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What Is Long-Term Care and Who Needs It?

Long-term care means assistance with things that healthy, independent persons can do without help. These are basic activities of daily living: eating, dressing, using the toilet, bathing, getting out of bed, and crossing the room to sit in a chair. Then there is another category of function, with tasks called instrumental activities of daily living such as writing checks, paying bills, cleaning the house, cooking, and going shopping.

Long-term care is a vague concept, not specific like a broken arm, or a tumor in the lung. In many ways long-term care is defined by what it is not, rather than what it is. It is not acute care. Nor is it rehabilitative care. Yet people who need acute care sometimes also need long-term care services. Certainly those who need long-term care also need health care. Benign neglect of long-term care has enabled a health-care system to develop with fuzzy boundaries between the care covered by health insurance and health plans, on the one hand, and long-term care, on the other.

Nearly ten million Americans are currently in need of some kind of long-term care assistance but the vast majority are managing to stay in the community with a little help from their family and friends. Only 1.6 million of the ten million reside in nursing homes.

For a more detailed discussion of long-term care related issues, see: