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What is Long-Term Care?

According to the National Institute on Aging, long-term care is defined as services that are curated to assist an older adult as their needs evolve with the aging experience (National Institute on Aging, 2017). The most common type of long-term care support is assisting an older adult with activities of daily living (ADLs). ADLs consist of activities one conducts daily, such as bathing, dressing, and preparing meals. Furthermore, long-term care encompasses health care and social services, as well as living environment.  

Who Needs Long-Term Care?

Long-term care is appropriate for older adults who are living with a chronic or serious illness and/or debilitating symptoms that are impacting their ability to do two or more ADLs independently. Some examples of a chronic illness or condition are heart disease, cancer, hypertension, asthma, diabetes, arthritis, and cognitive impairment. Potential limitations due to a chronic illness or condition include, but are not limited to, reduced mobility, lingering pain, swelling of joints, etc. The best time to plan for long-term care is before you need it. Please consult a medical professional to diagnose a chronic or serious illness.

Two Types of In-Home Care

Home Care

  • Services may include: housekeeping, transportation, assistance with hygiene and dressing, companionship, etc.)
  • Supports an individual with their ADLs or Instrumental Activities of Daily Livings (IADLs) to stay at home
  • Non-medical services
  • No need for a physician’s order
  • Utilizes a care aide
  • Pay per hour for service rendered

Home Health

  • Services may include: physical, occupational, and/or speech therapy, homemaker, nutritional support, pharmaceutical services, transportation, etc.)
  • Treat an illness or injury and help the individual regain their independence
  • Medical services
  • Usually requires a physician’s order
  • Utilizes an registered nurse (RN), occupational therapist (OT), physical therapist (PT), or other skilled medical professional
  • Paid per reimbursable services

Residential & Facility-Based Care

The most common example of long-term care services are services that assist older adults with ADLs due to a chronic or serious illness or debilitating symptoms wherever an older adult calls home. Furthermore, when considering long-term care services, it is important to factor in personal finances and financial planning. Please consult a financial advisor for questions and/or concerns regarding one’s personal finances and financial planning. Moreover, medical professionals should be consulted to determine if you need a referral for a long-term care facility.

Click on the residential and facility-based care option to view the services they may offer:

Assisted Living (AL)

  • Residential Care Facilities for the Elderly (RCFE)
  • Age 60+
  • Physical and/or cognitive health issues
  • Personalized care
  • Private pay
Board & Care (B&C)

  • Residential Care Facilities for the Elderly (RCFE)
  • Physical and/or cognitive health issues
  • Individual family home, normally 6 beds
  • Personalized care
  • Costs less than assisted living but can provide more support than home care
Continuing Care Retirement Community (CCRC)

  • Age 60+
  • All levels of care
  • Large upfront fee
  • Long-term, continuing care that includes
    • Housing
    • Residential services
    • Nursing care
Independent Living (IL) & Communities

  • Active and independent older adults
  • Single family homes/condos/apartments
  • Ages 55+
  • No personalized care
  • Private pay
Memory Care (MC)

  • Residential Care Facilities for the Elderly (RCFE)
  • Alzheimer’s disease and/or dementia
  • Specialized assistance for those with moderate to severe forms of cognitive impairment
  • Private pay
Skilled Nursing Facilities (SNF)

  • 24-hour nursing care
  • Short-term and/or long-term
  • Private pay, Medicare, Medi-Cal, private insurance
Sub-Acute Care Facilities

  • Facility care between SNF and hospital
    • i.e. coma, life support, tracheotomy, etc.
  • Out-of-pocket, long-term care/life insurance, Medicare, LTC Medi-Cal

Other Examples of Long-Term Care Services

Social Services

  • Adult day programs
  • Meal delivery service

Housing Options

  • Extended-care facility
  • Domiciliary care facilities
  • Section 202 and Section 8 housing programs

For more detailed information regarding living environment options, please visit Keiro’s Fact Sheet on Housing Options here.

Payment options may vary from facility to facility. Some payment options are out-of-pocket, long-term care or life insurance, or VA Aid & Attendance. Please get in touch with the facility to verify which payment they are able to receive.

Average Costs of Care in the United States

  • Independent Living – $3,650/month
  • Board & Care – $5,500 – $7,500/month
  • Assisted Living – $7,200/month
  • Memory Care – $9,900 – $10,000/month
  • Skilled Nursing Facilities – $10,875 – $14,100/month
  • Sub-Acute Care Facilities – $33,000/month
  • Home Care/Home Health – $40/hour

*Listed as of May 2025 from CareScout

Click here to watch Keiro’s  “Long Term Care 101” Quality of Life Class

Sources

Johns Hopkins Medicine. (n.d.). Types of home health care services. Johns Hopkins Medicine. Retrieved November 15, 2021, from https://www.hopkinsmedicine.org/health/caregiving/types-of-home-health-care-services.

Moody, H. R., & Sasser, J. R. (2018). Perspectives on Gerontology (9th ed.). SAGE Publications, Inc.

National Institute on Aging. (2017, May 1). What is long-term care? National Institute on Aging. Retrieved November 10, 2021, from https://www.nia.nih.gov/health/what-long-term-care.

Genworth. (n.d.). Cost of long term care by state: Cost of care report. Carescout.
Retrieved May 7, 2025, from https://www.carescout.com/cost-of-care