There is a lot to think about when it comes to long-term care. Some families will have time to plan ahead and some families will need to make very quick decisions. It can be scary and stressful.
One of the first things you’ll need to consider is what kind of care you or your loved one needs. This includes if you want or need care at home or in a facility. Most people will also need to think about costs and what insurance does and does not cover.
These can be overwhelming decisions. This website can help teach you about your options and what may be best for your situation.
All of the information on this website is unbiased. We provide it so that you and your family can make informed decisions. We are not associated with any of the facilities listed on this website and do not charge anything to use this website. You do not need to register or share any personal information to use this website.
How do I Decide Which Type of Long-Term Care to Choose?
In many situations, your doctor or another healthcare provider will recommend a certain type of care for you. This could include a skilled nursing facility, home health care, or hospice care, for example. Usually your doctor or provider will “order,” or “prescribe,” a certain type of care.
In other situations, you may look for a certain type of care or facility on your own. This could include an assisted living facility, continuing care retirement community, or adult day health care facility.
Your health insurance (Medicare, Medi-Cal, VA, Anthem, Blue Shield, etc.) or long-term care insurance may influence your choice. Please check with your insurance carrier for more information. There are also private pay options such as savings, retirement funds, and individual insurance plans.
No matter what your situation is, you will likely have to make some decisions. The information on this website can help you. It will tell you what the quality of care is in facilities across California. You can narrow it down based on your city or zip code. Follow these instructions to get help using this website.
What are the Different Types of Long-Term Care?
Each type of long-term care is described below. You can read about additional resources at My Care My Choice – California if you have Medi-Cal or Medicare. Also, the California Caregiver Resource Centers (CRCs) provide caregiver support and resources for each county in the state, across 11 nonprofit locations.
Skilled Nursing Facilities (Nursing Homes): Help recovering after a hospital stay with highest level of medical care
Skilled Nursing Facilities are also known as nursing homes. They provide short-term and long-term care. This includes:
- Skilled nursing care, similar to the type of nursing care you get in a hospital.
- Personal care, which provides help bathing, dressing, grooming, and going to the bathroom.
- Social services, which provides social and emotional help, help with accessing community resources, and counseling to patients and families.
- Social activities, such as exercise, games, movies, and crafts.
- Physical, occupational, and speech therapy.
Some skilled nursing facilities offer care for specific conditions. For example, they may have special units for people with memory impairment or dementia. Or, they may offer intensive care for serious chronic conditions, including a ventilator for people who cannot breathe on their own.
Short-Term Skilled Nursing Facilities are generally for people who have been discharged from the hospital but cannot take care of their medical or personal needs while they heal. Most people in a short-term skilled nursing facility go home in about two weeks. You cannot stay in a short-term skilled nursing facility for more than 100 days. While you are there, the following will be provided:
- Nursing care. Staff will make sure you take your medicine.
- Help with bathing, eating, walking, and going to the bathroom.
- Physical, occupational, and/or speech therapy (as needed). These are meant to help you regain your strength, mobility, and independence.
You may need to move to a long-term skilled nursing facility if you do not get better or if you get worse. Some people get worse because of medical complications.
Long-Term Skilled Nursing Facilities are generally meant to live in permanently. They are for people who have physical limitations (for example, due to a stroke) or permanent cognitive impairment (for example, due to Alzheimer’s Disease). People in long-term skilled nursing facilities require 24-hour assistance and some level of skilled nursing care.
Even though most people in a long-term skilled nursing facility live there for the remainder of their life, some people do move back home. For example, you may gain enough function so that you can move home and have a family member or caregiver help you. Or, you may choose to go home for end of life hospice care.
Home Health Care: Help at home after your health status has changed
Home Health Care is for people who need a limited amount of nursing and personal care. It is usually for people who have just been discharged from the hospital after an illness or injury or for people with chronic health conditions. The goal is to help them stay at home and live as independently as possible.
Home health care can provide the types of services listed below.
- Nursing care to evaluate, manage, and monitor your care. A registered nurse or licensed vocational nurse provides this care. They will provide some medical treatments, such as care for your wounds. They also will talk to your doctor and other healthcare providers to create your care plan. Nurses will also teach the best ways to care for yourself. This could include how and why to take your medicine, or what to eat and not eat.
- Physical therapy to improve or maintain your physical abilities or slow down their decline. A physical therapist or physical therapy assistant provides this care. They will use techniques such as massage, heat, or exercise. They may help you with walking, sitting in a chair, getting into and out of bed, and more. Physical therapy can also help you with your strength and balance. A doctor or other healthcare provider can prescribe physical therapy to people who are recovering from an injury or illness.
- Occupational therapy to improve or maintain your ability to do common daily activities or slow down their decline. An occupational therapist or occupational therapy assistant provides this care. They may help you learn how to do common everyday activities again, such as bathing, dressing, using the toilet, preparing meals, and housekeeping. They may also teach you and your caregiver how to use special equipment, such as poles, plate holders, and button hooks, so that you can gain everyday skills back again. A doctor or other healthcare provider can prescribe occupational therapy to people who are recovering from an injury or illness.
- Speech therapy to improve or maintain your speech and language skills and your ability to swallow or slow their decline. A speech therapist provides this care. Speech therapists may use exercises and/or equipment to help you improve or regain your speaking and swallowing abilities. A doctor or other healthcare provider can prescribe speech therapy to people who have had an illness or injury that has changed their ability to speak or swallow. This could include throat cancer, a stroke or other brain injury, or a disease like Lou Gehrig’s.
- Medical social services help with social and emotional concerns related to your injury or illness. A social worker provides this care. A doctor or other healthcare provider will prescribe it to people who need help finding food, getting legal aid, paying utility bills, and getting long-term counseling.
- Home health aides help with daily activities such as bathing, dressing, and preparing meals while you receive home health care.
Hospice Care: Help with end-of-life care
Hospice Care provides care to people when they have approximately six months or fewer to live and are no longer getting or seeking medical treatment. The goal of hospice care is to help keep you comfortable and keep your pain and other symptoms under control. It does not cure an illness.
Most people get hospice care at home or wherever they are living. You can also get it in a hospital, skilled nursing facility, or hospice facility.
A team of healthcare professionals, social workers, and trained volunteers provide hospice care. They are trained to help with your medical, psychological, and spiritual needs. They also provide education and support to caregivers, including respite care (time for your caregivers to rest or get away). And, they provide grief counseling for survivors after you pass away.
CaringInfo provides more details about hospice care and other similar services.
Assisted Living Facilities: Daily support, without nursing help, for adults 60 and older
Assisted Living Facilities provide support for everyday living for adults who are 60 and older. This can include help with bathing, dressing, taking medicine, housekeeping, and laundry. They also provide communal meals and social activities.
Assisted living facilities do not provide skilled nursing care like you could get in a nursing home. But, some assisted living facilities do provide care for people who have dementia or other memory-related impairments. If you or your family member needs this, please ask prospective facilities what type of memory-assisted care is provided.
Assisted living facilities range in size.
- The smallest facilities are called “board and care.” They have fewer than 10 residents and are usually in residential or group homes. They have private or shared bedrooms and provide meals in a dining or living room.
- Larger facilities usually have apartment-like suites. They provide restaurant-like dining and offer daily organized social activities.
- The largest facilities may have multiple buildings in a setting that looks like a campus. They also have apartment-like suites, provide restaurant-like dining, and offer daily organized social activities.
Adult Residential Facilities: Daily support, without nursing help, for adults younger than 60 with disabilities
Assisted Residential Facilities provide support for everyday living for adults younger than 60 with developmental, mental, or physical disabilities. This can include help with bathing, dressing, taking medicine, housekeeping, and laundry. It also includes communal meals and social activities.
Assisted residential facilities do not provide skilled nursing care like you could get in a nursing home.
Continuing Care Retirement Communities: Care that can increase as needs change over time, for adults 60 and older
Continuing Care Retirement Communities provide a range of services to adults who are 60 and older. They are also called “life care communities” and are set up to provide increasingly complex care and services as your needs change.
These types of communities have many different housing designs. For example, they may be apartments, high-rise buildings, or a subdivision. They usually have assisted living units and a skilled nursing facility either on site or nearby.
Adult Day Health Care Centers: Daily non-residential nursing care for adults who are frail or disabled
Adult Day Health Centers provide services to adults who are frail or have chronic disabling medical, cognitive, or mental health conditions and are at risk of being placed into an institution. Registered nurses work on site.
Adult Day Health Centers offer organized daytime programs focusing on health, various therapies, and social services. Some of them also have Alzheimer’s Day Care Resource Centers on site. Some only provide care during weekdays, and some also provide care on weekends.