Navigating the Overwhelming Options of Long-Term Care

Navigating the Overwhelming Options of Long-Term Care

by Nicole Amico Kane, MSW, LICSW, CMC

We are an aging nation.  Since 2011, baby boomers have been turning 65 at an average rate of 10,000 per day.  This will continue until 2030.  And we are living longer.  Fortunately, we are also healthier and more active than past generations.

However, according to the Administration on Aging, “70% of people turning age 65 can expect to use some form of long-term care during their lives.” 35% will spend some time in a long-term care facility, such as a nursing home or assisted living community.

What is Long-Term Care?

Long-term care encompasses a wide range of supportive services used by people who need help to function in their daily lives. Long-term care and services are those that help with the instrumental activities of daily living (IADLs): managing finances, handling transportation, shopping, doing laundry, preparing meals, household and basic home maintenance, using the telephone and other communication devices – as well as the activities of daily living (ADLs), defined as self-care activities: getting dressed, toileting, bathing and showering, personal hygiene and grooming, eating, and functional mobility.

The duration and level of care each person requires is as individual as the person needing the support.  On average, a person will need three years of long-term care.  Women may need services longer than men because they typically live longer. And 20% of older adults requiring long-term care services will need care for longer than 5 years.

Home and Community-Based Services (HCBS)

Most long-term care is not medical care. It includes home and community-based services (HCBS). These are the services and supports that provide assistance with daily activities that help older adults and people with disabilities to remain in their homes. Home can be their own homes or apartments, in assisted living, congregate care, or supportive living. Services such as chore assistance, transportation, meals, adult day services, and personal care are all considered HCBS.

Adult Day Programs are often a great choice for families who choose to keep a loved one at home. Adult day programs offer life enrichment, social engagement and an opportunity for caregiver respite, an often overlooked essential for caregiver health.

While the majority of people would prefer to age-in-place in their own homes or apartments, this isn’t always feasible from a safety and/or financial perspective.  Caring for someone in their own home can be the most expensive option, especially if 24/7 care is required. Care at home works best if someone needs limited support. But as needs increase, so does cost.

Housing Options

Independent retirement housing, assisted living, skilled nursing, and continuing care retirement communities are all housing options. Assisted living and skilled nursing sometimes include memory care. Some states, such as Washington State, offered adult family homes as a long-term care housing alternative.

Each housing option has pros and cons, and the best fit for a person needing the support is determined by a number of factors such as the level of care required, financial situation, understanding the person’s personality, preferences, and values, the quality of service available, and location (proximity to family and additional supports are the usual considerations).

Genworth Financial offers an annual Cost of Care Survey. From our experience, though, while the survey presents an average of monthly and annual costs for different housing types in the metro areas, the costs reflected in the survey are lower than what we encounter when assisting our clients in finding the right housing option.

How Can an Aging Life Care Professional® Help?

Long-term care options can be overwhelming. Aging Life Care Professionals provide a wide range of expert help and support. We understand aging and help families navigate the course of chronic conditions, such as cognitive changes, and connect families and individuals with the best resources and supports.

Aging Life Care Professionals also know our local long-term care service providers and resources well as we’ve built trusting relationships within our communities. We work collaboratively with HCBS and housing professionals and health care practitioners on our client’s behalf.

Additional benefits of working with an Aging Life Care Professional:

  • Personalized, compassionate service — focusing on the individual’s wants and needs.
  • Continuity of care – communications are coordinated between family members, doctors and other professionals, and service providers.
  • Cost containment — inappropriate placements, duplication of services, and unnecessary hospitalizations are avoided.
  • Quality control – aging life care services follow ALCA’s Standards of Practice and Code of Ethics.

By engaging an Aging Life Care Professional, you are working with someone who takes a holistic, client-centered approach. Visit the Aging Life Care Association website to locate an expert near you.


Nicole Amico Kane, MSW, LICSW, CMC, is the care management supervisor at Aging Wisdom, an Aging Life Care practice based in Seattle, WA. Nicole is a licensed clinical social worker and a certified care manager.

This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association® and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.

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