Long Term Care

What is Long Term Care?
Long term care is a term that encompasses a variety of services including medical and non-medical care to people who have a chronic illness or disability. Long-term care helps meet health or personal needs. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom. Long-term care can be provided at home, in the community (i.e. a day care, in assisted living or in nursing homes. It is important to remember that you may need long term care at any age.

Who should receive Long Term Care?
You may never need long term care. This year, about nine million men and women over the age of 65 will need long-term care. By 2020, 12 million older Americans will need long-term care. 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.

Individuals who have chronic or long term conditions that inhibit daily functioning may be candidates for long term care. Often candidacy for long term care will be determined using two categories of functional ability, the Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). The ADLs include whether individuals need help with eating, dressing, bathing, toileting, and motor skills; the IADLs refer to skills like money management, shopping, medication monitoring, meal preparation, housework, and transportation. If individuals have problems with any of these, they may be candidates for long term care assistance.

How to pay for Long Term Care
Often, paying for long term care is one of the most significant associated concerns. Colorado Medicaid will pay for long term care under certain circumstances. The care must have occurred for 30 consecutive days before Medicaid will pay, and individuals under 65 will have to be approved as disabled. There may be different thresholds if individuals need only home care.

Generally Medicare does not cover long term care, except limited coverage of skilled nursing or home health care when medically necessary. After a minimum 3-day hospital stay, Medicare will fully pay for 20 days of care in a skilled nursing facility, and most coverage from days 21-100 (with a $137.50 per day co-pay). After 100 days, Medicare will no longer cover skilled nursing. Home care is also available through Medicare.