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Long term care refers to medical and non-medical services provided to people who are physically or mentally unable to provide independent care for themselves. It is the type of care received by someone who needs assistance performing basic Activities of Daily Living (ADLs) or needs assistance because of severe cognitive impairment. Disabilities that require long term care can be caused by accidents, illnesses or advanced age.
This care could be provided in the home, in a residential care or assisted living facility, or in a skilled nursing facility such as a nursing home.
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| Bathing |
Washing oneself by sponge bath or in either a tub or shower, including the task of getting into or out of the tub or shower.
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| Dressing |
Putting on and taking off all items of clothing and any necessary braces, fasteners, or artificial limbs.
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| Toileting |
Getting to and from the toilet, getting on and off the toilet, and performing associated personal hygiene.
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| Transferring |
Moving into or out of a bed, chair or wheelchair.
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| Continence |
The ability to maintain control of bowel or bladder function; or when unable to maintain control of bowel or bladder function, the ability to perform associated personal hygiene (including caring for catheter or colostomy bag)
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| Eating |
Feeding oneself by getting food into the body from a receptacle (such as a plate or cup) or by a feeding tube or intravenously. |
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Severe cognitive impairment means a severe deterioration or loss in short or long term memory; orientation as to person, place, or time; or deductive or abstract reasoning as reliably measured by clinical evidence and standardized tests.
Such loss can result from a sickness, injury, advanced age, Alzheimer's disease, or similar form of dementia.
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There are three levels of long term care — custodial, intermediate and skilled.
Custodial care is for individuals needing help with ADLs. This type of care is typically provided in the home or a combination of the home and community-based facilities like an adult day care center. Custodial care could be provided by a home health care provider, friends, relatives and adult day care facilities.
When skilled care is needed on a regular basis, but only part-time, it is referred to as intermediate care. For example, an intermediate level of care would be required as someone recovers from a critical illness. He or she might no longer need around-the-clock skilled care, but still require some intermittent skilled care from nurses or licensed therapists. Or an individual with a degenerative condition may at first only require intermediate care, but as their condition worsens, may end up requiring full-time skilled care.
Skilled care encompasses nursing care, therapy or rehabilitation, performed by or under the supervision of medical professionals such as a registered nurse, licensed practical nurse or licensed therapist. Depending on an individual's needs, skilled care may be required on a full-time or part-time basis.
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Long term care can by provided by a professional caregiver, a family member or a friend. It can be received in the home or in an institution. While most people would prefer to receive and give care at home, this factor is usually determined by the type of disability. Here is a brief overview of each type of care:
Home Care
Even if a person has family or friends to assist with everyday activities, they may still need nursing care, physical therapy, or the help of a nutritionist who visits the home.
Adult Day Care
For individuals who live with a family member who works, an adult day care can provide care and activities during the day and allow the patient to return home at night. This may be a good option for those who are cognitively impaired.
Assisted Living or Residential Care Facilities
Assisted living and Residential Care facilities are suited for people who need assistance with their daily activities but do not need constant care. These facilities offer assistance with eating, bathing, dressing and household chores. Some of these facilities also have medical centers available.
Long Term Care Facilities
For individuals who need around-the-clock monitoring, or who have no one to care for them at home, care must be provided in a long term care facility.
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