Long-term care is provided in various institutional settings, in the community and the home.
Generally, people begin to receive long-term care informally from family, friends, neighbors and volunteers. Eventually, they may need care provided formally at home through home health care agencies and by individuals hired on an independent basis. Ultimately, care may be necessary through community-based services such as adult day care centers and through institutions such as nursing homes.
Institutional Setting Care
This care encompasses care facilities such as continuing care retirement communities, congregate homes, residential care facilities, board and care homes and assisted living facilities, as well as nursing facilities that provide custodial, intermediate and skilled nursing care.
Continuing Care Retirement Communities: These facilities offer both full housing and a range of health care, social and other services. A substantial initial investment plus a monthly fee is required by most CCRC’s.
Congregate Homes: These facilities offer independent living with some central facilities and services such as transportation, recreation, social and health services. These types of facilities are expanding rapidly as states move to cover their services under their Medicaid waivers.
Residential Care Facilities: a licensed facility with the primary purpose of providing intermittent care and services to support minor needs resulting from the inability to perform Activities of Daily Living or Cognitive Impairment. These facilities provide room and board and may offer social and recreational programs.
Board and Care Homes/Residential Care Facilities: provide a room, meals, personal care services and 24-hour protective oversight. These homes tend to be small, usually with fewer than twenty residents, and are known by many different names in different states, such as adult care homes and adult foster homes.
Assisted Care Facilities: a licensed facility with the primary purpose of providing continuous care and services (hands on) to support needs resulting from the inability to perform Activities of Daily Living or Cognitive Impairment.
Nursing Homes: licensed facilities with the primary purpose of providing continuous nursing care to inpatients through licensed nurses while under the observation and treatment of a Doctor. Nursing homes generally provide three distinct levels of care (skilled, intermediate and custodial), based on the amount of medical care provided and the skill level of their staff.
Community Delivered Care
This care encompasses a multitude of medical and non-medical services for a partially or fully dependent person. The purpose of providing care in the community is to serve a large number of people at a minimal cost, provide an opportunity for individuals to remain as independent as possible. Services provided in the community include adult day care, therapy services, nursing services, transportation and congregate meals.
Home Delivered Care
This care encompasses a multitude of medical and non-medical services for a partially or fully dependent person. The purpose of providing care in the home is to enable the individual to remain as independent as possible, maintaining their dignity and minimizing the costs of care. Services provided in the home include nursing services, therapy services, home health services, homemaker services, chore services and delivered meals.