Any conversation around long-term care obviously has to begin with answering “what is long-term care?”.
Long-Term Care is the type of assistance a person needs as a result of a long-term impairment.
Sometimes this is referred to as extended care because the term “long-term care” can carry many misconceptions and negative assumptions. The need for extended care begins with an impairment. When we become mentally or physically compromised, we need long-term care.
There are two types of impairments.
Acute vs Chronic
Acute impairments occur suddenly and often require immediate medical attention, i.e. a heart attack, stroke, broken hip, aneurysm. A care plan is created by a physician and treatment is administered by a skilled medical team. Most often full recovery from an acute impairment is expected.
Chronic impairment on the other hand could be the result of an acute impairment or could be due to an accident, illness, or frailty from aging. Chronic impairment can also include a cognitive impairment wherein care is needed to ensure personal safety. Recovery from chronic impairment is sometimes possible, but not expected.
Medical vs Personal Care
Another way of thinking about long-term care is whether the services received are medical or personal care services.
For example, medical services are provided by physicians, nurses, therapists, etc. Personal care can be provided by anyone. It may be provided by certified nursing assistants (CNAs) or other trained caregivers but it could also be provided by a spouse, adult child, or anyone else.
Personal (or custodial) care is helping people get through the normal activities of their day safely. This could even be providing what is called “stand-by” care. Stand-by care is staying within arms-reach of someone to provide assistance if needed but is not active hands-on assistance yet. Again, this is care meant to keep people safe.
Some examples of personal care include assistance walking, eating, getting dressed, running errands, performing household chores, bathing, paying bills, and much more.
What does long-term care insurance do?
Oftentimes when someone asks us, what is long-term care?, what they mean is “what does long-term care insurance cover?”.
Long-term care insurance covers the costs of personal care in whatever setting. This care could be provided at home, in an assisted living facility, in a skilled nursing facility, the home of your children, and virtually anywhere that you find yourself needing care. It can range from a few hours per day or per week getting assistance with particular activities that have become challenging or unsafe such as bathing or running errands, to 24/7 care to keep one safe at all times.
In nearly all instances, at least with policies bought since 1996, long-term care insurance would begin to pay its benefits when a physician confirms that one needs assistance with two out of six specified “activities of daily living” (ADLs) or is diagnosed with a cognitive impairment where care will be needed to maintain safety. The six specified ADLs that trigger insurance policies are bathing, dressing, eating, continence, toileting, and transferring.