Long-term Care: What's Available And How to Pay

By BlackRock Retirement
Long-term care costs frequently rise faster than inflation, and long-term care providers sometimes bundle services together, making it tougher for families to understand what they are paying for – or comparison shop for care.
Here are the basic care categories:

• Home care: Ranges from errand-running, housekeeping companion or meal-preparation services to personal assistance and some medical treatment. It's designed to help people stay in their homes longer than they otherwise might be able to.
• Adult day services: Provide social, therapeutic and health activities in a group setting for people with physical and cognitive needs. These typically work best for patients who can sleep through the night.
• Independent-living apartments: Age-restricted communities that traditionally offered no services. But in recent years, many have added nonmedical services such as transportation, dining and concierge desks. Those services can be combined with home-health care if needed.
• Assisted-living facilities: Provide help with daily-living activities but not necessarily 24-hour skilled-nursing care. Experts recommend trying to pay for services that are needed a la carte rather than paying for bundled packages.
• Skilled-nursing facilities: Commonly called nursing homes, these facilities offer the most comprehensive level of care, and typically are the most expensive option.
• Hospice care: Generally intended for patients in the last stages of a terminal illness. But it can be used earlier than families might realize, sometimes covered by Medicare.
• Continuing-care retirement communities: These typically offer progressive care, if needed, starting with apartments or houses where older adults can live independently. The drawback: They typically require large lump-sum payments upon entry, and sometimes also steep monthly fees.

More from BlackRock Retirement Center: When Parents Need Help http://www.blackrock.com/investing/planning/retirement/the-cost/long-term-care/eldercare?cid=aff:eldercare:investopedia:retirementcenter
The options for paying for care include:

• Covering the costs on your own.
• Using long-term care insurance, which generally requires policyholders to qualify based on health needs before tapping the benefits.
• Aid-and-attendance benefits for wartime veterans and spouses.
• Medicaid, which is state and federal medical coverage that people needing long-term care can tap when they have already spent most of their assets.

Resources:

• The Eldercare Locator, an online directory and call center (800-677-1116) supported by the federal government and run by the National Association of Area Agencies on Aging.
• Geriatric-care managers, often former social workers or registered nurses, who charge an hourly fee to help families select the type of care and provider, and also review contracts.
• Medicare's Home Healthcare Compare tool, which lets you search for local agencies.
• The federal government's long-term care website, which is a good starting point.
• Genworth's cost-of-care map provides detailed cost information by state and metro area for different types of care.

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