A Guide to Long-Term Care Options

By planning ahead, families can meet a loved one’s needs and avoid unnecessary grief

Navigating long-term care options can be confusing and emotionally exhausting.

Elizabeth Moses, 53, of Chesterfield, Michigan, was overwhelmed with trying to care for her ailing parents while also maintaining some normalcy and balance in her own life. “I don’t think anyone realizes how stressful caring for aging parents can be on everyone in the family,” she says.

Moses was juggling a full-time career and the needs of her own active family while dealing with her mother’s failing memory and father’s growing physical limitations. She was constantly worried about their well-being. Her mom was forgetting things like how to drive and cook meals; her dad was finding it increasingly difficult to perform household chores and navigate the stairs.

Still, her father was unwilling to talk about long-term care options. “Dad would fight me every step of the way,” recalls Moses of trying to get him to prepare for the future.

Unfortunately, only 13 percent of seniors have made plans for long-term care, while the majority of family caregivers said they wished their aging loved ones had begun this planning earlier, as found in a 2018 survey by Home Instead Senior Care.1

“By starting a conversation early, both families and their loved ones can feel more at peace and better prepared for the future,” says Lakelyn Hogan, a gerontologist and caregiver advocate at Home Instead, which provides personalized care to aging adults. “The goal should be figuring out the wishes of the adult parent, discovering what’s important to them and how they want to age.” It’s also wise to have a Plan B should their needs change, she says.

Start planning for long-term care by knowing your options

Staying at home. Loved ones who prefer to stay in their homes eventually may need help with laundry, cooking, bathing, getting to medical appointments, managing medications and other activities. This is where home care comes in.

“Home care is a great option for those who want to stay in their home but need some assistance, and the amount of home care can grow with the person’s needs,” says Hogan. A home care professional, typically paid by the hour, can provide support a few times a month or every day. For people with more complex medical needs, a separate health care assistant can also be brought in with a doctor’s approval.

Independent living. Independent living communities range from apartment buildings for people age 55 and older with no additional programming or amenities to luxury complexes offering communal dining, social activities and light housekeeping services.

“One of the main differences between an independent living facility and living in the home is that in an independent living facility you’re surrounded by other seniors,” explains Hogan.

Assisted living. Assisted living combines independent living with a higher level of personal care and health care support. A loved one may live in his or her own suite or with a companion, but isn’t responsible for household chores. Amenities may include communal dining and social activities. Medical professionals typically oversee the support staff.

Specialized care. Skilled nursing facilities provide around-the-clock medical care to help loved ones recover from hospitalizations and manage serious, chronic disease. A loved one with acute dementia or Alzheimer’s disease may need the support of a memory care center.

Combination care. Continuing care retirement communities combine multiple types of care. Loved ones can move to a higher level of care as their needs change without leaving the campus.

Deciding what is right for your loved one can be less stressful for all involved. “We know that the more times a senior has to move, the more it can impact their emotional and mental state,” says Hogan. Moving an older adult is hard on the family as well, she adds, so thinking about both the immediate and possible longer term needs can be helpful.

Do your research

To find a nearby long-term care community for her parents, Moses searched online and asked friends and co-workers for referrals. She visited six different facilities and toured two with her parents.

“I think the most important thing is go visit it for yourself,” says Moses. This helped her quickly eliminate some communities because “I just didn’t like the atmosphere,” she recalls.

It’s also important to closely compare what you get for the money: What does the price include, and what costs extra?

Fees for long-term care are increasing. By 2040, the cost of a home health aide is projected to exceed $46 an hour, a one-bedroom assisted living unit will cost nearly $8,948 a month, and a private nursing home room will cost more than $500 a day, according to the Mutual of Omaha 2018 Cost-of-Care Study.2

Don’t expect help from Medicare. “When it comes to long-term care, unfortunately Medicare does not cover very much at all,” explains Hogan. In some very specific situations, Medicare will cover short-term stays in a skilled nursing facility or for limited home health care that is doctor-prescribed and task-specific, such as for treating a wound, administering an IV or providing physical therapy after a hospital stay. It does not include help with activities of daily living.

The U.S. Department of Veteran Affairs may provide some financial assistance for veterans and spouses; Medicaid may help loved ones with low incomes pay for long-term care.

Long-term care insurance is another way to cover these expenses. Learn more about the basics of long-term care Insurance.

Meeting your loved one’s long-term care needs can be a daunting process. But by planning ahead and talking to your loved ones about how they want to spend their senior years, you can make the process easier and more reassuring for everyone involved.

1 Home Instead Senior Care Compose Your Life Song North American Research Report, conducted in December 2017; released in 2018 https://www.caregiverstress.com/wp-content/uploads/2018/03/Compose_Your_Life_Song_Executive_Summary_US_March_2018_opt.pdf

2 Mutual of Omaha Insurance Company’s Cost-of-Care Study conducted by LTCG, 2018; released April 2019 https://www.mutualofomaha.com/long-term-care-insurance/calculator