1. How do you define "long term care"?

2. What is the difference between skilled care and personal care?

Typically skilled care is needed by an individual for medical conditions that require medical personnel. This might include registered nurses, doctors, and physical therapists. Additionally skilled care is usually required round the clock.

A person requiring this type of care is usually in a nursing home environment, but occasionally a home situation with visiting professionals is provided.

Personal care is sometimes referred to as custodial care. This type of care helps an individual perform daily living activities such as:

• assistance with toileting
• bathing
• dressing
• transportation

This type of care generally does not require the level of intense and complex service as the skilled care. This type of care is often provided at home, adult day care centers, assisted living facilities, and nursing homes.

3. What are the chances that I will need long-term care?

Recent studies based upon nursing home admissions, indicate that 43% of all persons aged 65 and over will enter a nursing home in the future. In fact, a New England Journal of Medicine report (February 1991) suggested that of the 43% who enter nursing homes, 50% would stay an average of two years.

4. What could I expect in cost(s) if I needed care?

Nationally, nursing homes average $36,000 per year and costs in metropolitan areas like Washington, D.C. range from $50,000-$70,000 per year.

An American Health Care Association Study published in 1993 reported that if you received skilled nursing care in your home, by a nurse three times a week (two hours each visit) the bill would be about $12,300 per year.

Care received from a home health aid three times a week for a year with each visit lasting two hours would result in a bill of about $8400 per year.

5. Does Medicare cover any long term care?

Long term care expenses are generally not paid for by Medicare, Medicare supplement insurance, or major medical health insurance provided by most employers.

Medicare does not pay for personal or custodial care unless the assistance is related to an injury or illness. Even in this instance benefits are severely restrictive.

6. How does Medicaid play into all this?

Many people share the misconception that they will be able to receive Medicaid assistance. Stringent financial guidelines dictate an individual's ability to receive Medicaid. You must meet the federal poverty guideline for income and assets and you may have to "spend down" or use up most of your estate before meeting these guidelines.