Long-term care is the personal care and other related services provided on an extended basis to people who need help with activities of daily living or who need supervision due to a severe cognitive impairment. This type of care is considered skilled care, non-skilled care, or custodial care. It is NOT acute or rehabilitative care, which is known as skilled care.

When you need long-term care you usually need help with your activities of daily living. These are items such as bathing, dressing, toileting, continence, eating, and transferring. Or, you may be able to do all of your activities of daily living but still need care and supervision due to a severe cognitive impairment (memory loss, dementia, etc.). You may be able to dress yourself, but you may not remember to take your medications.

Statistics show that at least 6.4 million people aged 65 or older need long-term care, with one in two over age 65 requiring care. At least half of the population who are 65+ will need help with Activities of Daily Living.* Such care is provided when someone can no longer independently carry out essential everyday activities like eating, bathing, dressing, etc. Most people think of long-term care as something needed by older people, but accident or illness can strike someone of any age. When it does, they too may find themselves in need of assistance. *Planning for Long-Term Care United Seniors Health Council, Washington, D.C., McGraw-Hill, NY, 2002

This section describes the different types of long-term care and what causes people to need it.

Acute care is usually provided in hospitals and emergency rooms. Your health insurance and Medicare will likely cover some or all of the expenses because skilled care isusually required. Acute care is usually for conditions which are treatable and where recovery may occur with medical attention. These conditions usually develop rapidly and can strike suddenly.

Chronic care is usually provided in your home, nursing homes, and assisted living facilities. Your health insurance and Medicare will usually not cover chronic care because it is not considered skilled care. Chronic care is usually for conditions that are treatable but generally not curable. A lot of times these are not noticed or are ignored in the initial stages.

Skilled care is usually delivered in skilled nursing homes, but can be received in the home as well. If the skilled care meets strict criteria set forth by Medicare, then the facility providing it is referred to as a skilled nursing facility (SNF). Medicare defines skilled care as services and rehabilitation that require the skills of technical or professional personnel such as registered nurses, licensed practical nurses, and physical or occupational therapists.

Non-skilled care is provided to persons who need help on a regular basis with their activities of daily living because of a physical limitation, chronic problem, or a cognitive problem. This care can be provided by a family member. It does not have to be performed by a medical professional like skilled care does. Non-skilled care is also known as custodial care.