Understanding Your Long-term Care Options

March 2, 2020

Q: What long-term care options are out there?

A: There are many long-term care options available for you or your loved ones. Some of those options include:

  • Assisted living facility: This care setting provides 24-hour housing, support, service, supervision, meals and health care for elderly individuals. These services are offered in a home-like setting, allowing individuals to retain some sense of independence. They can include help with eating, bathing, dressing, toileting, taking medicine and transportation.
  • Nursing homes: This facility offers care to people who cannot be cared for at home or in an assisted living facility due to their age, health or their need for more around-the-clock care. They provide skilled nursing, rehabilitation services, meals and other help with daily living.
  • In-home care: This can be given by family members, friends, volunteers or paid professionals. Home care can range from help with shopping to nursing care. Some short-term, skilled home care may be covered by Medicare.
  • Patient advocacy: An advocate is one who pleads the cause of another. A patient advocate protects a client’s human and legal rights while providing assistance in asserting those rights if the need arises.

Q: What’s the difference between assisted living and a nursing home?

A: The main difference is that assisted living facilities typically do not provide 24-hour medical care and may only have a nurse on staff for a limited number of hours each day, while a nursing home provides 24-hour medical care with access to physicians on site. The assisted living facility will assess the elder to decide what kind of care his or her needs require. Nursing homes, on the other hand, are designed to house and assist individuals who have health conditions that require constant monitoring and more complex treatments.

Q: What are the main concerns people have as they consider leaving their home and entering into an assisted living community?

A: One of the main concerns that seniors facing this situation express is a desire to stay in control of their situation. Some have a strong desire to never live in an assisted living facility; others are open to this option and are actually more opposed to moving in with their son or daughter. Either way, the best thing to do is envision what the future looks like should an assisted living situation arise. Visit a continuing care retirement community ahead of time to get a better understanding of the services provided.

Sometimes it’s just knowing the options – there are companies that can provide private aids who can assist with basic activities, such as getting around to a doctor’s office, grocery stores, running errands, housekeeping, etc. 

These are typically certified nursing assistants (CNAs) who specialize in working with seniors to help them live independently. Depending on the situation, seniors may be able to preserve their independence with additional at-home help.

Q: What are some common misconceptions individuals express around aging, costs of care, family engagement and preparation?

A: One big misconception is underestimating the need for care. According to a 2019 Genworth study, seven out of 10 of us will need long-term care during our lifetime.1 Also, many people incorrectly believe Medicare will cover all of their health care costs in retirement, including long-term care.

So what do health care costs look like in retirement? According to a Fidelity study,, a 65-year-old couple in 2019 would need $285,000 in savings to cover their health care and medical expenses in retirement.2 Put another way, about 15% of the average retiree’s annual expenses will be used for health care-related expenses, including Medicare premiums and out-of-pocket expenses.3

Q: Are my assets protected if my spouse needs long-term care?

A: Yes, but the amount the healthy spouse is able to retain depends upon the state in which they live. In 1988, Congress passed the Spousal Impoverishment Act, which helps ensure that healthy spouses living at home are able to live a life with a level of financial security. Under this provision, a certain amount of the couple’s combined resources are protected for the healthy or “community” spouse. The community spouse may also receive a portion of the institutionalized spouse’s income depending on how much the healthy spouse has in own-income. According to the 2020 SSI and Spousal Impoverishment Standards, the Minimum Monthly Maintenance Needs Allowance (MMMNA) that all community spouses must receive is $2,113.75 with the maximum being $3,216.4

1 “Cost of Care Survey 2019,” Genworth.

2 “Health Care Price Check,” Fidelity.

3“How to Plan for Rising Health Care Costs,” Fidelity.

4 “SSI and Spousal Impoverishment Standards,” Medicaid.gov.

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