Long-term care (LTC) is a variety of services which help meet both the medical and non-medical need of people with a chronic illness or disability who cannot care for themselves for long periods of time.
It is common for long-term care to provide custodial and non-skilled care, such as assisting with normal daily tasks like dressing, bathing, and using the bathroom. Increasingly, long term care involves providing a level of medical care that requires the expertise of skilled practitioners to address the often multiple chronic conditions associated with older populations. Long-term care can be provided at home, in the community, in assisted living or in nursing homes. Long-term care may be needed by people of any age, even though it is a common need for senior citizens.
The Centers for Medicare and Medicaid Services (CMS) estimates that about nine million men and women over the age of 65 in the US will need long-term care in 2006. By 2020, 12 million older Americans will need long-term care. It is anticipated that most will be cared for at home; family and friends are the sole caregivers for 70 percent of the elderly. A study by the U.S. Department of Health and Human Services says that people who reach age 65 will likely have a 40 percent chance of entering a nursing home. About 10 percent of the people who enter a nursing home will stay there five years or more.
A 2006 study conducted by AARP found that most Americans are unaware of the costs associated with long-term care and overestimate the amount that government programs such as Medicare will pay.
Medicaid (US)
Medicaid is a government program that will pay for certain health services and nursing home care for older people. In most states, Medicaid also pays for some long-term care services at home and in the community. Eligibility and covered services vary from state to state. Most often, eligibility is based on income and personal resources.
Medicare (US)
Generally, Medicare does not pay for long-term care. Medicare pays only for medically necessary skilled nursing facility or home care. However, certain conditions must be met for Medicare to pay for even those types of care. Medicare specifically will not pay for custodial and non-skilled care.
Home care / Informal care
Home care can be provided by informal (nonprofessional, usually volunteer) or formal (professional) providers and can incorporate a wide range of clinical (nursing, drug therapy, physical therapy), social (food preparation, cleaning, shopping), and even physical construction (installing hydraulic lifts, renovating bathrooms and kitchens) activities. (Saltman et al. 2006) Informal care plays an important part in many countries across the world.
See also: Home care and Caregiving and dementia
In many countries, the largest percentages of older persons using services are those who rely on informal home care. Estimates of these figures often are in the 80 to 90 percent range.
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