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Long-Term Care Frequently Asked Questions

Question: What is Long-Term Care?

Answer: Long-Term Care is care provided to people who need help with activities of daily living, or supervision of someone who is cognitively impaired, has a degenerative condition, or a prolonged illness. LTC can be provided at home, in a nursing home, in an adult day care setting, or in an assisted living facility.

Question: What is respite care?

Answer: Respite care is care provided by a substitute provider. This can be for a few hours to a few days. The purpose of respite care is to give time off to the regular caregiver. An example is adult day care. Adult day care provides respite for caregivers and a welcome change of scene for seniors. Adult day care programs follow either a social model or medical model. Social programs may focus on providing companionship or on hobbies or other special interests, while medical programs may focus on providing therapies such as dialysis, ventilation, and rehabilitation. Adult day services are community-based group programs designed to meet the needs of functionally and-or cognitively impaired adults through an individual plan of care. These programs provide a variety of health, social, and other related support services in a protective setting.

Question: Where can I find out about long-term care services or benefits for veterans?

Answer: The Veterans' Administration offers a Special Pension with Aid and Attendance (A&A) benefit. This Special Pension allows for Veterans and surviving spouses who require the regular attendance of another person to assist in eating, bathing, dressing, undressing or taking care of the needs of nature to receive additional monetary benefits. It also includes individuals who are blind or a patient in a nursing home because of mental or physical incapacity. It is not a benefit for a person needing housekeeping or respite or part time care. Assisted care in an assisted living facility also qualifies. There are stipulations.  For further information see Veteran’s Express, which is dedicated to assisting seniors and veterans interested in assisted living and receiving the benefits to help pay for their services and rent. You can also contact the VA directly at 800-827-1000.

Question: What is PACE and does it work in rural communities?

Answer: PACE, which stands for Programs of All-Inclusive Care for the Elderly, was developed to address the needs of long-term care clients, providers, and payers. PACE provides programs that coordinate and provide needed preventive, primary, acute and long term care services to older individuals so they can continue to live in their community. Participants must be at least 55 years old, live in the PACE service area, and be certified as eligible for nursing home care by the appropriate State agency. PACE has a Rural Technical Assistance Program which provides technical assistance to organizations interested in developing a PACE program to serve a rural area.

Question: Is there a list of State Nursing Home Associations?

Answer: Yes - the American Health Care Association provides a list of state nursing home associations. These associations provide a viable voice in the states' long term care concerns.

Question: How is long-term care paid for? Is there insurance for this?

Answer: Long-Term Care is paid for either by private funds, through long-term care insurance, through commercial insurance, Medicare, or Medicaid. All of these have requirements and limitations.

Information on paying for long-term care can be found through the Federal Long-Term Care Insurance Program. The American Health Care Association also provides information on paying for long-term care. In addition to information on their website, they provide an online brochure on paying for long-term care.

Question: What happens when a resident runs out of money?

Answer: When private pay residents have used nearly all of their financial resources, they become eligible for Medicaid. When they reach Medicaid eligibility, residents can't be "kicked out" of a nursing home.

Question: What is the Meals-on-Wheels program and how can I find out if there is a program in my area?

Answer: The Meals on Wheels Association of America is the oldest and largest organization in the United States representing those who provide meal services to people in need. This program provides one hot meal per day to seniors. The guiding principle to which it subscribes is to help those men and women who are elderly, homebound, disabled, frail, or at risk. It also gives cash grants to local senior meal programs throughout the country to assist in providing meals and other nutrition services. The Meals-on-Wheels website has a complete listing of all programs throughout the United States.

Some Meals-on-Wheels programs provide congregate meals in addition to home delivered meals. Congregate programs are simply programs that serve at senior centers, where seniors can come and eat their meal in the company of others. While this is not a rare type of program, it is certainly less common so you should check with your local program to see whether or not they have a congregate program.

Question: What is an Ombudsman?

Answer: An Ombudsman is an advocate for residents of nursing homes, board and care homes, and assisted living. Ombudsmen provide information about how to find a facility and what to do to get quality care. Ombudsmen are dedicated to enhancing the lives of long term care residents. They are trained to resolve problems. If you want, the ombudsman can assist you with complaints.

Under the federal Older Americans Act, every state is required to have an Ombudsman Program that addresses complaints and advocates for improvements in the long term care system. To find the ombudsman nearest you, contact your State Ombudsman office or contact The National Long Term Care Ombudsman Resource Center.

Credits

Peter Fitzgerald, VP, Strategic Initiatives National PACE Association

Mary Reinertson-Sand, RAC Information Specialist

Last revised 12/03/2007