What is long-term care?

Someone with a prolonged illness, a disability, or a cognitive impairment — such as Alzheimer's disease — often needs long-term care. It's a broad set of services that help people with chronic conditions manage the limitations that keep them from being fully independent.

Long-term care is different from traditional medical care. Medical care aims to treat or cure a condition. Long-term care helps you live with a condition day to day — it may not improve or reverse the underlying medical problem. Services can include help with the basic activities of daily living, home health care, adult day care, respite care for family caregivers, hospice care, or care in an assisted living facility or nursing home. It may also include care management — a professional who evaluates your needs and coordinates your services.

Skilled care vs. personal care

Two terms describe most long-term care: skilled care and personal care.

Skilled care

Skilled care is for medical needs that require licensed professionals — registered nurses or physical, occupational, and speech therapists. A physician orders it and it follows a care plan. People often receive skilled care in a nursing home, but it can also be delivered at home by visiting nurses or therapists. Examples include physical therapy, wound care, or supervising intravenous medication.

Note: Medicare and Medicaid each have their own definitions of skilled care and strict limits on what they cover. Your state insurance department or Medicare.gov can explain how those programs define and cover it.

Personal care (custodial care)

Personal care — sometimes called custodial care — is help with the activities of daily living (ADLs):

• Bathing
• Dressing
• Eating
• Toileting
• Continence (bladder and bowel control)
• Transferring (for example, moving from a bed to a chair)

Personal care is less intensive than skilled care and can be provided in many settings — at home, in adult day care, in assisted living, or in a nursing home. Most long-term care people receive over a lifetime is personal care, not skilled medical care — and it's the kind of care that health insurance and Medicare generally do not pay for.