About half of Americans will need help with daily activities at some point in their lives due to chronic illness, mobility challenges, dementia, or frailty from aging. Many other conditions can also lead to a need for long-term care. To learn about who needs care and the steps you can take to prepare for care needs for you or a loved one, click "Read More" to read our full article on the subject.
The likelihood that you or a loved one will need long-term care increases with age. However, long-term care isn't exclusive to seniors.
In fact, anyone at any age or point in their lives can need long-term care, although older adults are at a higher risk. That's why it's important to identify the signs that you or your loved one might need care in the near future.
At LTC News, we collaborate with experts to provide current and accurate educational information. Our goal is to help everyone make informed decisions about long-term care.
In this article, we'll answer an essential question, "who needs long-term care?" We'll discuss care demographics in the U.S. and the early symptoms of long-term care needs. We'll also explain what steps you can take if you or your loved one need long-term care.
Everyone is susceptible to needing long-term care. Most people who do need care need it because of a chronic illness, accident, mobility issues, dementia, or the frailty of aging.
However, care needs can arise at any point in our lives for a multitude of reasons. These reasons include physical ailments such as accidents, illnesses, disabilities, or old age. But they can include emotional, mental, or social distress as well.
So how can you tell if you or your loved one needs long-term care? For the sake of this article, we'll follow the Health Insurance and Portability and Accountability Act (HIPAA) official definition for determining when someone needs long-term care.
To summarize, this definition states that an individual needs long-term care when they need help with at least two activities of daily living that are expected to last longer than 90 days or they need supervision for health or safety concerns due to cognitive impairment.
This definition also accepts that a long-term care event does not need to be permanent, and many times, it isn’t permanent. Individuals can make a recovery depending on the reason they need care.
In this section, we'll discuss how many people in the U.S. need care according to HIPAA's definition. We also want to help you learn about the conditions that often lead to care so you can better identify if you or your loved one needs long-term care.
There's an abundant need for long-term care services in the U.S. In fact, a congressional research service report from 2021 estimated around 14 million people received long-term care services in the U.S. in 2021.
They also estimated around 8.3 million of those people received in-home care or community-based services. Only about 1.4 million of the 14 million people receiving care did so at an institution such as a nursing home.
According to this caregiving study, there were around 53 million unpaid family or informal caregivers in the U.S. in 2020. Around 41.8 million of these unpaid caregivers cared for someone over the age of 50.
Favreault's 2016 study on long-term care recipients found that 52% of Americans turning 65 in 2016 would develop a serious disability, leading to a need for long-term care.
This study also estimated that around 19% of those people would only have care needs for less than a year. While 14% would have care needs lasting five years or longer.
Learning about these care demographics can feel nerve-racking. But not everyone is at equal risk of needing long-term care.
Everyone experiences health conditions and long-term care differently; however, some health conditions lead to care faster than others.
Dementia or Alzheimer's Disease
Obesity
Parkinson's Disease
Stroke
Multiple Sclerosis
Arthritis
Cancer
Spinal cord injuries
Traumatic brain injuries
Chronic Obstructive Pulmonary Disease
Diabetes
Keep in mind this isn't a comprehensive list. There are many other illnesses, disabilities, and conditions that will likely lead to a need for long-term care. People with poor lifestyle habits, overweight individuals, or those who smoke or drink excessively may also be at higher risk of needing care.
It can be tricky to tell if you or someone you love needs long-term care. Everyone's long-term care needs are different, especially at first.
But it's important to recognize the warning signs of long-term care before the situation becomes dangerous. It's even more important to look for these signs in our loved ones who may be in denial or trying to hide their need for care.
Here are a few signs to look out for that may indicate your loved one needs long-term care:
They don't feel comfortable driving, especially at night.
Their hands are too shaky to complete daily tasks.
They feel pain or have difficulty lifting objects they used to lift with ease.
They have trouble with or avoid stairs or have fallen on the stairs.
They feel winded after short exercises, such as going for a walk.
They seem excessively lonely, worried, sad, or emotionally distressed.
They seem confused, forgetful, paranoid, disoriented or have difficulty remembering things.
They need help with daily tasks or activities of daily living, such as bathing, eating, getting dressed, or going to the bathroom.
They forget to or refuse to take their medications.
They experience chronic pain.
They've had behavioral changes due to mental health concerns or cognitive decline.
They have trouble managing their money.
They have fallen or had a recent injury.
They've been diagnosed with a health condition that requires medical attention.
Many older adults with these symptoms can benefit from long-term care services and support. Proper intervention can help alleviate your loved one's pain symptoms. It can also help reduce stress about being unable to care for oneself.
It's better to have a conversation about long-term care sooner than later. Most symptoms left untreated only worsen as time goes on. The sooner you act, the sooner your loved one's quality of life will improve.
In today's day and age, needing long-term care does not mean your loved one will need a nursing home. In fact, most people start receiving care in the comfort of their homes. There are plenty of accessible and flexible in-home care options—no matter your or your loved one's budget.
In addition to the warning signs above, you may also want to look out for warning signs of dementia.
Dementia is a general term for a decline in cognitive abilities severe enough to interfere with daily life. While it involves a range of symptoms and conditions, there are common early signs to be aware of:
Memory loss. This is the most commonly recognized symptom of dementia. Individuals may be especially forgetful of recently learned information or important dates.
Difficulty with tasks. Individuals struggle with familiar or basic tasks, like following a recipe or managing a budget.
Language problems. They have trouble with vocabulary, such as calling things by the wrong name or needing help finding the right word.
Disorientation. They lose track of dates, seasons, or time or forget where they are or how they got there.
Poor judgment. Individuals make unusual or poor decisions, like giving away large amounts of money.
Misplacing items. They regularly place items in odd locations, like a wallet in the refrigerator.
Mood and personality changes. They become confused, suspicious, anxious, or easily upset, especially when out of their comfort zone.
It's essential to understand that occasional forgetfulness or confusion is a part of aging. However, consistent patterns or rapidly increasing signs should prompt a visit to a medical professional for evaluation.
Dementia and related cognitive diseases and disorders almost always lead to a prolonged need for long-term care. However, early detection and intervention can improve the quality of life for someone with dementia or cognitive decline.
If your loved one needs long-term care, there are a few steps you can take to ensure a smoother transition from independent living to caregiving intervention.
Below we'll explain how you can bring up your concerns to your loved one, research options for care, discuss how to pay for care, and offer a few resources and tips that may help the overall care journey.
Once you've realized your or your loved one's need for care, you should talk with those you trust. It's essential to have an open and honest conversation about the situation and what you think the best options are.
Hopefully, you or your loved one already have a plan for long-term care, whether that be a Long-Term Care Insurance policy or adequate savings or investments to help cover the costs.
If there's a plan, you and your loved ones can work together to identify the best way to use it. If not, your discussion might focus on brainstorming care ideas that work for everyone involved.
Your loved ones are here to help and support you. By talking to them, you can clear your head, access emotional support, and get on the same page about care needs and solutions.
If your loved one needs care, it's vital that you reach out to them with your support. Figuring out how and when you can be there for them will reduce stress for everyone involved and improve your relationship with your loved one.
After talking with your loved ones, you should research long-term care options. Long-term care is very flexible and customizable–there are several different services and facilities to help satisfy everyone’s preferences, needs, and budgets.
Some common facility options include:
Adult day care centers
Assisted living facilities
Continuing care retirement communities
Hospice care facilities
Memory care facilities
Nursing homes
Residential care homes
Skilled nursing facilities
While facility care works for some people, most people who need long-term care start with in-home care. There are numerous ways to receive care from the comfort of your home, including:
Home health care
Homemaker services
Personal care assistance
Companionship services
Medication management
Home modifications & safety assessments
Remote monitoring & telehealth
There’s no wrong or right way to start your or your loved one’s long-term care journey. We encourage you to explore all of your options before committing to one. LTC News has numerous long-term care articles to help you look for and learn about long-term care.
It can be overwhelming to navigate the world of long-term care on your own. A qualified long-term care professional can offer you or your loved one expert guidance, advice, and access to care resources.
Professionals like Long-Term Care Insurance specialists or case managers are experts in their long-term care fields. Long-Term Care Insurance specialists can help determine if LTC Insurance is available for you or your loved one. If not, they can help you find other types of insurance or coverage options for your expenses.
They can also help you or your loved one file a claim or learn more about an existing Long-Term Care Insurance policy if you or your loved one already have coverage.
Case managers specialize in helping those who already need long-term care. They can help you or your loved one create an efficient, affordable, and effective care plan. These plans often focus on streamlining care among providers and utilizing community resources.
RELATED: Find A Trusted Long-Term Care Insurance Specialist
Just as there are many options to receive care, there are also several ways to pay for long-term care. However, some methods work better than others.
It's worth mentioning that the best way to manage the cost of long-term care is to plan well before care needs arise. Most people incorporate care costs into their retirement plans. Buying Long-Term Care Insurance is one way to do this.
Long-Term Care Insurance can be a great way to cover costs, reduce stress, and protect your finances. If you or your loved one already have a policy and need care, you may want to learn about how to file a claim or learn more about your policy.
It may be too late to qualify if you or your loved one don't have insurance. Only those who meet specific health requirements at the time of application can get a policy.
In other words, those with proven and current long-term care needs may have difficulty getting approved for a new LTC Insurance policy. You can learn more about how your health affects your ability to get Long-Term Care Insurance here.
So what can you or your loved one do if you didn't plan for long-term care? Below we'll explain a few ways people can pay for long-term care.
A common way people get long-term care coverage is through the help of government assistance programs. This includes the Veterans Affairs and Medicaid programs.
The Department of Veterans Affairs offers long-term care coverage to veterans on the standard health plan. Full coverage is limited; individuals with service-related disabilities get first priority. Those with lower incomes get the next priority.
Medicaid is another option that offers long-term care coverage to qualifying individuals. Only individuals with little or no assets can qualify for coverage. And there are rules against giving away assets to qualify.
This leads to downsides like spending down your assets or income to meet specific requirements. It's also possible for the government to take your estate after passing away through a process called estate recovery.
In addition, Medicaid only covers care provided by Medicaid providers or facilities. You can learn more about Medicaid's guidelines here.
If neither insurance nor assistance programs are an option for you or your loved one, you may want to read our article on how to pay for long-term care. This article uncovers effective ways to cover the costs of care for those who may not know all their options.
Having a plan for long-term care can help you or your loved ones navigate through stressful and uncertain times. Often this plan forms throughout the steps mentioned above, but it may help to formalize, refine, or write down your plan for the future.
Your loved one's plan should include, but isn't limited to:
How and where they plan to receive care.
Their long-term care budget and how they plan to cover the care costs.
How your family and loved ones plan to help when or if they need care.
How they plan on modifying their home or lifestyle to be healthier and friendlier towards long-term care.
Proper legal documentation, including a living will, power of attorney, and financial trusts or documents.
A backup plan if any of the above goes wrong.
Long-term care planning can relieve stress around the cost and logistics of long-term care. It can help you get on the same page as your loved ones and family to face challenges together when care needs arise.
As with most things in life, long-term care situations can change. So while having a plan can help give you or your loved one a baseline, don't be afraid to change plans as your needs and situation change. In other words, your care plan should act more like guidelines for care instead of rules.
Health and long-term care policies and regulations are also constantly being refined. Sometimes these systematic changes can affect your long-term care plans, options, and costs.
You can stay informed about long-term care by regularly checking in with an expert and keeping up with the latest news. Keeping your mindset about long-term care flexible can set you or your loved one up for success throughout your care journey.
The bottom line is that anyone can need care for many reasons at any point during their lives. However, older adults are more likely to need long-term care, and a majority will need care due to chronic conditions, frailty from aging, an accident, mobility problems, or dementia.
It’s essential to learn about and plan for long-term care. Following steps like researching long-term care options and consulting with experts can help you or your loved ones prepare for the unknown.
In addition, LTC News has several resources to help you learn about and plan for long-term care.
What Is Long-Term Care? – This article defines long-term care and its commonly associated services. It also explains how long-term care differs from other types of care, like health care.
How Much Does Long-Term Care Cost? – This article discusses how much long-term care costs nationwide. It also covers the variables that can impact the cost of care.
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