Long-Term Care: What is it Really?

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LLong Term Careong-Term Care: What is it Really?

By Guest Blogger Valerie Hopson-Bell

For many years when the term long-term care was mentioned, it referred to placing your loved one in a nursing home.  Not anymore.  Long-term care refers to a “lifestyle” of sorts for those needing more assistance.  It still means living indefinitely in a nursing home, an assisted living facility or “Aging in Place” in your own home or the home of a loved one.

Long-term care is needed when someone with an extended physical illness, a disability, or a cognitive impairment (such as Alzheimer’s disease) requires assistance in their activities of daily living (toileting, bathing, transferring, feeding and ambulation).  It helps individuals to live as they are now; it may not help to improve or correct health issues.

 

Long-term Care Facilities

 Nursing homes generally have two levels of care: skilled nursing, also known as rehab or sub-acute care, and intermediate care, which is considered long-term care.  Skilled care provides physical therapy, occupational therapy, speech and skilled nursing care.  Skilled care is usually ordered by one’s physician after having a three-day stay in the hospital.  Skilled care services, whether provided in the nursing home, rehab hospital or on an out-patient basis, are covered under Medicare.

Intermediate care in a nursing home is when one must reside there indefinitely due to limitations in their physical or cognitive functions that need nursing supervision.  Along with the health care component, nursing homes provide 24-hour supervision, medication management, meal preparation and assistance with activities of daily living.  These services are covered on a private pay basis (including long-term care insurance) or through long-term care Medicaid.

Assisted-living facilities can look very different in size and populations, but are considered more of a residential environment than nursing homes.  They are nonmedical residential settings that provide or coordinate personal and health care services, 24-hour supervision, medication management, meal preparation, socialization and assistance with activities of daily living for those who are aged, infirmed or disabled.

It is important to note that nursing facilities are regulated by federal law, while assisted living facilities are under state mandate.  Both are monitored by the long-term care ombudsman program which can be found through your local area agency on aging.  The ombudsman can investigate complaints to resolve issues and to restore quality of life to residents in facilities.  The ombudsman also has the responsibility to educate the community on concerns affecting local long-term care facilities by sharing information regarding those facilities.

 

Aging in Place

 “Aging in Place” is the term for allowing someone to remain in one living environment no matter what their need may be as time goes on.  Oftentimes homes, especially those in 55- and-over communities, are built with this concept in mind.  Wider doors with lever door handles rather than twist knobs; bathrooms with grab bars and built-in seats in the shower area; smooth surface flooring, such as low pile carpet, hardwood, tile or linoleum makes a home more assessable.  Lower countertops, lever handles on faucets, cabinets and draws with easy pull hardware allow for functionality in the kitchen.  Other aspects of these homes that allow for aging in place are sidewalks and ramps, with zero clearance.

In addition to the physical modification of the home, there are services needed to complete the “Aging in Place” model.  If the caregiver is still working or needs time to run errands and/or care for themselves, adult day services may be an option.  This is where you can drop your loved one off in the morning and pick them up in the evening.  The staff provides supervision, medication management, activities and meals.  Some centers will also provide transportation and an aide to accompany your loved ones to doctor/medical appointments.

Home health care or home care is usually needed to offer support to the caregiver in the home environment.  Determining which agency depends on the level of health care service needed.  The home health agency provides skilled or medically trained personnel such as nurses; physical, occupational and speech therapist; respiratory care; nutritionist; and certified nursing assistants (CNA) to assist in maintaining or improving clients’ health situation while keeping them in the home.

Home care agencies, often referred to as “non-medical care,” offer companion aide and personal care services (hygiene), which provide for a greater quality of life by assisting with transferring, bathing, dressing, toileting, walking, accompany to appointments, meal preparation, light housekeeping, socialization, transportation and running errands.

Hospice is another service that is often used to assist in meeting your loved ones needs either at end of life or with advanced dementia.  Hospice emphasizes palliative rather than curative treatment; focusing on quality of life rather than longevity.  People can be on hospice from weeks to years depending on their situation and needs.

Although there are many ways to provide long-term care, individual choices are important to achieving a quality of life.  Consider your options and map out a plan that’s right for you and your loved one.

Learn more about Valerie at www.eldercareconnections.net

About Valerie.

 

January 11, 2019 |

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