Long-Term Care

For seniors and families everywhere, the transition into long-term care can be stressful and intensely emotional. From contemplating leaving a beloved home to realizing independent living is no longer possible, this process comes with many weighty considerations for the individual entering long-term care and their loved ones.

To those understandably worried about this important life transition, early preparation can help seniors take control of the long-term care planning process and recover their peace of mind. This page outlines everything you need to know about choosing and paying for a long-term care program—so your loved one gets the companionship and health care they need to thrive.

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What is Long-Term Care?

What is the meaning of long-term care? Long-term care or LTC doesn’t just refer to a single care service but instead describes a wide range of personal care services for seniors and ill individuals like home health care or nursing home care. These services differ in their access to professional medical personnel, their cost, and the degree of independence provided to seniors. From basic assistance with activities of daily living (ADLs) such as dressing and bathing to providing 24/7 medical care and one-on-one supervision, LTC programs cover the full breadth of care needs.

One of the reasons this term may provoke differing definitions is that LTC has come a long way in recent years. Gone are the days when seniors spent their retired lives unattended in wheelchairs.

Today, a wide variety of options provide seniors with the care they need and fun community events as well as comfortable, modern, and even luxurious residences. As their health conditions progress or they lose capabilities, seniors can transition from limited personal care into more robust forms of medical care. While in-home care may be a great fit, for now, seniors can easily move to a more appropriate facility when they grow older and their needs change.

From basic assistance with activities of daily living (ADLs) such as dressing and bathing to providing 24/7 medical care and one-on-one supervision, LTC programs cover the full breadth of care needs.

There is a program for each individual, lifestyle, and health condition to maximize the senior’s health and happiness. To give seniors and their loved ones the tools they need to identify the best fit for their needs, here are a few takeaways to consider throughout the long-term care planning process.

In-home health care, nursing homes, assisted living facilities—long-term care comes in various forms, each with its level of care and costs.

Factors such as health conditions, age, and required level of assistance with daily activities will determine which form of long-term care is the right for each senior.

LTC programs typically come with a hefty price tag, so it is best to begin the process of planning their finances as early as possible.

Who Needs Long-Term Care?

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Physical or Mental Deterioration

Impairments of the mind and body can significantly impact a senior’s quality of life and health, making these good indicators of LTC needs.

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Environmental Deterioration

Individuals who have lost the ability to keep their living space neat and clean may require long-term aid.

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Loss of Two or More ADLS

The inability to perform at least two ADLs or activities of daily living is a sign of chronic illness and indicates a need for long-term care.

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Informal Caregivers

When members of the individual’s family have informally taken on the role of caregivers, the individual would likely benefit from formal LTC.

Different Types of Long-Term Care

The meaning of long-term care covers a variety of health and personal aid services. In this section, we go over the pros and cons of each.

Assisted living facilities offer a range of community-building activities and limited assistance with daily activities. Their residents are usually self-sufficient in many areas, such as meal preparation. These facilities are best for seniors who desire a high level of independence combined with some assistance with ADLs, as they do not provide skilled medical care or constant supervision.

  • These facilities assist with dressing, grooming, medication management, and transportation. However, they do not provide around-the-clock care or on-staff medical professionals.
  • Assisted living facilities provide a sense of community and residential setting. Residents can often decorate their apartments with their own furniture and bring pets.
  • Because they offer a group living environment instead of one-on-one care, assisted living facilities are generally less expensive than more intensive care options.

In-home care is a popular option among seniors with chronic illnesses, disabilities, or trouble completing ADLs who aren’t ready to leave the comfort of their home to enter an LTC facility. For those individuals, in-home care offers the companionship of a familiar caregiver to provide one-on-one assistance. In-home care providers can come in several forms, such as hospice care and skilled in-home nursing.

  • In-home health care services can include therapy, supervision, nursing, and assistance with ADLs and household tasks.
  • The one-on-one care provided by in-home health care is often expensive, though the cost will depend on the level of assistance and sum of services the caregiver provides.
  • Seniors can choose between independent caregivers and home-care agencies. Though more expensive, agency fees will include worker’s compensation insurance and any necessary taxes.

Nursing homes are medical environments designed for seniors who need significant medical supervision and help with ADLs. The intense level of medical support and personalized care makes them an excellent choice for individuals looking for less independence and more healthcare, such as seniors with severe mental and physical impairments.

  • Nursing homes do not usually provide recreational and social activities as their focus is on supporting the health of their residents.
  • Instead of providing one or two consistent caregivers, nursing homes offer a team of on-staff nurses and trained healthcare professionals.
  • As these homes provide 24/7 skilled healthcare, assistance with ADLs, and prepared meals, their fees tend to be high.

How does Long-Term Care work?

Whether the discussion is driven by early preparation or a senior’s deteriorating living situation, families should not hesitate to begin the complex long-term care planning process as early as they can.

The first step in any senior’s journey to LTC is to decide when to make that important move. The senior and the family should be on the same page regarding the next steps to get the care they need. It is not a decision to spring on your loved ones. It should be the product of careful and open deliberation with the goal to better the senior’s quality of life. It is best to ease into the process, emphasizing the positives and starting with a discussion of the pros and cons of each form of care. Considering the senior’s medical conditions, age, preferred living situation, level of required assistance, and companionship needs will help ensure that this choice matches their lifestyle and required care.

Next comes a crucial step in the senior care planning process: deciding how to pay for long-term care. LTC costs vary by state and the type of service—some charging per day, month, or hour. Fortunately, seniors have many options to choose from when paying for long-term care rather than using their personal funds.

Life settlement. Selling a life insurance policy in a life settlement is a savvy way to pay for LTC expenses when operating within a fixed income. For seniors 65 and older with a life insurance policy worth at least $100,000, life settlements help them earn a significantly greater sum than they would if they surrendered their policy or allowed it to lapse. To avoid paying out of pocket for LTC, seniors can either use the settlement’s generous cash lump sum to pay for their long-term care or send the settlement funds to a long-term care benefit account. This bank-trust account will make automatic payments towards any form of LTC.

Medicare or Medicaid. These two forms of government-backed health coverage will pay for a range of senior care programs such as live-in health services, hospice care, short-term nursing home stays, and the Program of All-Inclusive Care for the Elderly or PACE. However, Medicare does not cover all forms of care, for example, non-medical in-home care or long-term nursing homestays.

Other government programs. Seniors can also register for various government programs which offer services for elderly citizens, such as the Older Americans Act and the U.S. Department of Government Affairs’ benefits for elderly veterans.

Reverse mortgage. If seniors would like to receive in-home care, reverse mortgages are a form of home equity loan that allows them to monetize the property while they continue to live in their home. This loan can come in the form of a cash lump sum, line of credit, or monthly income—all of which can be used to pay for long-term care.

Key Takeaways


With 10,000 baby boomers reaching retirement age every day, the discussion about long-term care options is more relevant than ever. But despite the negative stigma sometimes associated with this transition, careful research and preparation can make the move into long-term care a positive experience. It can also improve seniors’ quality of life and comfort their families.

Even if your loved one is not in need of immediate LTC, remember that 70% of people over the age of 65 will need some form of long-term care in their lifetime. It is never too early to start planning for future personal care needs and never too late for seniors to take steps to preserve their health wherever they are today. Making an effort to eat right and stay active will go a long way towards minimizing their long-term care needs in the future and securing a mobile and joyful retirement.

As seniors prepare for this life-changing venture, use the following takeaways to direct further research and as a summary of modern long-term care.

  • If you know a senior experiencing physical or mental deterioration, it is likely they could benefit from some form of long-term care. The same is true if a senior is experiencing a chronic illness, worsening living conditions, or substantial care from family members and friends.
  • Nursing homes, assisted living facilities, in-home care—seniors can choose from a variety of long-term care services, each suited for different levels of health impairment and care needs.
  • Though the cost of long-term senior care can be great, many financing options allow seniors to fund these essential services, such as life settlements, Medicaid, and reverse mortgages.
  • The type of care seniors should enroll in depends on their age, health conditions, ability to perform ADLs, and lifestyle.
  • Assisted living facilities may be the best choice for seniors seeking more independence and less professional medical care. But nursing homes offer around-the-clock health care from a team of skilled medical workers for seniors needing medical care.

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