Understanding Long-Term Care for Older Adults
When older adults need help with medical, physical, or emotional needs over an extended
period of time, they need long-term care. Long-term care consists of different types
of services, depending on a person’s needs and abilities. It can include help with
any of the following.
Personal care tasks such as bathing, dressing, and eating
Household tasks such as cleaning, laundry, and food shopping
Physical therapy, speech therapy, and occupational therapy
Transportation to medical appointments or other services
Long-term care services can be provided in many different settings, from assisted-living
facilities to the 24-hour medical care of a nursing home. Some older adults are able
to stay in their own homes as long as they get help with certain services.
Paying for long-term care
Long-term care is a major expense. How you pay for it depends on your finances and
the type of services you need. Many people end up using a few different payment sources,
including their own income and savings, life insurance, long-term care insurance,
and government programs. Medicare is a federal insurance program for people age 65
and older. It pays for certain types of long-term care in certain care settings, but
there are rules and restrictions. Medicaid is a joint federal and state medical assistance
program for people and families with low incomes. What is covered and who qualifies
for Medicaid benefits varies from state to state, and often changes based on new legislation.
To learn more about resources in your area, visit Medicaid.gov or use the Eldercare Locator. Or see our related article Paying for Long-Term Care, Home Health Care, and Hospice
Types of long-term care settings
Here is a look at the different types of long-term care settings, and the types of
services that are provided there.
Home health care
Many older adults want to stay in their own homes as long as possible. But to do so,
they often need some type of in-home services and supports. These services can also
provide a helpful break for a family caregiver. In-home services can include help
with personal care, such as bathing and dressing. It can also include help with cooking,
laundry, and cleaning. Services such as nursing, speech therapy, occupational therapy,
and physical therapy can also be provided in someone’s home. An older adult may also
need senior transportation services to get to appointments or to the store.
Adult day centers
These centers provide a safe place to go during the day for older adults who live
in their own home or in a family member’s home. Depending on the person’s needs and
abilities, adult day centers provide meals, activities, therapy, and the chance to
socialize with others. They also have trained staff who can help with eating and going
to the bathroom. Transportation is often provided too. These centers can give family
caregivers some much-needed personal time or allow them time to go to work, while
knowing their loved one is getting supervised care.
Subsidized senior housing
This federal program helps older adults of low or moderate income pay for an apartment.
The income limit to qualify changes depending on where you live. Rent is often based
on a percentage of income. Some programs offer help with meals and daily tasks
Group homes (residential care facilities
This type of housing is for people who can’t live entirely on their own, but who don't
need the full care provided in a nursing home. Group homes, also called residential
care facilities, are smaller private centers. There may be 20 residents or less in
one home. People in a group home get help with personal care tasks such as eating,
bathing, dressing, and using the bathroom. The monthly charge may be a certain percentage
of a person’s income on a sliding scale. This charge covers the cost of rent, meals,
and other basic shared services.
This is a group living situation that offers help with personal care tasks and meals.
A person in assisted living often has their own private room or apartment in the facility.
Residents who are able to can take part in recreation and day trips. The cost varies
according to the services provided and what part of the country the facility is located
in. Generally, medical care is not provided. But services such as physical therapy
and occupational therapy may be arranged for, if needed.
Adult family homes (certified family homes)
An adult family home, or certified family home, is operated by a care provider who
is registered in their state to provide services in their home. They may also be called
community residential homes. They accept fewer residents than a group home or assisted
living—often only a couple of residents. The regulations vary by state. Adult family
homes may be a good option for people who want a smaller facility with a home-like
feel. The owners of the home live in the house and provide care.
Continuous care retirement communities (CCRCs)
These communities provide a mix of housing types, depending on someone’s needs. More
independent residents have their own home or apartment. People with greater care needs
may be in an assisted-living area or nursing home. Residents can move from one type
of housing to another in the community as they require more care. Many CCRCs ask for
a large entry fee before you move in.
These facilities can serve as permanent residences for people who are too frail or
ill to live at home, and who require constant care. Nursing homes offer round-the-clock
supervision, medical care, and rehabilitation.
To learn more
To learn more about long-term care, visit Long-Term Care: The Basics from the U.S. Department of Health and Human Services.