long-Term Care?

If you have enough income and resources, it is likely that you will have to pay for your long-term care needs on your own. How you pay for these services depends on what type of assistance you need and if you have had the foresight to purchase long-term care insurance.

If your long-term care needs are related to recuperation from an illness, injury, or following major surgery, Medicare and your Medigap policy may cover all or part of the costs. And, if you have used up your resources, you may be eligible for long-term care assistance from Medicaid.

A tip from Dr. Mike: The time to plan for long-term care insurance is now—before you need it! According to a study conducted by AARP, almost 30% of “baby boomer” women said they were assuming that Medicare would take care of their long-term care needs. However, Medicare does not cover most long-term care services.