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Long-Term Care Home    |    Steps to Choosing Long-Term Care    |    Types of Long-Term Care    |    Paying For Long-Term Care

Types of Long-Term Care

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Depending on your needs, you may be able to get help with your personal activities (for example, help with the laundry, bathing, dressing, cooking, and cleaning) at home from family members, friends, or volunteers. If you think you need home care, talk to your family to see if they can help with care or help arrange for someone to come to your home to help.

Some home care can only be given by licensed health workers, such as if you need skilled nursing care and certain other health care services that you get in your home for the treatment of an illness or injury. Skilled nursing care includes services and care that can only be performed safely and correctly by a licensed nurse (either a registered nurse or a licensed practical nurse) or a licensed therapist. Remember, Medicare only pays for home care if you meet certain conditions. For more information, look at the Medicare booklet, Medicare and Home Health Care.

You can also hire a home health care agency for care in your home if Medicare doesn’t cover it. In this case, you will need to pay for this care on your own. Home care costs can vary depending on where you live, the type of care you need, and how often you need care. Usually home care is charged by the hour.

To locate home health agencies that provide services in your area, look at Home Health Compare on this website. You can also look at the National Association for Home Care website to get information about home care and hospice. This website includes information on how to find a home care or hospice agency and how to prepare for care.

The following home health services may be available in your community:

Homemaker/Health Aide Overview

Homemaker/health aides provide medical and personal care if you are elderly or disabled living in your own home or a residential care facility. Home health aides work under the supervision of a registered nurse, licensed practical nurse, or therapist to provide health services. The home health aide is required to record the services performed and your condition and progress.

Personal and home health aides—also called homemakers, caregivers, companions, and personal attendants—provide housekeeping and routine personal care services. They clean clients’ houses, do laundry, and change bed linens. Aides may plan meals (including special diets), shop for food, and cook. Aides may also help clients move from bed, bathe, dress, and groom. Some accompany clients outside the home, serving as a guide and companion.

Medicare may pay for home health aide and homemaker services only if the individual requires skilled nursing care or therapy. The individual must also be homebound, have a plan of care that is prepared and signed by a physician, and the services are performed by a Medicare-certified home health care agency. Your state Medicaid program or Medicaid waiver program may pay for home health aides and homemakers if you qualify. Private long-term care insurance may also pay for health aide/homemaker services.

Hospice Overview

If you have a terminal illness, hospice care may provide health and personal care services for you. Hospice also provides assistance to caregivers working in your home. Hospice staff will assess your health and provide additional care or services with regular visits. Hospice staff is on-call 24 hours a day, seven days a week and focuses on supportive care and pain relief during the last period of an individual’s life. Hospice care may also be provided in freestanding hospice centers, hospitals, nursing homes and other long-term care facilities.

What services are provided?

The hospice staff:
  • manages the individual’s pain
  • provides medical and personal care services to the individual
  • assists family members to care for the individual;
  • assists the individual and his/her family members with the emotional and psychosocial and spiritual aspects of dying
  • provides needed drugs, medical supplies, and equipment
  • arranges for additional services when needed - including respite care, speech and physical therapy, or inpatient care
  • provides bereavement care and counseling to surviving family and friends.

Medicare may compensate you for hospice care if a physician certifies that the individual has less than six months to live if the disease runs its normal course. Medicaid may pay for hospice care in some states. Many private insurance plans, HMOs, and other managed care organizations will pay for hospice care. Individuals can pay privately for hospice care if they do not qualify for other funding.

Home Repair and Modifications

Home modifications and repairs improve your safety, helps you perform daily activities such as bathing, cooking, and climbing stairs as well as maintain the value of your home.

Possible adaptations for aging include:
  • Installing grab bars, shower seals, or transfer benches
  • Placing non-skid strips or decals in the tub or shower
  • Adding lever handles on doors, loop handles on cupboards, and paddle electrical switches
  • Installing ramps, elevators, or stair lifts
  • Installing insulation, storm windows, and air conditioning
  • Installing handrails for support
  • Improving lighting around the home
  • Installing security systems
  • Adding living space for a caretaker
  • Widening doorways to accommodate walkers, crutches, and wheelchairs
  • Installing lock out features on stoves or ovens
  • Adding digital displays on thermostats
  • Minimizing thresholds on interior and exterior doorways for easy maneuvering

Occupational and physical therapists are helpful in suggesting additional ways to adapt your home for safety and accessibility. Medicare does not pay home adaptations but does pay for some durable medical equipment. Medicaid may pay for home modifications and medical equipment. Many state and local governments have programs to provide loans and grants to help you pay for home modifications.

Page Last Updated: April 10, 2007

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