When to Consider Long-Term Care

If possible, try to discuss and plan long-term care options with your loved one before these services are needed. This will allow you to involve them in the discussion and learn their preferences. Waiting until there is an emergency or until the need is urgent will make an already difficult discussion much more stressful, and may put strains on your relationship.

When considering speaking with your loved one about long-term care, there is a lot to consider. What is their current health status, and is that likely to change in the next few years? Are they able to care for themselves for the most part, and just need assistance with certain activities of daily living (ADLs)? Or do they need more professional, facility-based care? Make sure to think about your loved one's current situation when researching possible services, as well as what their future may look like.

Before discussing with your loved one, we recommend performing some background research and noting your concerns very clearly. This will help keep the conversation fact-based and solution-oriented. Educating yourself beforehand will also give you confidence, help your loved one see you as a trusted source of knowledge and support, and help you recommend an option or combination of options that will take care of your loved one's needs, while still allowing them to maintain the greatest amount of independence possible.

You will want to discuss this sensitive topic with your loved one as their partner – not as their decision-maker. Don't approach the conversation with a pre-determined plan, but rather with a few options that you believe will benefit them the most. Emphasize repeatedly throughout the conversation that the decision is theirs, and that you are there for support only.

Staying positive, listening, and showing empathy and support is very important during this conversation. Most likely, you won't agree on everything – which is normal. This is a big decision, and one that will impact their daily life.

Give them time after your discussion to make a decision. You won't be able to have their whole future planned out after one conversation; the goal is to have multiple productive conversations throughout this process.

Most forms of long-term care are provided directly in the person's home by a family member (usually the primary caregiver). This is known as personal care. Personal care can also be provided by a professional or a paraprofessional, and generally involves helping individuals with activities of daily living (ADLs), which include the daily activities that are necessary for living at home. Helping with ADLs may involve assisting with household chores (such as general cleaning, laundry, or yard work), hygiene (such as dressing, grooming, or bathing), meal planning or preparation, or helping with errands or transportation.

Skilled care is performed by a licensed professional either at home or at a facility, and includes services such as physical therapy, occupational therapy, nursing, wound care, or medication management.

A CCRC is a living environment for seniors who would like to continue living independently, but would like to live in a community of similar-aged individuals and couples. CCRC often provide basic care, along with the option of providing more advanced care as it becomes needed.

Learn more about continuing care retirement communities from FindingContinuingCare.com.

Adult day care centers can be a good solution for seniors who need assistance, companionship, or supervision throughout the day, beyond what a family caregiver can provide. They allow seniors to be cared for as needed during the day while their caregiver is at work or otherwise engaged, and return home at the end of the day.

There are different levels of adult day care, so check the location you're considering to ensure they perform the needed services. For example, some programs offer mainly social activities, recreation, meals, and some health-related services, while others offer more intensive health care services for those who may soon require nursing home care.

Learn more about adult day care services from Eldercare Locator, the National Caregivers Library, and the NYSDOH.

Assisted living facilities are housing options for seniors who need some assistance with ADLs or slight medical care, but would still like to live a relatively independent lifestyle. This often resembles a high-quality hotel where residents live in a private room, and the facility's staff provides meals, social activities, housekeeping, medication monitoring, laundry, and sometimes simple medical services. This type of care is often ideal for those who don't need the level of care provided in a nursing home and who would like to live independently, but it is difficult or unsafe to do so completely.

Learn more about assisted living facilities from Seniorliving.org and the Eldercare Directory.

Nursing homes are for seniors who require 24/7 care and support due to physical disabilities or cognitive impairments that other long-term care facilities cannot provide. Depending on the facility, nursing home staff may mainly provide non-medical care called custodial care, which includes services such as assisting with dressing, bathing, feeding, and getting in and out of bed. Some nursing homes do offer medical care for their residents, which may include special care units for residents with memory issues, such as Alzheimer's disease or other forms of dementia. It's important to note that separate, specialized facilities exist for seniors needing extensive health or memory care, so be sure to consider all of your options before making a decision.

Learn more about nursing homes from the NYSDOH (including NYS nursing home profiles), AARP, MedlinePlus, and HelpGuide.

Like a nursing home, skilled nursing facilities (SNF) provide 24/7 care and support, but they focus on providing advanced medical care to their residents through licensed nursing professionals. The services provided at skilled nursing facilities typically involve treating and managing complex medical conditions and offering physical, occupational, and speech therapy. Seniors who require a high level of medical care on a regular basis due to a chronic medical condition, such as a stroke, typically receive long-term care at a skilled nursing facility.

Skilled nursing facilities also offer short-term care for those who require rehabilitation services. Because of this, many patients receive temporary care at a skilled nursing facility after being released from a hospital following an illness, injury, or emergency surgery.

Learn more about skilled nursing facilities from Seniorliving.org and SeniorCare.com.

Memory care is provided for seniors with Alzheimer's disease or another form of dementia, or for those who are otherwise cognitively impaired. Memory care is a type of skilled nursing care that focuses specifically on memory-related services. While some nursing homes and skilled nursing facilities provide memory care services, it is typically not the same level of comprehensive care that facilities specifically focused on memory care can provide.

Learn more about memory care facilities from Seniorliving.org and Caring.com.