What are my other long-term care choices?

You may have other long-term care options (besides nursing home care) available to you. Talk to your family, your doctor or other health care provider, a person-centered counselor, or a social worker for help deciding what kind of long-term care you need.

Before you make any decisions about long term care, talk to someone you trust to understand more about other long-term care services and supports like the ones listed below. You might want to talk to:

  • Your family
  • Your doctor or other health care provider
  • A person-centered counselor
  • A social worker

If you’re in a hospital, nursing home, or working with a home health agency (HHA), you can get support to help you understand your options or help you arrange care. Talk to:

  • A discharge planner
  • A social worker
  • An organization in a "No Wrong Door System," like an Aging and Disability Resource Center (ADRC), Area Agency on Aging (AAA), or Center for Independent Living (CIL)

American Indians and Alaska Natives can contact their local Indian health care providers for more information.

Some long-term care options you can consider:

Home- and community- based services

A variety of home- and community-based services may be available to help with your personal care and activities.

Medicaid may cover some services, including:

  • Home care (like cooking, cleaning, or help with other daily activities)
  • Home health services (like physical therapy or skilled nursing care)
  • Transportation to medical care
  • Personal care
  • Respite care
  • Hospice
  • Case management

Medicaid programs vary from state to state. Medicaid may offer more services in your state. Call your Medicaid office for more information.

These types of services may also be available through other programs, like the Area Agency on Aging, Medicare, or hospice programs. Learn more about Medicare’s coverage of hospice and home health services.

Community sources, like volunteer groups that help with things like shopping or transportation, which may be free or low cost (or may ask for a voluntary donation) are another option. Examples of the services and programs that may be available in your community are:

  • Adult day services
  • Adult day health care (which offers nursing and therapy)
  • Care coordination and case management (including transition services to leave a nursing home)
  • Home care (like cooking, cleaning, or help with other daily activities)
  • Meal programs (like Meals on Wheels)
  • Senior centers
  • Friendly visitor programs
  • Help with shopping and transportation
  • Help with legal questions, bill pay, and other financial matters
Accessory Dwelling Unit (ADU)

An ADU (sometimes called an "in-law apartment," "accessory apartment," or a "second unit") is a second living space within a home or on a lot. It has a separate living and sleeping area, a place to cook, and a bathroom. If you or a loved one owns a single-family home, adding an ADU to an existing home may help you keep your independence.

Space like an upper floor, basement, attic, or over a garage may be turned into an ADU. Family members may be interested in living in an ADU in your home, or you may want to move into an ADU at a family member’s home.

Check with your local zoning office to be sure ADUs are allowed in your area, and find out if there are any special rules. The cost of an ADU can vary widely, depending on many factors, like the size of the project.

Subsidized senior housing

There are state and federal programs that help pay for housing for some seniors with low to moderate incomes. Some of these housing programs also offer help with meals and other activities, like housekeeping, shopping, and doing the laundry. Residents usually live in their own apartments within an apartment building. Rent payments are usually based on a percentage of a person’s income.

Continuing Care Retirement Communities (CCRCs)

Some retirement communities offer different kinds of housing and levels of care. In the same community, there may be:

  • Individual homes or apartments (for residents who still live on their own)
  • An assisted living facility (for people who need some help with daily care)
  • A nursing home (for people who require higher levels of care)

Residents can move from one level to another based on their needs, but usually stay within the CCRC. If you're considering a CCRC, be sure to check the quality of its nursing home and the inspection report (posted in the facility).

Group living arrangements

Residential care communities (sometimes called "adult foster/family homes" or "personal care homes") and assisted living communities are types of group living arrangements. In some states, residential care and assisted living communities mean the same thing. Both can help with some of the activities of daily living, like bathing, dressing, using the bathroom and meals. Whether they offer nursing services or help with medications varies by state.

In most cases, residents of these communities pay a regular monthly rent and additional fees depending on the type of personal care services they get.

Hospice & respite care

Hospice is a program of care and support for people who are terminally ill. Hospice helps people who are terminally ill live comfortably. The focus is on comfort, not on curing an illness.

Respite care is a very short inpatient stay given to a hospice patient so that their usual caregiver can rest. 

Learn more about Medicare's coverage of hospice & respite care.

PACE (Program of All-inclusive Care for the Elderly)

PACE (Program of All-inclusive Care for the Elderly) is a Medicare/Medicaid program that helps people meet health care needs in community.

Learn more about PACE.

Visit LongTermCare.gov for information and resources to help you and your family plan for future long-term care needs.

If you have limited income and resources, there may be state programs that help cover some of your costs in some long-term care choices. Call your Medicaid office or use the Eldercare Locator for more information.