What is Long-Term Care?

Long term care (LTC) includes a range of services for people who have functional limitations or chronic health problems.  Many people need assistance in doing things that a vast majority of us take for granted.  When was the last time you needed help eating, dressing, bathing, walking, getting out of a bed, and using the toilet?  For many people doing this simple task requires assistance.  Some people with a long physical illness, a disability, or cognitive impairment (such as Alzheimer’s disease) needs long term care. 

Long term care (LTC) services may include home health care, adult day care, respite care,  nursing home care, assisted living care or help when it comes to performing the activities of daily living.  A person’s age is not a prerequisite to requiring long term care.  An auto accident can cause a disabling condition to a 26-year-old man.  Christopher Reeve (of superman fame) was paralyzed due to a fall from a horse.  People in their 50’s are victims of Alzheimer’s.  The need for LTC can strike any of us at any time. 

Long-Term Care is offered in a variety of settings, of which three  are prevalent:

At home care.  Most home care is provided by a “caregiver”, which is usually a wife, husband, family member, friend or home health care agency representative.  As the needs of the LTC recipient increase for their day-to-day existence, the caregiver will give more and more of themselves in order to provide assistance to the person needing long term care.  Many times,  home health agencies will be used to provide nursing, skilled care, attendant care, and hospice services.  Home care is often the first option that people choose for their LTC needs.  This is due to their wish to remain in their own homes.

When home health agencies are used, the cost for home care in most cases is less than nursing home care. The cost for  8 to 10 hours of care per day can be as costly as a full day’s stay in a nursing home.

Assisted living facilities.  Assisted living provides independent seniors with assistance, supervision and limited health care services.  Assisted living is a popular form of LTC because the setting is more like a home setting and costs less than a skilled nursing facility.

These facilities provide less nursing and other medical services than a skilled nursing facility and are geared for long-term residents’ impairments or illnesses, but whose overall condition is not as crucial as residents of a skilled nursing facility are.

Assisted living provides a setting that resembles independent living.  Assisted living facilities make it possible for spouses to remain together, whereas nursing homes usually do not.

Nursing Facilities.  One of the major differences between hospitals and nursing homes is that hospitals are not meant to be permanent residences but are to be used for a short time until the patient can be sent home or maintained elsewhere.  There are skilled and intermediate care facilities.

Skilled nursing facilities provide a relatively high degree of nursing care and assistance.  These patients are typically in need of close monitoring due to illness or impairments.  Licensed nursing is available around the clock with at least one supervising registered nurse on duty at all times.  Additionally, most other prescribed medical services can be provided.  Depending on the seriousness of the illness, a stay in a skilled nursing facility can be for a short term or extended to a long-term stay.

Intermediate or custodial care facilities provide less nursing and other medical services than skilled nursing facilities.  These facilities are geared for long term residents with chronic illness or impairments but whose conditions are not as acute as those who would stay in a skilled nursing facility.  Staffs are arranged toward personal care and assistance.  LTC patients who require custodial care such as help with eating, dressing, walking, using the toilet, moving in and out of a bed or chair, dressing, etc. -- the things that we all take for granted.