What is a Long-Term Care Facility?

A long-term care facility is any place long-term care (LTC) is provided, and LTC can be provided in a number of different locations depending on the extent of care that is needed. 

Long-term care consists of a range of services and systems that help meet medical and personal needs of people who have chronic illnesses or conditions that prevent them from fully taking care of themselves. LTC generally is defined as needing assistance with at least two of the six activities of daily living (ADL) or having cognitive impairment. The ADLs are eating, dressing, bathing, walking (or mobility), transferring (as from a chair to a bed), and toileting or going to the bathroom.

Though it is called “long-term” care, often the services are provided to people over the short-term, such as for rehabilitation after surgery or an injury. 

A long-term care facility can range from a person’s home to a dedicated medical center or nursing home. Most long-term care starts at home and then transitions to one or more other facilities depending on changes in the needs of the individual. 

Long-term care facilities tend to be very flexible and can meet the needs of many different people. In addition, long-term care facilities are typically not for those that have been involved in a sudden crisis and tend to be geared towards people who have been experiencing a gradual decline in mobility and health over a period of time. 

Details below feature some of the most common long-term care facilities.

Home Care 

LTC most often is delivered in the home of the person needing the care. Rather than moving into a nursing home, assisted living facility, or retirement community many people try to stay in their homes for as long as possible. To do this they modify their homes to fit their needs and have people come to the homes as needed to provide assistance. Home care often is provided by family members and friends but also can be provided by home care workers and licensed professionals. Home health care allows people to live safely and independently in their own homes. Home care can be provided short-term or long-term depending on the needs of the individual. 

Home care services include:

• Assistance with Activities of Daily Living (ADLs) 
  • Includes bathing, dressing/grooming, feeding, maintaining continence and mobility.
• Companionship 
  • Providing patients with a companion/someone to look after them and keep them company.
• Managing other daily tasks and chores
  • Feeding pets, managing medication, cleaning, doing laundry, preparing meals, using the telephone, housework, etc. 
• Therapy and rehabilitation 
• Short-term or long-term nursing care for illness, disability, or injury. 

Assisted Living Residences

Assisted living residences offer personal and limited medical care to individuals in a supervised and communal setting. These facilities are designed for people with disabilities who need assistance with some of their ADLs and cannot live independently. Assisted living facilities offer more flexibility and autonomy than  nursing facilities, however residents are still observed and cared for by staff. Each resident has his or her own room, similar to an apartment or hotel, and shares common social spaces around the facility. An assisted living residence, however, is not a medical facility and offers only limited medical services. Often there is no medical doctor employed on the premises and only one registered nurse on duty at a time.

In assisted living, residents are provided with prepared meals and receive assistance with daily personal care and activities. Residents in consultation with their physicians and the facility’s staff can help determine the level of care received. Some people may need help only with medication management, getting in and out of bed, and bathing while others may not be able to eat, dress, use the restroom, etc. without assistance. 

Nursing Facilities

Skilled nursing facilities (SNFs), often also known as nursing homes, offer the most medical care out of the three most common long-term care facilities. SNFs have a higher ratio of registered nurses and other licensed medical professionals per resident than other LTC facilities and also have medical professionals on call 24 hours a day in case of emergencies. Most residents of SNFs have severe illnesses or injuries and need significant assistance or medical care and attention. Many SNF residents are bedbound and cannot accomplish most ADLs without help. SNFs also have the constant presence of nurses or physicians and offer rehabilitation services such as speech therapy and physical therapy.

SNFs are more expensive than other LTC facilities. Residents in an SNF often are there temporarily to recover from an injury, illness or surgery and will transfer elsewhere once they are able to do so. Sometimes a distinction is made between a nursing home and an SNF. In that case, a nursing home is a longer-term residence in which residents will stay for months or years while an SNF keeps residents for only days or weeks until they recover enough that they don’t need as much care. 

The appropriate long-term care facility depends on the needs of and level of care needed by the individual. Home health care often provides less medical care but allows patients to remain in their homes. Assisted living and skilled nursing facilities offer additional amounts of care and provide a greater degree of socialization. They also generally are more expensive than in-home care. An individual and family members should consult with medical professionals and perhaps a financial advisor and patient advocate before making an LTC decision. It’s also important to visit several alternatives, because services and costs differ among even the same types of facilities.

Special assistance in preparing “What is Long-Term Care Facility?” was provided by Bob Carlson, editor of the Retirement Watch financial advisory service and chairman of the Board of Trustees of Virginia’s Fairfax County Employees’ Retirement System with more than $4 billion in assets.

Jaxon Kim is an editorial intern with Eagle Financial Publications.