Long-term Care: More than just nursing homes

By AARP State Director Marguerite Ro, DrPH

What are the images that come to mind when you hear the phrase “long-term care”?  Do you think of adult family members preparing meals and caring for their parents? Or the mutual assistance that older adults provide to one another so that they can stay in the homes that they’ve been in for years and years? Or perhaps the certified nursing assistant who checks the vital signs of a nursing home resident?

The reality is that long-term care comes in many forms and ways depending upon where we are in our aging journey. A recent study by the Center for Retirement Research at Boston College found that 83 percent of adults over 65 will need some form of long-term care as they age. About 26 percent will have high long-term care needs for 3 years or more.

Long-term care (LTC) refers to services and supports provided to individuals periodically or on-going depending upon his or her needs.  LTC can be considered in three categories: family caregiving, home & community-based services, and residential care. 

Family Caregiving can be considered as the services and supports that are often provided by unpaid family or friends at home.  For instance, caregiving could be helping with groceries or with dishes or laundry. It could mean driving a friend to their doctor’s appointments, managing medications or handling bills. Though it can also be full-time for individuals who remain living at home and require constant care.  A recent AARP study showed that in 2021, there were over 820,000 family caregivers in Washington who provided 770 million hours of care valued at $16.8 billion. Caring for a family member or close friend can be one of the most important roles we play in our lifetime. While many consider it a privilege and labor of love, it can also be a difficult task. According to another 2022 AARP report, two-thirds (67%) of Washington caregivers ages 45+ say they feel stressed emotionally due to their caregiving responsibilities. AARP is here to support caregivers and the older loved ones who count on them. Information, resources and connections for Washington state caregivers can be found at www.aarp.org/caregiverswa.

In Washington state, there are a variety of home & community-based services (HCBS) programs which assist individuals with LTC needs often due to chronic conditions or disabilities and are provided in home or community settings. This includes assistance with “activities of daily living” such as personal hygiene, dressing, toileting, and moving around.  The aim of HCBS is to enable individuals to stay in their homes and communities, where they are often more comfortable and where they prefer to be.  In fact, Washington state is seen as a national leader when it comes to providing choices and options for long-term care, including an emphasis on HCBS. The latest Long-Term Services and Supports State Scorecard shows Washington ranks second in the nation for our approach to long-term care, and we continue to be on the forefront of efforts to support quality and choice.  For instance, to help address the shortage of home care workers, Governor Inslee recently signed a bill (SB 5278) to make it easier for individuals to become home care workers.

Residential care consists of facility-based long term care services provided in many different settings including assisted living facilities, adult family homes, and nursing homes (i.e., skilled nursing facilities).   These facilities range in terms of the level of care provided with nursing homes providing the most extensive care to those who require full-time medical care and monitoring.  The types of residential care available are often more extensive than most people realize. 

While our specific care journeys may be different, the fact remains that the vast majority of us will need long-term care at some point in our lives. The most important time to plan for long-term care is before we need it, as small steps now can help secure a safer, happier future. To assist individuals in finding the support needed, AARP has developed tools and compiled resources which can be found at https://www.aarp.org/caregiving/long-term-care/.