When Elder Care attorneys talk about the need to plan for long-term care, what exactly are they referring to? Unfortunately, when we think of long-term care, we often think of a nursing facility, but long-term care is simply the need for ongoing assistance. A person who needs long-term care may not need to be in a nursing facility so much as they need help with daily living at home. Much of this care can be costly, but the Texas Health and Human Services Commission offers programs to help offset the costs of care for those who meet certain criteria.

There are several different levels of care available to elders as they age depending on their need for assistance. Each level of care may include a medical and health component, a personal care component and/or a social and recreational component.

One type of community-based care is adult day care. Adult day care offers a supportive group environment for seniors with cognitive and/or functional impairments. These services may include medical and health services, social services or both. Importantly, adult day care gives full-time caregivers a much needed break. In Houston, the costs vary between $30 and $78 per hour.

Home care is another type of assistance available to seniors. Home care consists of either a home health aide or a companion/homemaker. Services may include light housekeeping, meal preparation, transportation to appointments, or assistance with medication. The goal of home care is to allow the senior to “age in place” as an outside service comes into the home to help. The median cost for these services in Houston is around $44,000 per year.

The next level of care is an assisted living facility (ALF). An ALF is a housing option for seniors to live independently in safe environment. Depending upon the chosen level of care, an ALF may provide services ranging from care management, assistance with every day activities, housekeeping, medication management, security, transportation, meals and social and recreational activities. The yearly median cost is $43,500 in Houston.

Finally, nursing homes are available to those who require the most assistance. Nursing homes typically provide a secure environment and services to meet the physical, medical and social needs of their residents. Many patients in nursing homes require assistance with multiple everyday activities (bathing, dressing, eating, toileting, transferring in and out of chairs or beds, and continence) and/or have cognitive limitations due to Alzheimer’s disease or another form of dementia. The median cost in Houston for a private room in a nursing home is $83,000 per year.

Since health declines as we age, and we become more likely to need help with everyday activities, it is smart to consider what options will be available if and when assistance is needed. Family members with the best intentions may try to care for their loved ones alone thinking there is no other way, but there are many options out there that can provide assistance even when a full service nursing home is not required. Long-term care planning or Medicaid planning can help families prepare to pay for these services when they are not covered by Medicare or private insurance.

Costs of care from: Genworth 2015 Cost of Care Survey Texas