What Is Long-Term Care? It’s Probably Not What You Think

I was talking with a teacher friend the other day, and he was telling me that some of his favorite students were the ones who questioned everything: why do I need to know this? when will I ever use it? and why should I care?

My first thought was, Good grief, you need the patience of Job to be a teacher. But then, I remembered applying the same logic to a few of my GenEd classes in college. (Insert art history here.) To him, the questions signaled engagement. His students were open to learning, if he could show them how the learning applied to their lives.

This made me think about the grown-up version of these students whom I’ve encountered in the hybrid long-term care insurance business. When it comes to long-term care planning, they’re still asking: why do I need this? will I ever use it? and why should I plan?

My observations aren’t unique. According to Retirement Watch, fewer than 30% of adults have talked about long-term care, and a recent research survey out of the University of Chicago found that 38% of people 40+ don’t know they need to talk about it, because they think Medicare covers long-term care. It doesn’t.

It’s the not talking about it that worries me. I’m afraid a whole lot of people in their 40s and 50s are going to get caught with their pants down 30 years from now. Their choices will be far more limited than if they’d just asked their questions now and gotten good information.

Before you can plan for anything, you need to know what it is you’re planning for, so let’s dive into what long-term care is and isn’t.

Myth-Busting Long-term Care: What It’s Not

One of the most common myths about long-term care is that it is synonymous with nursing homes. This just isn’t true. Long-term care is a set of services, not a location where the services are performed. While it’s true that you can receive long-term care services in a nursing home, they’re referred to as custodial care and are part of a larger nursing care plan.

Another common myth is that long-term care is medical care. It’s not. Long-term care focuses on daily living activities with different levels of care available depending on a person’s needs. We’ll get to that in a minute. It’s possible to receive medical care from a skilled nurse or therapist at home or in a facility simultaneous to receiving long-term care, but they’re not the same.

A third common myth is that long-term care and long-term care insurance are the same thing. Again, not true. There are currently 45 million Americans providing long-term care services for a family member – without pay. Long-term care insurance is a means to pay for long-term care, but isn’t long-term care itself.

Long-term care is not living in a nursing home, it is not medical care, and it is not insurance.

Did you know that Capital Retention’s long-term care insurance offers plans that cover your care in a nursing home, memory care unit, assisted living, or at home? Learn more here.

So, What Is Long-term Care?

Long-term care is a range of services and supports for daily living designed to help you live as independently as possible for as long as possible. It involves several personal, social, and supportive services for when you can no longer fully care for yourself because of frailty, disability, or chronic illness. The services you receive are determined by your needs, which may change over time.

Those who need the most care need help with Activities of Daily Living (ADLs) over a long period of time. Think of it as the personal care routine you do every morning to get ready for your day. Being unable to do two or more of these activities independently indicates a need for custodial care – living with someone who can help with them. ADLs include:

  • Bathing/showering
  • Grooming
  • Dressing
  • Eating
  • Using the toilet
  • Continence
  • Transferring (moving to and from bed, or a chair)

Unlike ADL personal care activities, Instrumental Activities of Daily Living (IADLs) are related to independent living skills. Think of these as the tasks that keep your world in order – household tasks, errands, and the like. They include:

  • Meal preparation
  • House cleaning
  • Laundry
  • Shopping
  • Bill paying
  • Making/keeping appointments
  • Caring for pets
  • Taking medication
  • Responding to emergencies

You’ll want to understand the distinction between ADLs and IADLs, because they’re signs to watch for indicating that the need for long-term care may be close at hand. They’re also used by industry professionals to determine the level of services someone needs, make a care referral, and develop a care plan.

There’s one other component to long-term care that you should be aware of, and that’s community services. They can include social activities at a senior center, local transportation to neighborhood services like the store or doctor, community meal programs, adult day programs, and caregiver respite programs.

We did some myth-busting about what long-term care isn’t, and talked about what it is. Now you need a working vocabulary so you’re informed enough to engage industry professionals in conversation, rather than being talked to. Along with ADLs and IADLs, there’s more. Getting a working knowledge of these terms, will help you confidently advocate for yourself or a family member when the time comes – and it will come, ready or not.

You don’t need to memorize them all, lest you think there’s an upcoming quiz. (Whew!) The best use of the glossary is to skim through it, then use it as a resource to refer to when you need it.

Capital Retention’s hybrid long-term care plans offer Care Coordination – so you don’t have to sweat the care terms, financial, social, and family dynamics. Click the blue link to learn more.

In Part II, we’ll learn more about the factors that determine who may need long-term care and when. You’ll find out if you’re part of a demographic likely to need future care, and how much care. (Hint: “The lifetime probability of becoming disabled in at least two activities of daily living or of being cognitively impaired is 68% for people age 65 and older.” – A Report to the Nation on Independent Living and Disability, AARP)

In the meantime, if you’re ready to start a conversation about long-term care planning or have questions about what you’ve read so far, by all means
reach out. I’ll just be over here catching up on my art history.

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(Source: Family Caregiver Alliance National Center on Caregiving)