Information on Long-Term Care

What is long-term care?

Long-term care is what people need when they are unable to care for themselves because of prolonged illness, disability or frailty. It can be as simple as in-home help with daily activities such as dressing or bathing, or as specialized as skilled medical attention received in a nursing home.

What long-term care options are available?

Nursing Facilities

Today's nursing facilities are designed to care for the young and old alike, both those who expect to recover fully as well as those in need of extended long-term care services. The goal of care in a nursing facility is to help individuals meet their daily physical, social, medical, and psychological needs and to return home whenever possible. Nursing facilities provide skilled, 24-hour nursing care services. While not always the case, today's typical nursing home patient is very sick, requiring 24 hour supervision and assistance with 4 of 5 "activities of daily living," including bathing, dressing, transferring, toileting and eating. Many nursing facilities serve special populations, such as patients with Alzheimer's disease, AIDS, or others requiring specialized services.

Assisted Living

Assisted Living is one of the fastest growing segments of long-term care and is a long-term care alternative for seniors who need more assistance than is available in a retirement community, but who do not require the heavy medical care and attention provided in a nursing facility. The philosophy of assisted living is to provide maximum independence in a home-like setting, with individualized care and assistance when needed. Assisted living services can be provided in freestanding residences, near or integrated with skilled nursing homes or hospitals, as components of continuing care retirement communities, or at independent housing complexes.

Home Health Care

Home health care includes the provision of periodic nursing assistance in the home. An example would be a nurse or nurse aide visiting the home on a regular basis to assist an older person, to check blood pressure, assist in bathing, or to administer prescribed medication. Some services may be reimbursable by Medicare or Medicaid.

Adult Foster Care

Adult Foster Care is a comprehensive, residential service. Individuals who receive this service reside in a home with an unrelated primary caregiver and family, as well as up to two other consumers of this service. Adult Foster Care Services may include, but are not limited to, the following: personal care, homemaker, attendant care, companionship, medication oversight, and transportation. The services are provided in a home-like environment that includes, but is not limited to, a private bedroom, semi-private bathroom, home-cooked meals, a common living area, and assistance with activities of daily living.

Adult Day Services

Adult Day Services is a comprehensive, non-residential service. Individuals receive this service in a structured community setting, which provides a variety of health, social, recreational and therapeutic activities, supervision, support services, and in some cases, personal care. The individual receives Adult Day Services in a congregate, protective setting, allowing him or her to continue to reside with family or other caregiver. This service allows participants to continue to live in their communities and allows caregivers the ability to maintain routine activities and responsibilities while assured that their loved ones' needs are being met in a safe and familiar setting.

What are the chances I'll need long-term care?

Your likelihood of needing long-term care increases as you get older, if you live alone, and if you're a woman. Your family and individual medical history also play a major role in determining whether or not you will need longterm care. General population statistics are very informative. For instance, one-half of all women and one-third of all men reaching age 65 will enter a nursing home at some point in their lives. Even more will require some kind of in-home care or assistance. Of those entering a nursing home, the average length of stay is 2.6 years. Older persons aren't the only ones needing long-term care. More than 40% of Americans receiving long-term care are between the ages of 18 and 64. No one really knows at what age he or she may experience a paralyzing accident, suffer a stroke, or be diagnosed with Parkinson's or Alzheimer's disease or some other debilitating condition.

Some factors to consider:

Age and Gender

The need for long-term care increases as you get older. If family members have lived to ages over 85, there is a good chance you may live as long or longer. Living longer increases your chances for needing long-term care. If family members have lived to younger ages than 85, advances in medical technology may allow you to live to be over age 85. Women tend to live longer than men. They are therefore more likely to develop a disabling chronic condition and/or to live alone, which increases their likelihood of needing long-term care at some point in their lives.

Living Arrangements

For elderly persons living alone, with few friends or family members living close by who could provide assistance, chances of needing nursing home care at some point in their lives are increased. If home health care is considered as an option, the person will usually need someone at their home or nearby,to help them when the home health care aides or nurses are not available.

Health History

The need for long-term care usually results from a disabling chronic condition (such as diabetes, arthritis, heart condition, stroke, emphysema or other respiratory problems, Alzheimer's or cancer). These conditions may be related to your family history or to health risk factors you may have (smoking, overweight, high blood pressure). If you currently have a serious chronic health condition, insurance companies may not insure you.

Personal Preferences

Your feelings and preferences are important to consider, in determining whether to purchase long-term care insurance. How do you feel about your adult children or others providing fi nancial support for you? What is your attitude about receiving Medicaid, should you need it? How important is it to leave an estate to your children or others? Is there a specifi c nursing home you would like to use should you need long-term care?

How much does long-term care cost?

Long-term care can be expensive. The average cost of nursing home care in Indiana is more than $44,000 a year (as of 2002). In-home care can be costly too, with the annual price of three nursing visits a week costing over $15,000. Plus, the cost of long-term care has been rising 4% to 5% each year. For instance, at a 5% annual growth rate, the average daily cost of nursing home care would rise from $121 in 2002 to $295 in 2020.