Health care exam 3 Long term care Website

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What Is Long-Term Care?
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Long-term care involves a variety of services designed to meet a person’s health or personal care needs during a short or long period of time. These services help people live as independently and safely as possible when they can no longer perform everyday activities on their own.
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Where is it Provided?
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-Long-term care is provided in different places by different caregivers, depending on a person’s needs. -Most long-term care is provided at home by unpaid family members and friends. -Care can also be provided by paid caregivers, usually at home, but also in a facility such as a nursing home.
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What is the most common type of LTC?
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The most common type of long-term care is personal care — help with everyday activities, also called “activities of daily living.” These activities include bathing, dressing, grooming, using the toilet, eating, and moving around — for example, getting out of bed and into a chair.
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What other services are part of LTC?
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Long-term care also includes community services such as meals, adult day care, and transportation services. These services may be provided free or for a fee.
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What drives the need for care?
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-Health Drives the Need for Care -People often need long-term care when they have a serious, ongoing health condition or disability. The need for long-term care can arise suddenly, such as after a heart attack or stroke. -Most LTC needs arise gradually from growing health problems and frailty
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How Long Does Care Last?
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1. Short term- Short-term care lasts several weeks or a few months while someone is recovering from a sudden illness or injury. For example, a person may get short-term rehabilitation therapy at a nursing facility after hip surgery, then go home. 2. Long term-Long-term care can be ongoing, as with someone who is severely disabled from a stroke or who has Alzheimer’s disease. Many people can remain at home if they have help from family and friends or paid services. But some people move permanently to a nursing home or other type of facility if their needs can no longer be met at home.
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Who needs it?
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-About 70 percent of people over age 65 need some type of long-term care during their lifetime. -More than 40 percent need care in a nursing home for some period of time.
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Who is at most “risk” of needing it? (5 factors)
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1. Age- Older you are the more chance you’ll need it 2. Gender-Women are at more risk than men, primarily because they live longer 3. Marital status — Single people are more likely than married people to need care from a paid provider. 4. Lifestyle — Poor diet and exercise habits can increase a person’s risk. 5. Health and family history — These factors also affect risk.
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Types of home based long term care (2)
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1. Services from unpaid caregivers 2. Services from paid caregivers
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Services from unpaid caregivers
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Most long-term care is provided either in the home of the person receiving services or at a family member’s home. In-home services may be short-term — for someone who is recovering from an operation, for example — or long-term, for people who need ongoing help. Most home-based services involve personal care, such as help with bathing, dressing, and taking medications, and supervision to make sure a person is safe. Unpaid family members, partners, friends, and neighbors provide most of this type of care.
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Services from Paid Caregivers
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Home-based long-term care services can also be provided by paid caregivers, including caregivers found informally, and health care professionals such as nurses, home health care aides, therapists, and homemakers, who are hired through home health care agencies. These services include â– home health care â– homemaker services â– friendly visitor/companion services â– emergency response systems.
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Home Based Services
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1. Home-based long-term care includes health, personal, and support services to help people stay at home and live as independently as possible. 2.Most home-based services involve personal care, such as help with bathing, dressing, and taking medications, and supervision to make sure a person is safe. Unpaid family members, partners, friends, and neighbors provide most of this type of care. 3. Can also be provided by paid caregivers-informal care givers and health care professionals 4 types -home health care -homemaker services -friendly visitor/companion services -emergency response systems
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Home Health Care
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Home health care involves part-time medical services ordered by a physician for a specific condition. These services may include nursing care to help a person recover from surgery, an accident, or illness. Home health care may also include physical, occupational, or speech therapy and temporary home health aide services. These services are provided by home health care agencies approved by Medicare, a government insurance program for people over age 65.
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homemaker services
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Home health agencies offer personal care and homemaker services that can be purchased without a physician’s order. Personal care includes help with bathing and dressing. Homemaker services include help with meal preparation and household chores. Agencies do not have to be approved by Medicare to provide these kinds of services
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friendly visitor/companion services
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Friendly visitor/companion services are usually staffed by volunteers who regularly pay short visits (less than 2 hours) to someone who is frail or living alone. You can also purchase these services from home health agencies.
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emergency response systems
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Emergency response systems automatically respond to medical and other emergencies via electronic monitors. The user wears a necklace or bracelet with a button to push in an emergency. Pushing the button summons emergency help to the home. This type of service is especially useful for people who live alone or are at risk of falling. A monthly fee is charged.
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What is Community Based long term care
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-Focus on helping people live independently Like home-based services, community-based long-term care services help people — old and young — stay at home and live as independently as possible. These services can be given at home or at a location in the community. Some programs are limited to people with disabilities or low-income people, but many are open to all. Community-based services are often provided by a local government, social service agency, or private company.
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Types of Community Based long term care
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Community-based services may supplement other services provided at home. They can also give family members a break from caregiving. These services include 1. adult day service programs 2. senior centers 3. transportation services 4. meals programs 5. respite care. 6. Villages How to find these programs? geriatric care managers are professionals, usually nurses or social workers, who help people with their long-term care needs. They can assess a person’s needs, develop a plan of care, and identify and coordinate whatever services are needed.
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Adult Day Care
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Adult day service programs provide health, social, and other services in a safe place, generally on weekdays. They are designed for adults with mental or physical impairments. They are also for adults who need time to socialize and a place to go when their family caregivers are at work. Some programs provide rides to and from their locations.
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Senior Centers
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Senior centers offer a variety of services, including meals, recreation, social services, and classes. Many of them also provide information and referrals to help people find the care and services they need. Generally, senior centers are for healthy older adults without cognitive problems.
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Transportation Services
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Transportation services help people get to and from medical appointments, shopping centers, and other places in the community. Some senior housing complexes and community groups offer transportation services. Many public transit agencies have services for people with disabilities. Some services are free. Others charge a fee
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Meals Program
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Community-based meals programs include services that deliver meals to homebound people (“Meals on Wheels”). Some programs offer group meals at senior centers, places of worship, and other locations.
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Respite Care
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Respite care temporarily relieves families of the responsibility of caring for family members who cannot care for themselves. It is provided in a variety of settings, including homes, adult day centers, and nursing homes.
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Villages
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One new type of service is the local “village,” in which neighborhood residents band together to trade and buy services they need to live independently. Members typically pay an annual fee to obtain services such as home repair and rides to the doctor but not skilled nursing care.
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What are Facility based services?
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At some point, support from family, friends, and local programs may not be enough. People who require help full time might move to a residential facility that provides many or all of the long-term care services they need. Usually involves State often regulates services Some facilities have only housing and housekeeping, but many also provide personal care and medical services. Many facilities offer special programs for people with Alzheimer’s disease and other types of dementia.
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What are the types of facility based services?(5)
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1. adult foster care 2. board and care homes 3. assisted living facilities 4. nursing homes 5. continuing care retirement communities.
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board and care homes
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Board and care homes, also called residential care facilities or group homes, are small private facilities, usually with 20 or fewer residents. Rooms may be private or shared. Residents receive personal care and meals and have staff available around the clock. Nursing and medical care usually are not provided on site.
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assisted living facilities
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Assisted living is for people who need help with daily care, but not as much help as a nursing home provides. Assisted living facilities range in size from as few as 25 residents to 120 or more. Typically, a few “levels of care” are offered, with residents paying more for higher levels of care. Assisted living residents usually live in their own apartments or rooms and share common areas. They have access to many services, including up to three meals a day; assistance with personal care; help with medications, housekeeping, and laundry; 24-hour supervision, security, and onsite staff; and social and recreational activities. Exact arrangements vary from state to state.
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nursing homes
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Nursing homes, also called skilled nursing facilities(SNF), provide a wide range of health and personal care services. Their services focus on medical care more than most assisted living facilities. These services typically include nursing care, 24-hour supervision, three meals a day, and assistance with everyday activities. Rehabilitation services such as physical, occupational, and speech therapy are also available. Some people stay at a nursing home for a short time after being in the hospital. After they recover, they go home. However, most nursing home residents live there permanently because they have ongoing physical or mental conditions that require constant care and supervision.
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continuing care retirement communities.
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Continuing care retirement communities (CCRCs), also called life care communities, offer different levels of service in one location. Many of them offer independent housing (houses or apartments), assisted living, and skilled nursing care all on one campus. Health care services and recreation programs are also provided. In a CCRC, where you live depends on the level of service you need. People who can no longer live independently move to the assisted living facility or sometimes receive home care in their independent living unit. If necessary, they can enter the CCRC’s nursing home.
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Paying for LTC?
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Long-term care can be expensive. Americans spend billions of dollars a year on various services. How people pay for long-term care depends on their financial situation and the kinds of services they use. Often, they rely on a variety of payment sources, including 1. personal funds 2. government health insurance programs, such as Medicare and Medicaid 3. private financing options, such as long-term care insurance.
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Personal Funds
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First way people pay for long term care. They may use personal savings, a pension or other retirement fund, income from stocks and bonds, or proceeds from the sale of a home. Much home-based care is paid for using personal funds (“out of pocket”). Initially, family and friends often provide personal care and other services, such as transportation, for free. But as a person’s needs increase, paid services may be needed. Professional care given in assisted living facilities and continuing care retirement communities is almost always paid for out of pocket, though in some states Medicaid may pay some costs for people who meet financial and health requirements.
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Government health insurance programs
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Pays for majority of long term care Medicare coverage is limited-Contrary to what many people think, Medicare does not cover most long-term care costs. It does pay for some part-time services for people who are homebound and for short-term skilled nursing care, but it does not cover ongoing personal care at home, like help with bathing. It may cover part of the first 100 days in a nursing home. Medigap” policies, which supplement Medicare, are not designed to meet long-term care needs. But some policies cover co-payments for nursing home stays that qualify for Medicare coverage.
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Medicaid coverage
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Broader coverage than Medicare Medicaid pays for health care services for people with limited income, and it is an important source of payment for long-term care services. Personal care, home health care, adult day care, and nursing home care are examples of the types of Medicaid-covered services used by older adults. However, Medicaid is not available for everyone. To be eligible, you must meet certain financial and health requirements. People with financial resources above a certain limit will most likely not qualify unless they first use up their own resources to pay for care, which is called “spending down.” Who is eligible and what services are covered vary from state to state.
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Paying for nursing homes
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Nursing homes and 24-hour skilled care at home are the most expensive types of long-term care. Because nursing homes cost so much — thousands of dollars a month — most people who live in them for more than 6 months cannot pay the entire bill on their own. At first, many residents pay with their own money. They “spend down” their resources until they qualify for Medicaid. There are rules for spending down resources. Long-term care in facilities generally costs more than home-based care unless you need extensive services at home.
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Veterans’ Benefits
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Veterans’ benefits are another source of government funds, and they may help veterans with disabilities and their spouses pay for personal care and homemaker services provided at home. Disabled or aging veterans with long-term care needs may be able to get help from the U.S. Department of Veterans Affairs (VA). Its benefits pay for care in VA nursing homes and certain services at home.
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Older Americans Act Programs
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The Older Americans Act is a Federal program designed to organize, coordinate, and provide home- and community-based services to older adults and their families. A broad array of programs help older adults remain in the community as independently as possible. Services under the Older Americans Act are provided by state and local agencies and other organizations. They include in-home personal care and homemaker services for frail older adults, meals in the community and for homebound elderly, local transportation services, respite care, and services for older Native Americans. You do not have to have a certain income to use these programs, but they are targeted at low-income, frail, or disabled seniors over age 60; minority older adults; and older adults living in rural areas.
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Private Financing Options
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Most people don’t have enough money to pay for all long-term care costs on their own, especially ongoing or expensive services like a nursing home. By planning ahead, they can use other private payment options, including 1. long-term care insurance 2. reverse mortgages 3. certain life insurance policies.
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Long term care insurance
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Long-term care insurance pays for many types of long-term care. The exact coverage depends on the type of policy you buy and what services are covered. You can purchase nursing home–only coverage or a comprehensive policy that includes both home care and facility care. Many companies sell long-term care insurance. It is a good idea to shop around and compare policies. Buying long-term care insurance can be a good choice for younger, relatively healthy people at low risk of needing long-term care. Costs go up for people who are older, have health problems, or want more benefits.
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reverse mortgages
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A reverse mortgage is a special type of home loan that lets a homeowner convert part of the ownership value in his or her home into cash. Unlike a traditional home loan, no repayment is required until the borrower sells the home, no longer uses it as a main residence, or dies. There are no income or medical requirements to get a reverse mortgage. The loan amount is tax-free and can be used for any expense, including long-term care. If long-term care costs are higher than the amount you borrow, selling your home is not required, but doing so may provide enough funds to repay the loan.
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Life Settlements
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Some life insurance policies can help pay for long-term care. Policies with an “accelerated death benefit” provide cash advances while you are still alive. The advance is subtracted from the amount your beneficiaries (the people who get the insurance proceeds) will receive when you die. You can get an accelerated death benefit if you live permanently in a nursing home, need long-term care for an extended time, are terminally ill, or have a life-threatening diagnosis such as AIDS. Check your life insurance policy to see exactly what it covers. You may be able to raise cash by selling your life insurance policy for its current value. This option, known as a “life settlement,” is usually available only to people age 70 and older. The proceeds are taxable and can be used for any reason, including paying for long-term care. A similar arrangement, called a “viatical settlement,” allows a terminally ill person to sell his or her life insurance policy to an insurance company. This option is typically used by people who are expected to live 2 years or less. A viatical settlement provides immediate cash, but it can be hard to get.

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