Long-term care for seniors is a vital issue in society today. As our population ages, the need for care and support increases. Long-term care refers to a range of services that help people with chronic illnesses, disabilities, or other conditions that limit their ability to perform everyday activities. In this blog post, we will discuss different long-term care options, costs, insurance, and the problems associated with it.

According to the Department of Health and Human Services, 70% of people over the age of 65 will require some form of long-term care during their lifetime. This includes in-home care, nursing home care, or both. Additionally, women are more likely to require long-term care than men, and the likelihood of needing long-term care increases with age.

Types of Long Term Care

In-Home Care


In-home care allows seniors to remain in the comfort of their own homes while receiving the necessary care and support they need. This type of care can include assistance with activities of daily living (ADLs) such as bathing, dressing, eating, and medication management. In-home care can also include skilled nursing care, physical therapy, and occupational therapy.


If you opt for in-home care, you may need to employ these workers, so allow for the extra salaries in your budget:

  • Nurse or social worker
  • Home health aide
  • Handyman
  • Housecleaner
  • Transportation to appointments, hospital, tests, etc


In-home care is a popular option for seniors who wish to remain in their own homes while receiving the necessary care and support they need. However, one of the significant challenges with in-home care is the availability of well-trained caregivers.

Caregiving is a demanding and often challenging job that requires patience, compassion, and specialized skills. Unfortunately, many caregivers are not adequately trained, which can lead to subpar care for seniors. This is especially true in rural areas, where there may be a shortage of qualified caregivers.

To address this issue, it's essential to invest in training and support for caregivers. This includes providing access to educational programs, professional development opportunities, and ongoing supervision and support. By investing in the professional development of caregivers, we can ensure that seniors receive the highest quality care possible.

Another challenge with in-home care is the lack of support for family caregivers. Many families choose to provide in-home care for their loved ones, but this can be a significant burden, both emotionally and financially. The Family and Medical Leave Act (FMLA) provides some job protection for family caregivers, but it does not provide paid leave, which can be a significant barrier for many families. As of February 2023, 7 states and the District of Columbia had paid family leave programs: California, New Jersey, Connecticut, DC, Massachusetts, New York, Rhode Island, Washington and New Hampshire.

Adult Day Care

Cheaper than a health aide, the daily classes help reduce social isolation and physical deterioration in those with Alzheimer’s, dementia and other diseases. Adult day care is designed for those with physical or cognitive disabilities who need more supervision and services.  Adult day care serves about 286,000 people in the United States.

The seniors socialize over meals, played trivia and table games, take part in exercise classes and hobbies, and talk about current events under the supervision of nurses and other professionals who monitor health, administer medications and offer counseling.

In 2021, adult day care was estimated to cost $1,690 a month.

When to consider adult day care

  • Not able to structure daily activities
  • Feel isolated and lonely
  • Need social interactions to avoid anxiety and depression
  • Difficulty starting and focusing on activities
  • Feel unsafe on their own
  • Finding programs

    These links may be helpful: NADSA, Eldercare Locator

    Skilled Nursing Facilities

    Nursing homes, also known as skilled nursing facilities, provide 24-hour care and support for seniors who require a high level of medical attention. Nursing homes are a popular option for seniors who have complex medical conditions that require regular medical monitoring, medication management, and assistance with activities of daily living (ADLs).


    One of the benefits of nursing homes is that they provide a safe and secure environment for seniors who may be at risk of falls, wandering, or other safety concerns. Nursing homes are staffed with trained medical professionals, including nurses and certified nursing assistants, who are available to provide round-the-clock care and support.


    However, nursing homes also have several drawbacks that should be considered when choosing a long-term care option. One of the most significant drawbacks of nursing homes is the cost. Nursing homes are generally more expensive than in-home care, with a national median monthly cost of $8,821 for a semi-private room and $10,469 for a private room, according to Genworth Financial's 2021 Cost of Care Survey.

    Another potential drawback of nursing homes is the quality of care. While there are many excellent nursing homes, there are also instances of neglect, abuse, and subpar care. It's crucial to research nursing homes thoroughly and visit them in person before making a decision. Additionally, nursing homes are often understaffed, which can lead to long wait times for assistance and an increased risk of falls and injuries.

    Finally, nursing homes can be isolating for seniors who are accustomed to living in their own homes and communities. Many seniors report feeling lonely and disconnected in nursing homes, which can have negative effects on their physical and emotional well-being.

    In conclusion, nursing homes provide 24-hour medical care and support for seniors who require a high level of medical attention. However, nursing homes can be expensive and may have issues with quality of care, understaffing, and social isolation. It's important to carefully consider all options when choosing a long-term care option and to research nursing homes thoroughly before making a decision.


    • Creating a plan for in-home care is an important step in ensuring that you or your loved one receives the necessary care and support to live comfortably and safely at home. Here are some steps to consider when creating a plan for in-home care:
    • Assess your needs: The first step in creating a plan for in-home care is to assess your needs. Consider what activities of daily living you need assistance with, what medical conditions you have, and what type of care you require.
    • Determine your budget: In-home care can be expensive, so it's important to determine your budget and what you can afford. Consider whether you have insurance coverage for in-home care or if you need to pay out of pocket.
    • Research in-home care providers: There are many in-home care providers available, so it's important to research and compare providers to find one that meets your needs and budget. Look for providers that are licensed, insured, and have good reviews from other clients.
    • Develop a care plan: Once you have selected an in-home care provider, work with them to develop a care plan that meets your needs. This should include a schedule for care, a list of activities of daily living that will be provided, and any medical services that will be needed.
    • Discuss communication: Communication is essential when working with an in-home care provider. Make sure that you have a plan in place for regular communication with the provider and that they are available to answer any questions or concerns you may have.
    • Make necessary home modifications: Depending on your needs, you may need to make modifications to your home to ensure that it is safe and accessible. This may include installing grab bars in the bathroom, adding wheelchair ramps, or modifying furniture to accommodate medical equipment.
    • Establish emergency protocols: In case of an emergency, it's important to have protocols in place to ensure that you or your loved one receives the necessary care quickly. This may include having a list of emergency contacts, ensuring that medical information is readily available, and having a plan for contacting emergency services.


    Long-term care costs have outpaced inflation for nearly two decades. The annual national median cost of a private room in a nursing home is now up to $108,405, Genworth reports; a home health aide tops out at $61,776. That can quickly exhaust the average $426,000 that the Federal Reserve estimates Americans 65 and older had saved before the start of COVID for their entire retirement.

    People of all wealth and income levels underestimate how many years they’ll live and how much it will cost.

    Medicare pays only for skilled nursing home care, and only after a qualifying hospital stay, for a maximum of 100 (and an average of 22) days, the Department of Health and Human Services says.

    Medicaid subsidizes long-term care, but only for people with income and assets below a certain level or who first spend down their savings.

    Long-term care insurance is not cheap, typically costing from $2,000 to $5,000 a year. So, much of the responsibility for providing and paying for long-term care for older adults is falling on their children, who use their personal savings and fall behind in planning for whatever long-term care they might need.


    The rising cost of long-term care insurance is a significant concern for seniors and their families. Long-term care insurance is designed to cover the costs of long-term care services, including in-home care, nursing home care, and assisted living facilities. However, the cost of long-term care insurance has been increasing steadily over the years, and coverage has been decreasing.

    One of the main reasons for the rising costs of long-term care insurance is the increasing demand for long-term care services. As the population ages, the demand for long-term care services is expected to grow significantly, which will put pressure on insurance providers to increase premiums and decrease coverage.

    Another factor contributing to the rising costs of long-term care insurance is the increasing cost of healthcare. Long-term care services are medical services that require highly trained professionals, and the cost of providing these services has been increasing over the years.

    Additionally, many insurance providers have been struggling to manage the costs associated with long-term care insurance policies. As a result, many providers have reduced coverage, increased premiums and even exited the long-term care insurance market altogether.

    The decreasing coverage of long-term care insurance policies is a significant concern for seniors and their families. Without adequate coverage, seniors may be forced to pay out of pocket for long-term care services, which can be expensive and financially devastating for many families.

    To address the issue of rising long-term care insurance costs and decreasing coverage, policymakers and insurance providers must work together to develop innovative solutions. One potential solution is to expand access to affordable long-term care services, which would reduce the demand for long-term care insurance and help lower premiums.

    Another potential solution is to increase public funding for long-term care services. This could include expanding Medicaid coverage for long-term care services or providing tax credits to help families pay for long-term care services.

    Tax Breaks for Family Caregivers

    ( the topic for tomorrow)

  • Kate, another beautifully written, totally clear and organized article. I am too familiar with the issues of long-term care for seniors. Thanks for elucidating.

  • The picture in the header looks like everyone is doing well. Unfortunately, the truth is that for many it is not a pretty picture. Substandard care in a nursing home could cost five times as much as a person would be paying at home. As for insurance, they seem to be cutting back on what you originally bought into and probably have no recourse to hold them to their original promises.

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