Long-Term Care Choices

Overview

As you age, you may have concerns about how to manage health problems. Most people would like to stay in their homes with help from someone they know, like a family member or friend.

But this isn't always possible. For many reasons, people may not have a family member or friend who can provide care.

This is where long-term care can help. It can give you a safe and structured environment.

Long-term care:

• Can be at home, in the community, or in a residence (such as a nursing home).
• Offers a range of services and supports.
• Can provide medical or nonmedical help.
• Meets personal needs, such as dressing, bathing, grooming, and help using the bathroom.
• Can help with everyday tasks, such as housework, making meals, and shopping.

Why might you consider long-term care?

You may consider long-term care when a health condition makes meeting health and personal needs hard to do on your own. For example, you may need long-term care because of:

• Stroke.
• Dementia, such as Alzheimer's disease.
• Head injuries.
• Broken bones or problems after joint replacement surgeries.
• Frailty.

You may also consider long-term care when you are planning your future or when you have concerns about your future health or your ability to live on your own.

What are the types of long-term care?

There are several types of long-term care. Each provides different levels of care, assistance, and services. The quality and costs of care and services vary widely. Your community may not have all of these options.

Community-based services

Community-based services can help you remain independent. These include meals at home, transportation, housework, help with shopping, and adult day care. These services are generally coordinated by a local organization.

Specific services may include help with using the bathroom, taking medicines, and checking blood pressure and weight. They may offer care for dementia.

Assisted-living and residential care facilities

Assisted-living and residential care facilities offer a range of services. These services may include meals and cleaning and laundry services. And they may help with personal needs, such as bathing, grooming, and dressing.

Some of these facilities may have a nurse on staff. You may be able to have help with things like getting medicines, checking glucose levels, and checking blood pressure.

Assisted-living facilities sometimes provide private, apartment-style housing. In residential care, rooms may be private or shared. Residential care provides a greater level of supervision than assisted living. Examples of residential care include board-and-care homes, retirement homes, and foster-care homes.

These types of housing may work well if you need daily help and supervision but you don't need daily nursing care.

Nursing homes

A nursing home provides care up to 24 hours a day and offers medical care and medicines. They provide meals and laundry and help with dressing, bathing, and using the toilet. It may be the best choice if you have a lot of trouble with daily tasks and need ongoing medical care. Some nursing homes have a skilled nursing facility (SNF). This facility provides a higher level of care to people who may need additional care for a short period of time.

Special care units

Special care units (SCUs) are offered at some residential care centers and skilled nursing facilities. They focus on memory care needs, like dementia. If you have dementia, they have staff trained to work with you. There are also facilities that will only accept you if you need memory care.

Continuing-care communities

Continuing-care communities offer several levels of care. They offer assisted living up to full nursing care in the same center. They may be a good choice because they can meet your changing needs.

Home health care

Home health care may include physical and speech therapy and nursing care. Nursing care may include getting shots, using a feeding tube, and changing dressings. Home health aides may help with bathing.

Someone like a family member or friend could also provide some types of home care. They can help with such things as bathing, dressing, and cooking. Some home health care can only be given by health professionals.

How can you decide about long-term care?

Choosing the right type of long-term care is a very personal process. It's important to look carefully at your options. You want to be sure that the level of care is right and that you will feel comfortable.

To get started, work with your doctor, social worker, hospital discharge planner, or geriatric care manager to help find which type of long-term care would be best. Then see which types of care are available in your community.

Make a list of the places that interest you, and visit them. A visit is the best way to see if the facility, the residents, and the staff feel right to you. It may be helpful to keep written notes about each one. You may want to visit each one more than once and bring along a family member or friend, if possible.

Talk things over with someone you trust, like your doctor or a family member. Did the facility feel right to you? Were you comfortable with the people there? Do you feel it will give you the right care? Does it fit within your budget? How much of the cost, if any, may be covered by insurance?