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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:

A number of different home- and community-based services may be available to help with your personal care and activities. Some services are covered by Medicaid. Depending on your state, these may include home health services, transportation to medical care, personal care, hospice, or case management. Other services may be available through other community sources, like volunteer groups that help with things like shopping or transportation. These services may be low cost or the group may ask for a voluntary donation. Some services may be available at lower costs depending on where you live and what you need.

Examples of the home services and programs that may be available in your community are:

  • Adult day services
  • Adult day health care (which offers nursing and therapy)
  • Meal programs
  • Senior centers
  • Friendly visitor programs
  • Help with shopping and transportation
  • Help with legal questions, bill paying, or other financial matters

Depending on your needs, you may be able to get help with your personal care and activities (like laundry, shopping, cooking, and cleaning)  from family members, friends, or volunteer groups. Home care agencies are also available to help with personal care, like bathing and dressing.

If you think you need home care, talk to your family to see if they can help with your care or help arrange for other care providers. There are also some home health care agencies that can help with nursing or attendant care in your home. Medicare will only pay for these if you meet certain conditions.

Find a home health agency.

There are also some home health care agencies that can help with nursing care in your home. Home health care agencies may also provide other services, like physical therapy, occupational therapy, and help bathing.

Medicare only covers short-term home health care if you meet certain limited conditions.

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.

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.

Board and care homes (sometimes called "group homes" or "personal care homes"), and assisted living communities, are types of group living arrangements. In some states, board and care homes and assisted living communities mean the same thing. Board and care homes and assisted living communities provide help with some of the activities of daily living, like bathing, dressing, and using the bathroom. Whether they offer nursing services or help with medications varies by state.

In most cases, residents of board and care homes and assisted living communities pay a regular monthly rent, and extra fees for the services they get.

Medicare doesn’t pay for assisted living communities. Medicaid doesn’t pay for room and board in these settings, but, depending on the state, Medicaid may cover other costs.

These facilities provide help with activities of daily living. Some help with care most people can do themselves (like taking medicine, using eye drops, getting to appointments, or fixing meals). Residents often live in their own room or apartment within a building or group of buildings. They also often have some or all of their meals together. Social and recreational activities are usually provided. Some of these facilities have health services on site. 

Not all assisted living facilities provide the same services. In most cases, assisted living residents pay a regular monthly rent, and then pay extra fees for the services they get. 

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 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.

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) is a Medicare/Medicaid program. PACE helps people meet health care needs in the community.

Learn more about PACE.

Note

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.