The Long-Term Care Spectrum: From Independent Living to Skilled Nursing

As of 2024, approximately 6.9 million people received long-term care in the United States. Many of these people needed care due to the challenges of aging or chronic illnesses. 

In fact, it’s estimated about 56% of people turning 65 (as of 2022) will need long-term care. Statistics like these can be intimidating for many individuals approaching or in their golden years. No one wants to need long-term care. 

However, the dreaded stereotypes of sitting in a nursing home until the end of your days are past us. Long-term care today comes in many forms, but most care is provided at home. 

Before diving into the different types of long-term care, we want to inform you about a powerful tool you can use to find long-term care in your area. LTC News’s Long-Term Care Directory offers thousands of long-term care options nationwide so that you can find the best options near you.

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Long-Term Care Is A Spectrum

As mentioned before, long-term care looks different for everyone. Just because you need help in your daily life doesn't automatically mean you're destined for a nursing home. In fact, most people today receive long-term care outside of nursing homes.

To give you a better idea of how the long-term care spectrum works, we should first define long-term care. When someone needs long-term care, it means they need help with custodial or personal care needs, such as activities of daily living that are expected to last 90 days or longer.

Long-term care is a very broad term that encapsulates many different levels of care. For example, not everyone who needs long-term care needs hands-on assistance. Many people need stand-by assistance, which is when a caregiver remains present in case they need to step in at any point.

Other people may only need help a few times a day or a few times a week. Still, others may need help constantly throughout their day. Some may even need medical care or skilled care services like wound care, medication management, or injections.

No one's long-term care situation is the same. Outside of just having different long-term care needs, there are several options for receiving long-term care as well. Some of the most common options include:

• In-home care

• Independent living community

• Adult day care center

• Assisted living community

• Continuing care retirement community

• Nursing home facility

• Memory care facility

• Skilled nursing facility

Below, we'll discuss what care looks like for each service and facility. 

Independent Living

Independent living is a residential community or facility where seniors can enjoy an independent and enhanced lifestyle. Residents usually live in either a private apartment or a small home. These communities are for relatively healthy older adults who can live on their own and need little to no help with daily activities.

Instead of helping with long-term care, independent living focuses on enhancing residents' lives. For example, the facility staff will take on maintenance or upkeep responsibilities. Residents can enjoy a hassle-free lifestyle without worrying about maintenance and some chores.

An independent living facility is an appealing option because of its social interaction opportunities and amenities. These can include workout classes, recreational areas, game nights, meal plans, or transportation. These communities aim to provide residents with stability, safety, and peace of mind, helping them live a fulfilling lifestyle well into old age. 

However, this living arrangement is not for those who need extensive long-term care services. Independent living is on the low end of the care continuum. Residents are expected to be able to live mostly independently or only need long-term care occasionally. 

Some independent living facilities may offer optional in-home care services or transportation to and from long-term care or medical appointments. 

However, the main goal of independent living is to provide seniors with a safe place to connect and thrive in their golden years. It’s popular because of the social and recreational benefits rather than the long-term advantages.

Adult Day Care Center

Adult day care centers (ADCC) are non-residential facilities for adults who need long-term care during the daytime. These can be a great option for family caregivers who work during the day and need someone to care for their loved ones while they’re away. 

Adult day care centers mostly help with personal care services and activities of daily living. They also offer countless social opportunities as well as games and activities to keep patient’s minds’ sharp and stimulated throughout the day. 

Some adult day care centers may also offer supervised physical exercises or activities to keep seniors active and engaged. Adult day care centers may also offer nutritious meals and snacks throughout the day. Some ADCCs may also offer medication management, transportation, and a personalized care plan for each person.

In-Home Care

In-home care is a broad, popular, and growing form of long-term care. Home care is a flexible, comfortable option for many people. The level of care can range from help a few times a week to live-in nurses. It's customizable to your budget, needs, and personal preferences.

As the name would imply, in-home care happens when a caregiver comes to a patient's house to provide care. However, home care can also include telehealth appointments and check-ins which do not involve leaving your home.

There are many types of in-home care professionals like homemakers, home health aides, social workers, and other home care nurses.  

Home care often consists of:

• Help with activities of daily living or personal care needs

• Occasional skilled nursing care services

• Medication management

What makes in-home care so unique are the endless flexibility and personal touch. Caregivers and patients can develop a close and kind relationship, and help develop a plan of care together.

In-home care is also scalable, so as your care needs increase, you could receive more in-home care rather than moving into a facility. However, as your needs increase, sometimes facility care is the best option.

Assisted Living

Assisted living is a type of community or facility where residents receive help with activities of daily living while maintaining their sense of independence in a private apartment, private room, or small home. 

Assisted living facilities are most similar to independent living arrangements, except instead of just covering maintenance and providing extracurriculars, assisted living facilities also help out with regular long-term care services. 

Individuals in assisted living facilities often can live somewhat independently but may need help with activities of daily living like bathing or dressing. Many assisted living facilities are oriented to make long-term care as integrated and stress-free as possible so residents can maintain a high quality of life and independence without concern over meeting their daily care needs. 

Continuing Care Retirement Community

A continuing care retirement community (CCRC) is a senior living option where an individual lives on a campus with access to multiple levels of care. Residents can move freely within the community as their long-term care needs change, creating a comprehensive continuum of care. 

Most continuing care retirement communities include independent living, assisted living, skilled nursing, and sometimes memory care facilities. As residents need more or less care, they can move to different sections within the CCRC to meet all of their needs. 

This eliminates the concern of needing to move facilities or locations as long-term care needs change. It allows residents to age in place comfortably, remaining in a familiar, home-like environment with familiar faces and a stable sense of safety and community. 

Nursing Home

Nursing homes are residential long-term care facilities for individuals with intensive long-term care needs. Residents at nursing homes often need help throughout the day with activities of daily living and skilled nursing. These individuals usually cannot live on their own or in other long-term care facilities like assisted living. 

Residents in nursing homes usually live in shared or private rooms. Staff are available around the clock to provide residents with long-term care and skilled care as often as they need. 

Nursing homes also offer comprehensive meal plans and personalized care plans. Some nursing homes may also offer mental health services, transportation to and from doctors appointments, and various types of therapies, including physical therapy and occupational therapy. 

Many nursing homes also hold regular events and group activities to create a sense of community. They may also have shared recreational areas like gyms, outdoor parks, or gardens. 

Memory Care Facility

Memory care facilities are specifically designed for individuals suffering from Alzheimer's disease or dementia. These facilities can be standalone or act as a part of nursing homes or assisted living facilities. 

Memory care facilities provide structured environments with countless precautions and alert systems to keep residents safe. Most facilities also offer mentally stimulating activities to help slow down the impacts of memory loss. 

Staff at memory care facilities specialize in memory care. They're able to de-escalate situations and calm down residents while ensuring long-term care needs are met. 

Memory care facilities are essential for individuals with dementia and Alzheimer's. These cognitive decline diseases are extremely stressful on family caregivers and require a unique type of compassion, planning, and care. 

Skilled Nursing Facility

When we first hear the term skilled nursing facility, our minds often jump to the term “nursing home.” However, skilled nursing facilities and nursing homes have clear differences. 

Nursing homes are long-term care residential options for individuals with intense care needs. Residents are expected to need prolonged care and encouraged to make their space feel more homey and get involved in the community. 

Skilled nursing facilities are a bit different. While these facilities do provide custodial care services, stays at a skilled nursing facility are expected to be short.

Many people who receive care at skilled nursing facilities do so after a hospital stay as a form of rehabilitative or transitional care. These facilities are not intended to be a long-term care solution. 

How to Cover the Cost of Long-Term Care

Just as the level of care needed is a spectrum, so is the price. Generally, the more care you need, the more it will cost. However, the cost of care also varies depending on where you live and what types of care services you need. 

You can explore the cost of care in your area with LTC News’s Long-Term Care Cost Calculator. This tool allows you to compare the current and projected costs of different types of long-term care across the country. 

There are several ways to pay for long-term care, but one of the most effective methods is with Long-Term Care Insurance. Long-Term Care Insurance covers all types of long-term care services and facilities, including in-home care. 

The way it works is simple: you'll pay a yearly or monthly premium for your policy. As soon as you need care, you can file a claim to get it covered. The total dollar amount covered will depend on your policy.

However, there's one catch: if you already need care, you cannot start a new Long-Term Care Insurance policy. If this is your situation, there are several other ways to pay for long-term care, including out-of-pocket, short-term care insurance, or government assistance programs like Medicaid.

To learn more about your options, you may benefit from speaking with a Long-Term Care Insurance specialist.

Choosing the Best Long-Term Care Option for You or Your Loved One

Long-term care looks different for everyone; no two people have the same needs or experiences with long-term care. Just because you need some help in daily life doesn't mean you'll lose your independence or be forced to move into a long-term care facility.  

Today, there are countless flexible options for care, including in-home care, continuing care retirement communities, and adult day care centers. If you're struggling with where to start finding long-term care in your area, consider using LTC News's Long-Term Care Directory. This tool can help you find affordable, high-quality care close to home. 

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Care Directory

Comprehensive caregiving & care facility listings in your area

Search Now

• Find and contact facilities near you
• Every major care and facility type
• View facility ratings and amenities
• Find quality care for you or a loved one

If you're not looking for long-term care yet but still want to learn more, consider reading the following resources:

• Assisted Living Facilities vs. Nursing Homes: What’s The Difference? – Assisted living facilities and nursing homes provide different levels of care to their residents. In this article, we’ll explore the differences and similarities between assisted living facilities and nursing homes. 

• What Is a Continuing Care Retirement Community (CCRC)? – Continuing care retirement communities are growing in popularity because of the security and flexibility they offer. This article takes a deep dive into CCRCs and why they might be the perfect choice for you or your loved one. 

• Finding Quality In-Home Care – In-home care is the most popular and preferred way to receive long-term care. But how can you tell if your caregiver is meeting expectations? This guide explains how to find quality in-home care so you or your loved one can continue to live at home safely.