Understanding Long Term Care Needs

Individuals with disabilities, seniors and others with long-term care needs face many challenges every day including how they will obtain and keep the assistance they need. There are many different long-term care options available to most individuals but only a limited few which truly provide the freedom and ability for individuals to be in charge of how they live their life.

According to a study conducted by the AARP, 90% of seniors want to remain living in their homes as they age.

The U.S. Department of Health and Human Services estimates that 70% of people turning 65 will need long-term care at some point in their lives. Those living with physical or developmental disabilities may also require long-term care throughout their lives. Long-term care needs vary widely depending on an individual’s specific needs and desire for assistance. From help with everyday tasks such as cooking and cleaning to 24/7 medical care, long-term care services assist with a wide array of challenges. 

Long-Term Care Options

The different long-term care options fall into four main categories of services.

  • Nursing Home – Typically a hospital type facility that can provide skilled nursing services for individuals with significant care needs and health issues.
  • Assisted Living – These facilities are places where individuals live in a supervised community with various services available to them. Meals, some personal care services, social functions / activities and assistance with daily tasks like bathing and laundry are generally included.
  • Home Care Agency – Care is provided in the individual’s home through a home care staffing agency. Individuals usually pay an hourly wage to the agency which employs their caregiver who provides services from assistance with daily tasks to skilled nursing services on a predetermined schedule.
  • Self-Direction – Care is provided in the individual’s home by a caregiver that they choose and hire directly. The individual is in complete control of what care services they receive and how and when their care is provided. Payment is made to the caregiver(s) through a fiscal intermediary who also files all state and federal taxes and conducts background checks on potential caregivers. The individual can choose someone they know, like and trust to provide their care including friends and family.

Long-Term Care Comparison

Cost for long-term care varies greatly based on the different needs an individual has. The table below details cost comparisons for full time care through the different care options based on a national average.

Stay in Home Control Care and Schedule Hire Family to Provide Care Cost Per Day Cost Per Year
Nursing Home No No No $250 / Day $91,250
Assisted Living No No No $118 / Day $43,200
Home Care Agency Yes Sometimes No $125 / Day $45,760
Self Direction Yes Yes Yes $76 / Day $27,973

*Home Care Agency and Self Direction costs are based on 44 hours of care per week for 52 weeks. Nursing Home and Assisted Living cost are based on the national average for a private room. Cost vary by state. Source: Genworth Cost of Care Study 2013

Self-Direction Advantages

  • Better Caregivers – Individuals have complete control over all hiring and firing of caregivers to ensure they receive the care they need and that they like their caregiver. Because of the cost savings of self-direction, individuals are often able to offer caregivers a higher hourly rate which translates into a higher quality of care.
  • Care Delivery – Individuals who self-direct make all the decisions of how, when and where they want to receive their care. Caregivers can be scheduled to meet the individual’s needs, desired care times and care preferences.
  • Remaining in Home – Care services can be provided in an individual’s home and can adapt to increased care needs. Individuals don’t have to worry about changing their community or their familiar surroundings.
  • Supplemental Care – Self-directed care services can decrease the strain placed on family caregivers. Because of the flexibility of self-direction, individuals can hire caregivers as part-time staff to supplement the care received from family members.