-Most long-term care is provided at home by unpaid family members and friends.
-Care can also be provided by paid caregivers, usually at home, but also in a facility such as a nursing home.
-People often need long-term care when they have a serious, ongoing health condition or disability. The need for long-term care can arise suddenly, such as after a heart attack or stroke.
-Most LTC needs arise gradually from growing health problems and frailty
2. Long term-Long-term care can be ongoing, as with someone who is severely disabled from a stroke or who has Alzheimer’s disease. Many people can remain at home if they have help from family and friends or paid services. But some people move permanently to a nursing home or other type of facility if their needs can no longer be met at home.
-More than 40 percent need care in a nursing home for some period of time.
2. Gender-Women are at more risk than men, primarily because they live longer
3. Marital status — Single people are more likely than married people to need care from a paid provider.
4. Lifestyle — Poor diet and exercise habits can increase a person’s risk.
5. Health and family history — These factors also affect risk.
2. Services from paid caregivers
■home health care
■friendly visitor/companion services
■emergency response systems.
2.Most home-based services involve personal care, such as help with bathing, dressing, and taking medications, and supervision to make sure a person is safe. Unpaid family members, partners, friends, and neighbors provide most of this type of care.
3. Can also be provided by paid caregivers-informal care givers and health care professionals
-home health care
-friendly visitor/companion services
-emergency response systems
Like home-based services, community-based long-term care services help people — old and young — stay at home and live as independently as possible. These services can be given at home or at a location in the community. Some programs are limited to people with disabilities or low-income people, but many are open to all. Community-based services are often provided by a local government, social service agency, or private company.
1. adult day service programs
2. senior centers
3. transportation services
4. meals programs
5. respite care.
How to find these programs?
geriatric care managers are professionals, usually nurses or social workers, who help people with their long-term care needs. They can assess a person’s needs, develop a plan of care, and identify and coordinate whatever services are needed.
Some facilities have only housing and housekeeping, but many also provide personal care and medical services. Many facilities offer special programs for people with Alzheimer’s disease and other types of dementia.
2. board and care homes
3. assisted living facilities
4. nursing homes
5. continuing care retirement communities.
Assisted living residents usually live in their own apartments or rooms and share common areas. They have access to many services, including up to three meals a day; assistance with personal care; help with medications, housekeeping, and laundry; 24-hour supervision, security, and onsite staff; and social and recreational activities. Exact arrangements vary from state to state.
Some people stay at a nursing home for a short time after being in the hospital. After they recover, they go home. However, most nursing home residents live there permanently because they have ongoing physical or mental conditions that require constant care and supervision.
In a CCRC, where you live depends on the level of service you need. People who can no longer live independently move to the assisted living facility or sometimes receive home care in their independent living unit. If necessary, they can enter the CCRC’s nursing home.
1. personal funds
2. government health insurance programs, such as Medicare and Medicaid
3. private financing options, such as long-term care insurance.
Much home-based care is paid for using personal funds (“out of pocket”). Initially, family and friends often provide personal care and other services, such as transportation, for free. But as a person’s needs increase, paid services may be needed.
Professional care given in assisted living facilities and continuing care retirement communities is almost always paid for out of pocket, though in some states Medicaid may pay some costs for people who meet financial and health requirements.
Medicare coverage is limited-Contrary to what many people think, Medicare does not cover most long-term care costs. It does pay for some part-time services for people who are homebound and for short-term skilled nursing care, but it does not cover ongoing personal care at home, like help with bathing. It may cover part of the first 100 days in a nursing home.
Medigap” policies, which supplement Medicare, are not designed to meet long-term care needs. But some policies cover co-payments for nursing home stays that qualify for Medicare coverage.
Medicaid pays for health care services for people with limited income, and it is an important source of payment for long-term care services. Personal care, home health care, adult day care, and nursing home care are examples of the types of Medicaid-covered services used by older adults. However, Medicaid is not available for everyone. To be eligible, you must meet certain financial and health requirements. People with financial resources above a certain limit will most likely not qualify unless they first use up their own resources to pay for care, which is called “spending down.” Who is eligible and what services are covered vary from state to state.
Services under the Older Americans Act are provided by state and local agencies and other organizations. They include in-home personal care and homemaker services for frail older adults, meals in the community and for homebound elderly, local transportation services, respite care, and services for older Native Americans.
You do not have to have a certain income to use these programs, but they are targeted at low-income, frail, or disabled seniors over age 60; minority older adults; and older adults living in rural areas.
1. long-term care insurance
2. reverse mortgages
3. certain life insurance policies.
Buying long-term care insurance can be a good choice for younger, relatively healthy people at low risk of needing long-term care. Costs go up for people who are older, have health problems, or want more benefits.
There are no income or medical requirements to get a reverse mortgage. The loan amount is tax-free and can be used for any expense, including long-term care. If long-term care costs are higher than the amount you borrow, selling your home is not required, but doing so may provide enough funds to repay the loan.
You can get an accelerated death benefit if you live permanently in a nursing home, need long-term care for an extended time, are terminally ill, or have a life-threatening diagnosis such as AIDS. Check your life insurance policy to see exactly what it covers.
You may be able to raise cash by selling your life insurance policy for its current value. This option, known as a “life settlement,” is usually available only to people age 70 and older. The proceeds are taxable and can be used for any reason, including paying for long-term care.
A similar arrangement, called a “viatical settlement,” allows a terminally ill person to sell his or her life insurance policy to an insurance company. This option is typically used by people who are expected to live 2 years or less. A viatical settlement provides immediate cash, but it can be hard to get.