What is Long-Term Care?

To fully understand long-term care funding, long-term care insurance, and state partnership programs, which will be discussed in this course, we must first understand long-term care itself. What exactly is meant by long-term care? When is it needed? What services and settings does it include? And how much do these services cost? This chapter lays the groundwork for the remainder of the course  by addressing these questions.


Long-Term Care

Long-term care is a broad range of services provided over a prolonged period, the purpose of which is to minimize or compensate for a person's loss of physical or mental functioning resulting from an illness, disability, cognitive impairment (such as Alzheimer's disease), or simply the frailties of old age.

To understand long-term care, it is helpful to understand how it differs from acute care.

Acute care is medical treatment for an illness or injury. Its purpose is typically to cure the patient and restore previous levels of functioning. Acute care is provided by physicians, nurses, and other medical professionals, and it normally takes place in a hospital, clinic, or doctor's office. It typically lasts a relatively short time.
Long-term care, unlike acute care, is not primarily intended to cure or treat a medical condition. Instead, it focuses on coping with a person's reduced level of physical or cognitive functioning over an extended time, sometimes indefinitely. Some long-term care services are rendered by healthcare professionals, such as nurses and therapists, but it is more often provided by nonprofessional personnel, such as home health aides, or by informal caregivers, such as family and friends.

Coping with a person's reduced level of functioning can include medical treatment, skilled nursing care, and various kinds of therapy. but it more typically involves assisting a person with the following:

basic functions, such as bathing, dressing, getting in and our of bed, going to the toilet, and eating (called activities of daily living, or ADLs -- see below);
household chores, such as meal preparation and cleaning;
life management, such as shopping, money management, and taking medications; and
transportation.

Long-term care also often involves the supervision required by a person with a cognitive impairment so that he will not harm himself or others.

 Long-term care can take place in a number of different settings. These include the home of the person receiving care, community-based facilities (such as adult day centers), residential facilities (such as assisted living residences), and nursing homes. And as mentioned above, long-term care is provided by a variety of individuals, including healthcare professionals such as nurses or therapists, who provide skilled care, as well as nonprofessional personnel, family, and friends, who provide personal care (assistance with basic living functions and household chores) and supervisory care (the close supervision of a cognitively impaired person to ensure his health and safety).