Choosing a Long-Term Care Option
Many older adults are able to remain in their homes when they need long-term care, if they can access assistance with specific tasks or activities and have the financial resources (qualify for government programs or are able to pay privately for services and/or have long-term care insurance) to cover the cost of the care. Some older adults prefer to move to a residential care setting or find that it is the best option available to them.
The various options for receiving long-term care services include:
- Staying in one's own home with in-home assistance with a variety of activities that may include housekeeping, meal preparation, medication supervision, personal care (help with bathing, dressing, grooming, etc.) and/or participating in an adult day care program.
- Moving in with a family member with care provided by family members, home care services and/or an adult day care program.
- Moving to an assisted living facility (ALF) or a continuing care retirement community (CCRC) which provides a continuum of services.
- Moving into a nursing home if full-time care becomes necessary due to severe dementia or chronic disease or financial issues that make the nursing home the best choice.
In-Home Care
When the elder chooses to remain in his or her own home (or the home of a family member), in-home care assistants can provide care. Assistants can be obtained through a home care agency, nurse registry or you can hire and manage your own caregivers. To find out about home care agencies and nurse registries visit Eldercare Locator to be referred to your area agency on aging which should be able to give you a list of these organizations. AARP and the National Association for Home Care and Hospice also provide useful information about home care. Click here to download Ten Absolutes for Alzheimer's caregivers from the Alzheimer's Caregiver Institute.
Assisted Living Facilities (ALFs)
ALFs are residences for adults who need assistance with daily living activities such as meals, housekeeping, medication supervision, dressing, grooming and transportation. ALFs provide a middle ground between independent living (in your home, a relative's home, senior housing or a continuing care retirement community) and nursing homes. To find out about ALFs visit Eldercare Locator to be referred to your area agency on aging which should be able to give you a list of ALFs in your area. National organizations that provide information to consumers about ALFs include the American Health Care Association/National Center for Assisted Living , the Consumer Consortium on Assisted Living, the Center for Excellence in Assisted Living, and AARP. Click here to download Consumer Questions Regarding Staff Training from Fox Learning Systems.
Continuing Care Retirement Communities (CCRCs)
For older adults with significant financial reserves, CCRCs are an attractive option. These communities provide a continuum of living arrangements from independent living (apartments or villas) to assisted living to skilled nursing care (usually called the "Health Center"). CCRCs typically require a long-term contract and can provide a range of services that meet the elder's changing needs. To find out about CCRCs visit Eldercare Locator to be referred to your area agency on aging which should be able to give you a list of CCRCs in your area. National organizations that provide information to consumers about CCRCs are the American Association of Homes and Services for the Aging and AARP.
Nursing Homes
Many nursing homes provide both short-term and long-term care. Short-term care is for people who need rehabilitation services and nursing care for a short time to be able to return home (wherever home may be). These services are usually covered by Medicare while long-term care in a nursing home is not. Long-term care in a nursing home includes round-the-clock nursing supervision, a medical director, meals, activities and many other services. To find out about nursing homes visit Eldercare Locator to be referred to your area agency on aging which should be able to give you a list of nursing homes in your area.
National organizations, in addition to Pioneer Network, that provide information to consumers about nursing homes include:
For information on financing options for long-term care, visit the National Clearinghouse for Long-Term Care Information.
To learn more about person-directed care in long-term care environments, visit For Consumers, Consumer Guide, Consumer Links and Culture Change on this website.
Portions excerpted from As Families Grow Older, Winter Park Health Foundation and Senior Resource Alliance 2006.