Long-Term Care Explained
With advancements in medicine, many of us are living longer. However, as we progress in age, many of us may experience health issues that may lead to a long-term care event.
A long-term care event starts when a licensed health practitioner has certified you as “chronically ill.” This can mean two things:
- you’re unable to do at least two activities of daily living (ADL’s) without the help of a personal caregiver or
- you need to be supervised to protect your health and safety because you have a cognitive impairment such as Alzheimer’s or Dementia.
Activities of daily living are considered eating, bathing, dressing, toileting, transferring (in and out of bed), and continence.
A person’s inability to do “ADL’s” is normally due to a loss of functional capacity. A loss of functional capacity can be caused by health issues that occur in the later stages of life.
Now long-term care services are typically provided by two types of individuals:
- A non-licensed personal caregiver such as a family member or relative
- A licensed professional such as a home health care worker or a nurse.
While medical care focuses on remedying your medical condition(s), long-term care services focuses on helping you live your daily life just the way you are.
Now consider this, approximately 70% of people turning age 65 can expect to receive some form of long-term care during their lives. This is according to the U.S. Dept. of Health and Human Services.
That’s why having an understanding of a long-term care event and its impact is so important. Long-term care events are too common in today’s day and age not to be fully informed.
As we continue, we are going to look at the different ways long-term care services are offered and why planning for a long-term care event is so important.
5 Places You Can Receive Long-Term Care Services
Now where do you think of when you hear the words “long-term care?” Often times people think of a nursing home. However, long-term care services are provided in a number of settings or facilities.
Here is a list of settings where long-term care services are offered:
|Examples of Long-term Care Settings:|
|Adult Day Care Facilities|
Assisted Living Facilities
Hospice Care Facilities
Adult Day Care Facilities
According to the U.S. Administration on Aging, adult day care facilities offer care and companionship for elderly adults. In addition, they provide supervision and assistance during the day. They are not intended for older adults who need around the clock care.
Adult day care facilities are generally community-based centers. Therefore, they are often referred to as “adult day care centers.” Typically, several services are offered at the centers including:
- personal care
- providing hot meals and snacks
- performing physical or occupational therapy
- social activities
- & providing transportation
The centers provide a wide range of well-balanced services. For example, the therapeutic services offered at the center involve exercise and mental interactions.
Staff members at the facility may also manage or monitor medication for the seniors. In addition, they also provide personal care by helping with activities of daily living such as toileting and eating.
Adult day care centers can also be a great source of respite care. They provide helpful relief to family caregivers. This allows family caregivers to go to work, handle personal business, or just relax from the demanding responsibilities of caregiving.
The goal of adult day care centers are to delay or prevent institutionalization.
This is done by providing alternative care, working to enhance seniors’ self-esteem, and by encouraging socialization. Some adult day care centers even focus on individuals with cognitive impairments such as Dementia.
Assisted Living Facilities
Assisted living facilities provide older adults personal care in a residential setting. They offer help with activities of daily living such as bathing, eating, and dressing.
Assisted living facilities are an alternative for seniors who don’t need the in-depth skilled nursing care associated with nursing homes. The facilities are similar to independent living communities except for the residents needing personal care.
Residents usually receive their own units or apartments but must go through a health assessment according to state regulations. The assessments are done so residents can receive individualized service plans that meet their personal care needs.
According to statistics by the National Center of Assisted Living:
- 64% of assisted living residents need help with bathing
- 48% of residents need help with dressing
- 40% of residents need help with toileting
- & lastly 4 in 10 residents are living with Alzheimer’s
Hence, assisted living facilities give elderly adults a high level of personal care while allowing them to maintain their independence.
Assisted living facilities do offer other services aside from personal care. These services include providing meals, health care management and monitoring, help with medications, recreational activities, and transportation.
Home Health Care
According to the U.S. Department of Health and Human Services, about 80% of older adults receiving long-term care services are living at home. The type of long-term care services received at home generally are home healthcare services.
Home healthcare is medical in nature and professionals are typically licensed practical nurses or home health aides. In addition, these professionals are often associated with home health agencies or hospitals licensed by the state. Their services can include
- medical care
- nursing care
- personal care
- medication management
- homemaker services
- social services
- & occupational or physical therapy.
According to the U.S. Administration on Aging, home health care helps older adults live independently for as long as possible. Hence, it can often delay the need for long-term nursing home care.
If you live in a neighborhood that offers home delivered meals, accessible transportation services, and other needed resources, it makes it easier to remain at home and receive care.
Hospice Care Facilities
Hospice care facilities focus on care for individuals who are terminal. They provide “end-of-life care.” Their goal is palliative in nature.
These facilities work to reduce pain and discomfort experienced by the terminal patient. This allows for the patient to adjust to a decreasing quality of life and helps ensure that death occurs as pain-free as possible.
According to the National Hospice and Palliative Care Organization, hospice staff members make regular visits to assess the patient and provide additional care or other services. Also, hospice care staff members are on-call 24 hours a day, seven days a week.
The staff members are made up of a combination of professionals including nurses, medical directors, social workers, as well as clergy or counselors. The assortment of professionals provide physical, emotional, spiritual, and social comfort in the terminal phase of life.
Nursing homes are licensed facilities that provide skilled nursing care to those who are chronically ill or cannot do one or more activities of daily living. Some of them even have special care units for older adults with cognitive impairments such as Alzheimer’s disease.
They generally provide the most comprehensive range of services for long-term care patients. Also, they are often referred to as “skilled nursing facilities.”
When we think of “long-term care” we often think nursing home. This may be due to the fact that more than a third of older adults receive long-term care services in a nursing home. This is according to the U.S. Department of Health and Human Services.
Nursing homes must meet strict criteria and standards in order to be certified. Services provided by nursing homes generally include:
- medical care
- nursing care with 24-hour supervision
- daily meal provisions
- physical and occupational therapy
- & assistance with everyday activities
According to the National Institute on Aging, most residents who live at the nursing homes live there permanently. This is because they have ongoing physical or mental conditions that require constant care and supervision. This is a main reason why nursing homes often strive to provide a more “homely” feel for their patients.
Why Is Long-Term Care Planning So Important?
Long-Term Care Events Affect Your Family
With no long-term care plan in place, the burden of care falls on your family when your chronically ill. It typically falls on your spouse first & then on your children.
Unfortunately, if your spouse is close to you in age, they may be unable to care for you for the rest of your life. They would begin buckling from the stress of providing care.
This will then leave to your children with no choice but to get involved. This is especially true if they see their elderly parent buckling from the stress of providing care for another elderly parent.
It is very important to understand that providing long-term care for a loved one is an all-consuming task. It often-times compromises the emotional and physical well-being of the family.
If your son or daughter is forced to provide care for you, they are basically being forced to put aside their own life. They end up having to put aside their own families, their careers, and their opportunities to care for you.
In addition, they also put aside future goals, aspirations, and plans to focus on your care. This happens quite often as children tend to feel a sense of commitment and duty to their parents.
From my experience, depression and/or frustration tends to be the end result for the child providing care.
Sometimes, a family can even be torn apart as friction is created between the child who provides care and the siblings who do not assist.
Long-Term Care Events Affect Your Assets and Future Goals
The median cost of long-term care here in America is over $100,000 a year! Long-term care expenses can easily disrupt your financial plans sending you into financial turmoil. Therefore, consider all your different assets that may be depleted paying long-term care expenses:
Checking & Savings Accounts
|Funds For Your Living Expenses|
Funds for a Second Home
College Funds For Grandchildren
Cash Value In Your Life Insurance Policy
Have you ever double booked on your schedule before? For example, have you ever accidentally booked an appointment for the doctor and lunch with a friend for the same time?
- Which appointment would you go to?
- Which would you reschedule?
Chances are you would likely go to the doctors appointment. The doctor’s appointment is more important and more urgent than your lunch date. Well this is the same thing we would do with our money in a long-term care event.
If we had to choose between spending on a joyful retirement or for the ability just to perform activities of daily living, our money would go towards our more important more urgent “appointment:” our long-term care needs.
The cost of long-term care services is not cheap. In addition, according to the U.S. Dept. of Health and Human Services,the average duration of receiving long-term care services is about 36 months.
Therefore, you can easily compromise your financial security and everything you’ve worked towards by not planning for long-term care.
Consider “Who & What” Are Important to You In A Long-Term Care Event?
As the provider and protector of your family, as the nurturer, as the person who wants to remain in control of their life, consider your position:
- “Who and what are important to you?”
- “How have your responsibilities to your loved ones changed over the last 10-15 years?”
It is likely that the people that are important to you are those that are the closest, your family. Likewise, your responsibilities to your loved ones really have not changed over the last 10-15 years. Instead, they have grown into a different phase of life.
You once cared for a young family and now you care for an older spouse and children who now have their own lives. Nevertheless, both stages of life requires you to maintain the responsibility of protecting the emotional and physical well-being of your family.
Needing long-term care is not an event we hope happens to any of us. However, if faced with this life changing event, it is good to know our available options.
So what can you do to protect your loved ones from the consequences of a long-term care event? Well, I’ve written about “4 Ways To Pay For Long-term Care.”
Having a plan to pay for long-term care is the most sensible and strategic way of keeping your commitments to your loved ones.
In addition, it helps you maintain your financial goals and allows you to stay independent and in control of your life.
It is important to know what services will be covered when we look at ways to pay for long-term care.
One thing I know for certain, hybrid long-term care insurance policies cover services in ALL of the settings listed in this post. Therefore, long-term care insurance should definitely be a priority if you want to plan ahead
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