Long-term care is a type of health care that refers to a variety of services provided for someone with a chronic illness. A patient needing long-term care is unable to fully care for his or her own needs, and requires assistance to some degree. This care provides both the medical care and the non-skilled care that a person needs, such as housekeeping services and assistance with bathing or dressing.

People who provide long-term care are as varied as the services, from doctors and nurses to home health aides and non-skilled workers. Care may be provided at home or in a residential setting, such as a nursing home. Cost and insurance are important considerations for anyone needing long-term care, as the costs of all the services over a long period of time can add up quickly.

Who Needs Long-Term Care?

Many people will need long-term care at some point in their lives. This type of care may be needed long-term, but temporarily, such as for someone who has a serious illness or injury that they will eventually recover from. But, in most cases, long-term care is for someone who is not expected to get better or to be able to function fully independently again. Some factors or situations that lead to long-term care include:

  • Age and gender. The older a person is, the more likely they are to need long-term care. Even if there is no specific illness, function begins to decline with age and most people struggle with staying independent. Women are more likely to need long-term care because they generally outlive men
  • Chronic health conditions. A person of any age who has a chronic illness is likely to need some degree of long-term care. This may be relatively minor, such as ongoing outpatient treatment for diabetes and related conditions. It may also be more intensive care, such as in-home support for someone with terminal cancer or advanced kidney disease.
  • Disabilities. A permanent or long-term temporary disability may require ongoing support in the form of long-term care. Being impaired after a stroke, being paralyzed, or having a developmental disability are examples of disabilities that require long-term care, either in the home or in a residential facility.
  • Living alone. Someone who lives alone is more likely to eventually need long-term health care than someone living with family. With age or the onset or worsening of an illness or disability, living alone may become challenging or impossible.

Where is Long-Term Care Provided?

The location where a person receives long-term care depends on that individual’s needs, resources, and any informal support. Informal long-term care is any care giving provided by family or friends. If someone has good informal care, formal long-term care may be provided in the home, allowing the patient to have some degree of independence. In-home care also works for people who are more able to be independent and need minimal care or assistance.

Long-term care may also be provided in a hospital, nursing home, assisted living facility, or another type of residential care center. This type of care is used when someone is not able to live independently and has little support in the home. Where care is provided may also depend on resources, how much money can be spent on care, and type and extent of long-term care insurance.

What is Provided in Long-Term Care?

Long-term care can generally be divided into three main types of care: medical and nursing care, personal care, and support services. Medical care is the care that is provided to manage or treat illnesses or chronic conditions. This may include monitoring, medication and IV administration, or treatments like dialysis for kidney disease or chemotherapy for cancer.

Personal care is care that does not require a doctor or nurse: personal hygiene, eating, getting dressed, getting from one place to another, and other similar personal tasks of daily living. This can be provided by a home health aide or by nursing assistants in a residential facility. Support services are non-medical and non-personal. They may include housework, cooking, cleaning, shopping, taking care of pets, assisting with communication, or managing finances.

Who Provides Long-Term Care?

Informal long-term care is unpaid care by a family member or friend. This is a common type of long-term care. Family may choose to use informal care because of love for a family member, feelings of guilt or responsibility, to save money, or some combination of these factors. Informal care may provide a patient with everything they need, but sometimes, more professional care is needed.

Other professionals who can provide formal long-term care include doctors and nurses for medical care, as well as support professionals, like physical and occupational therapists. Non-medical caregivers include home health aides, workers in residential facilities, and people who are not necessarily skilled but can provide support services such as cleaning or pet care.

Cost Considerations for Long-Term Care

Long-term care can be expensive because of the duration of care and the extent of care that is needed for an individual. People need to be aware of the costs and be prepared, both for themselves and older or disabled loved ones. It is important to understand insurance plans and what and how much of long-term care is covered, if at all.

Government programs that help pay for long-term care are Medicare and Medicaid. Medicare covers long-term care for older adults but only in when skilled care or rehabilitative care is needed. There are time limitations on Medicare coverage as well. Medicaid covers long-term care for people with low incomes and who meet state eligibility requirements. Other government programs that can assist special populations include the Department of Veterans Affairs and the Older Americans Act.


Long-term care is something that most Americans will eventually need, so it is important to understand what the options are and to prepare to make big choices and to be able to cover the costs of this care. Finding long-term caregivers that provide quality care is also an important consideration. Family members of those who need care should spend time ensuring that the facilities and caregivers they are choosing for their loved ones will provide the best possible care.