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Hear this textWhat is Long-Term Care?
Long-Term Care is defined as “assistance and services provided to people who, because of chronic illness or disabling conditions, are limited in their ability to perform basic activities.” Disabilities can arise from physical or mental health problems. People with disabilities may require the assistance of another person to accomplish important tasks necessary for every day living. These tasks (bathing, feeding oneself, using the toilet, getting dressed, and basic mobility, i.e. from bed to chair), which are commonly defined as basic activities of daily living (ADL), are also referred to as ‘self care’ or ‘personal care.’ Another set of activities referred to as ‘instrumental’ activities of daily living (IADL) (using the telephone, taking medications, light housework, money management, meal preparation, and shopping), are tasks that require a higher level of physical capacity and mental function than ADLs. People who cannot drive a car or handle finances may be able to dress bathe and feed themselves. However, they cannot do those activities unless somebody else does the laundry, goes grocery shopping, and prepares meals.
Most people with long-term care needs live in their own homes or with relatives. If they cannot do this and require an institutional setting, there are several types of facilities where people with long-term care needs can live: Personal Care Homes, Nursing Homes.
In-Home Care
Many people with long-term care needs can live at home, or with a family member. There are many different services available to help people remain independent while living at home. These include adaptive aids, personal care attendants, care management, home delivered meals, homemaker services, and respite. In Pennsylvania, the Area Agencies on Aging are a valuable resource for finding out about what services available, and whether financial assistance can be obtained. http://www.portal.state.pa.us/portal/server.pt?open=514&objID=616424&mode=2
Personal Care Homes
There are 1,550 licensed Personal Care Homes in the state of Pennsylvania. These facilities serve elderly people with self-care disabilities who need assistance on a daily basis but whose level of need is lower than required to meet requirements for nursing home care. Personal Care Homes typically provide very limited services (meals and housekeeping) as part of the basic ‘rent;’ however residents can pay additional fees to receive assistance with personal care. Many Personal Care Homes use the term ‘Assisted Living’ to refer to the type of services they provide. The state of Pennsylvania has recently created a new licensure category for Assisted Living Residences to distinguish them from Personal Care Homes. One important effect of this change is that people with nursing home level of needs can live in an Assisted Living Residence if sufficient services are available (and paid for). Personal Care Homes are licensed by the Department of Public Welfare, which maintains a directory of facilities in Pennsylvania. http://www.dpw.state.pa.us/servicesprograms/physicaldisabilities/003670207.htm
Nursing Homes
There are approximately 700 nursing homes in the state of Pennsylvania, currently serving more than 77,000 residents. Nursing homes provide housing and medical care to residents who need 24 hour nursing care and supervision, monitoring, administration of medications and treatments. They are licensed and regulated by the State Department of Health. http://www.portal.state.pa.us/portal/server.pt/community/nursing_home_care/14152
The Department of Health maintains a database of facilities in the state that can be used to locate a provider near you. http://app2.health.state.pa.us/commonpoc/nhLocatorie.asp In addition, the federal Centers for Medicare and Medicaid Services, maintains a database of nursing homes with detailed information about quality. http://www.medicare.gov/NHCompare/
Most families must pay for nursing home care themselves, unless they have long-term care insurance or qualify for Medicaid. Medicare will pay for care in a nursing home only for people who need rehabilitation after a hospitalization. This care is limited to a very specific number of days.
Skilled Nursing Facility
The term, Skilled Nursing Facility is often used to refer to nursing homes. However, a Skilled Nursing Facility refers specifically to facilities that provide certain specific services that are paid for by Medicare.
Selecting the Right Long-Term Care
Selecting Long-Term Care can be confusing for people because it is both a service (e.g., help with daily activities and medical needs) and a place to live (e.g., your own home, personal care home, or nursing home). The Pennsylvania Long Term Living Website has a section that can help determine your needs. http://www.ltlinpa.org/portal/server.pt/community/determine_your_needs/4000 Another resource that can help with these decisions is the Long-term Care Choices Navigator http://longtermcarechoices.minnesotahelp.info/ a free website hosted by the Minnesota Board of Aging. This website can help people create a plan that lists their needs and the types of resources that can help.
