Most of us would prefer to live independently in our own homes as we age. However, Americans over age 65 have more than a 75 percent chance of needing some assistance due to chronic illness, accidents, cognitive impairment, or disability. Families have traditionally been the primary sources of care and support for older relatives, however, today there are other choices for care available.

What Is Long-Term Care?

Long-term care covers a variety of arrangements such as skilled nursing facilities, shared housing, group homes, continuing care retirement communities, and assisted living. Given the complexity of the systems of care for older adults, it is critical that they and their families become familiar with the various options for long-term care prior to the onset of a disability.

When the older adult’s safety becomes a critical issue, or when a family caregiver can no longer provide adequate care, families must explore other options, such as institutional care. For example, a person with Alzheimer’s disease that quickly becomes advanced and requires constant supervision may receive the best care in the dementia unit at a local nursing home.

What Are the Options?

If you or your family are considering various types of long-term care, your decision will be based on the level of care needed. One option is an assisted living community for someone who can no longer live at home, but does not require skilled nursing care. Assisted living residences may provide meals, basic housekeeping, and assistance with bathing, dressing, and other activities of daily living. Some residences also arrange for transportation and provide limited health care services.

These residences may be known by various names, such as personal care homes, sheltered housing, residential care, catered living, and board and care homes.

Assisted living residences may be a part of a continuing care retirement community (CCRC). These communities provide separate housing for active and independent older adults, those who require some assistance, and those who have serious physical and mental disabilities. Residents move from one location within the community to another as their needs change with age or illness.

Older adults who need round-the-clock nursing care and help with meals, bathing, medications, personal care, and other tasks may want to consider moving to a nursing home. Also called skilled nursing facilities, extended care services, or health care centers, nursing homes provide 24-hour services and supervision, medical and nursing care, personal care, and residential services for social and spiritual needs. In most nursing homes, living spaces consist of a single room for one or two residents.

Determining the type of care needed and choosing the highest quality facility takes time and planning. Social workers can help you choose the right option for you and your family.

How to Find Long-Term Care Services?

Selecting a long-term care option can be challenging. Social workers in private practice and at community-based social service organizations can help you identify the type of long-term care services needed.  Nursing homes and assisted living residences often have social workers on-site to answer questions about the facility and help older adults and their family members become acclimated to the new living environment.

To find in-home or residential long-term services, visit the Eldercare Locator  a public service of the U.S. Administration on Aging connecting you to services for older adults and their families. You can also reach us at 1-800-677-1116.

How to Pay for Long-Term Care

Medicare does not provide comprehensive long-term care and generally does not cover the costs of custodial care, such as assisted living. Even when Medicare does cover long-term care services, coverage is limited and the services will only be paid for after certain conditions are met.

Costs of long-term care are typically paid for with private money or through long-term care insurance. Whatever the case may be, everyone is encouraged to plan ahead for long-term care needs and make informed decisions before services are needed.

Social workers can also help you explore options for financing long-term care services.

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