What Are Your Long Term Care Options?

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Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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UPDATED: Jul 16, 2021

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Our grandparents didn’t have many choices when it came to long term care. The concept of adult day care didn’t yet exist and in home care was reserved for the very wealthy. Nursing homes weren’t nearly as prevalent in society as they are today, so chances are that family and friends bore most of the responsibility in caring for their elderly and disabled loved ones. Times have certainly changed. Today, there are a multitude of options available for long term care including nursing homes, adult day care, in home health care and assisted living facilities that provide various degrees of care. Let’s take a look at each of these options.

Nursing homes. Nursing homes, commonly referred to as retirement homes, have undoubtedly been around longer than any other log term care option. While any adult can stay in a nursing home, the majority of nursing home patients are elderly and need assistance with daily activities. In fact, nursing homes are required to have a licensed nurse on duty at all times and a registered nurse on duty for at least one shift.

There are nearly 16,000 nursing homes in the United States – some are very good and others are not. Due to a multitude of complaints in the past, the nursing home industry is one of the most highly regulated industries in the country. It is subject to federal regulation if the facility receives Medicare or Medicaid, state regulation and sometimes both. Many nursing homes have reinvented themselves over the past few years and now provide different degrees of care – allowing patients to receive progressively increased levels if needed. They have also tried to improve their image by becoming less like a hospital and more like a home. Unfortunately, the costs associated with nursing homes are staggering. Rates vary greatly, but studies show the average cost for a year’s stay is approximately $75,000.

Assisted living facilities. Assisted living facilities are similar to nursing homes, but residents normally don’t need as much care as those in nursing homes. Facilities can be very small or vary large and are more transitional in nature, meaning that residents can receive (and pay for) various degrees of care. In some cases, residents have their own apartments; in others, residents live in dormitory style housing. Most have common areas where residents can socialize and unlike nursing homes, residents of assisted living facilities generally reported feeling less isolated. It’s a viable option for many, but can be expensive – up to several thousand dollars per month. Studies show that the length of stay at assisted living facilities averages three years, after which time many must transfer to nursing homes.

Adult day care centers. Adult day care centers are gaining in popularity. The concept is similar to child care, but for adults. They are non-residential, generally open for 10-12 hours and provide meals, supervision, entertainment and generally a place ‘to be’ while family members are at work and cannot provide care. Many centers provide some amount of on-site medical assistance, such as a nurse. There are over 3500 adult day care centers in the United States – the majority of which are operated by non-profit agencies. The costs are much less than a traditional nursing home or assisted living facility – generally under $100 per day.

In home health care. In home health care is just that – care provided in your home. It is estimated that over 1.3 million Americans receive in home health care of some degree – the majority of them being elderly. The services provided vary in degree, as do the prices.

As you can see, today’s generation has more options when it comes to long term care. Unfortunately, few of these options come cheap and the reality is that few can afford the hefty price tags that accompany any form of long term care. What’s worse is that care is generally not covered by private insurance, so unless one has long term care insurance or receives Medicare or Medicaid (which are extremely limited), payment for care is usually out of pocket and many have had to liquidate their assets to pay for it.

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