Long-term care is needed when you have a chronic illness or disability that causes you to need assistance with activities of daily living. Your illness or disability could include a problem with memory loss, confusion, or disorientation. (This is called cognitive impairment and can result from conditions such as Alzheimer's Disease.) Or you could have a challenge such as a physical disability, arthritis, or difficulty moving around.

This year, about 9 million Americans over the age of 65 will need long-term care services. By 2020, that number will increase to 12 million. While most people who need long-term care are age 65 or older, a person can need long-term care services at any age. Forty percent of people currently receiving long-term care are adults 18 to 64 years old.

Source: www.longtermcare.gov

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Long-term care includes health and supportive services that are needed daily. Most of the time, these services are for personal care, however, some services are performed by nurses and other medical professionals.

There are variations in costs based on the type and amount of care you need, the provider you use, and where you live.

The average costs in the United States (in 2008) were:

• $187/day for a semi-private room in a nursing home

• $209/day for a private room in a nursing home

• $3,008/month for care in an Assisted Living Facility (for a one-bedroom unit)

• $29/hour for a Home Health Aide

• $18/hour for Homemaker services

• $59/day for care in an Adult Day Health Care Center

Source: www.longtermcare.gov

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No. Medicare pays only for acute hospital stays, a short stay in a nursing facility, and a few visits from a Home Health Agency as long as you are making progress toward a rehabilitation goal.

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Call or go to your county's social or human services agency. Find your county social or human services office and ask for the Medi-Cal Eligibility Worker. Some counties may ask you to make an appointment and bring certain papers to your visit.

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Apply for Food Stamps at a county social or human services office. Find your county social or human services office and ask for the Food Stamp program. If you have income, the amount of your income will be used to determine the amount of food stamps you get. Call ahead to find out what documents you need to attach to your application and if you need to make an appointment.

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Some chronic conditions like Parkinson's, Alzheimer's, emphysema, diabetes, obesity, heart disease, Lou Gehrig's disease, Multiple Sclerosis, and others might add to the likelihood that you may need assistance with daily activities during your lifetime. Living and aging with a disability may also contribute to your need for assistance.

Not everyone will need long-term care. Each person is different and each person manages his/her life decisions, including health and wellness, in a unique way. You can make wise decisions by learning more about your health. You can search for medical literature about chronic conditions on the Internet. You can also read about how others manage disabilities on the Internet. New treatments and new assistive devices are developed each year to help people stay well and independent. Staying healthy and connected to your family and community can help you give and receive care in a way that is meaningful throughout your lifetime.

Regardless, it is smart to create a personal long-term care plan to make things much easier should the time come when you need long-term care services and supports.

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You may want to discuss and get help with decisions from your loved ones. However, you have a right to make all your health care decisions, decisions about where to live, and money decisions unless you've been given due process by a court of law. Call the Adult Protective Services 24-hour hotline in your county if you feel those rights have been taken away from you without a court process. See also Question 16 below for information about  Durable Power of Attorney for Health Care and Advance Directives.

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If you suspect that an elder or dependent adult is the victim of abuse or if you are a victim:

• Call Adult Protective Services 24-hour hotline 1-800-451-5155 if the victim lives in a private home or apartment.
• Call the Long-Term Care Ombudsman CRISIS HOTLINE 1-800-231-4024 if the victim lives in a nursing home or assisted living facility.

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Local offices on aging, senior centers, and other community agencies can offer information and programs for you to learn about how to avoid slips and falls and other safety tips. On the Internet, search for fall prevention.

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Local Social Security Administration offices handle Medicare applications. You may be eligible for Medicare at age 65. Others who might be eligible are people who are disabled, people who have end-stage renal disease, and people who have disabled children. To see if you might be eligible for Medicare, download this questionnaire from the federal Medicare website.

If you are close to age 65 and not yet getting Social Security benefits or Medicare, you can apply for both at the same time. If possible, you should apply three months before the month you turn 65. To apply, you can call or visit your local Social Security Administration office or call Social Security Administration at 1-800-772-1213 to find an office near you. You can also apply online if you meet certain rules.

To get help with Medicare, each area of California has a Health Insurance Counseling and Advocacy (HICAP) office. There is no cost. Call 1-800-434-0222 to find the HICAP near you or view a list of the local HICAP offices.

You can also read more about Medicare by going to the federal government's Medicare website.

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Local offices on aging, area agencies on aging, senior centers, and volunteer centers like United Way and Red Cross have information on volunteer jobs in your area. Most Information and Assistance call centers and 2-1-1 call centers can give you information about volunteering.

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The Alzheimer's Association is an important resource for education, research, and support. Find an find an Alzheimer's support organization near you.

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Each county provides a para-transit service for people living with disabilities. Unfortunately there is no central listing for all counties in California. Call your local office on aging, information and referral network, senior center, independent living center, local transit authority, transit district, or 2-1-1.

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Local senior and community centers maintain calendars of activities, social events, bus trips, classes, and sometimes a schedule and menu of meals served at those centers. Contact your local office on aging, area agency on aging, independent living center, or senior center.

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Some communities in California have organizations that deliver meals to seniors and people with disabilities. Some communities call this Meals on Wheels. Each community is different but most expect donations or a small fee. Find the area agency on aging that funds the home-delivered meal program for seniors in your county. You can also call 2-1-1 for information.

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In California, you can name a person to make health care decisions for you if you are no longer mentally or physically able to communicate your wishes. The Durable Power of Attorney for Health Care is a legal document available on the Internet that you can fill out ahead of time. It does not require an attorney to prepare the document. It names a person of your choice who can carry out your wishes. Another legal document is called an Advance Directive. This document describes the kinds of medical treatments you want or don't want when the time comes. Read more at the Attorney General's webpage on this subject. Visit our Planning page too.

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Contact your employer's personnel department and ask for COBRA coverage. Your employer is required by law to offer you the continuation of its group health policy for up to 18 months if there are more than 20 employees. You will need to request a COBRA packet from your employer. You must return it promptly. You will have to pay for this coverage.

Each person's situation is different. Other assistance to explore is Workers Compensation if the condition is due to a situation on the job. You can also explore Disability benefits by talking to the Social Security Administration office near you.

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Medicare, Medicare supplemental insurance (Medigap), and traditional health and disability insurance plans typically do not cover long-term care services.

Long-term care, whether in a facility or at home, is for people who need assistance with the basic tasks of everyday living for an extended period due to chronic conditions, medical conditions, cognitive conditions, or disabilities.

If you purchase long-term care insurance, it will cover some or all of the costs of personal care services and other long-term care services, depending on how much you purchase, the type you purchase, and for what period of time. It can be costly, but it can help you delay spending resources you'd rather pass on to loved ones or a charity.

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Most likely, it does not. Health plans typically do not cover ongoing chronic care such as an extended stay in an assisted living facility or a continuing need for a home health aide to help you in and out of bed. These services are costly, especially when they are for an ongoing need.

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In most cases it will not. For most people, Medicare will cover the first 100 days of care in a nursing home. There are rules about what services you get during that 100 days and the deductibles and co-pays that may apply.

Medicare can cover limited home visits for skilled care. It is important that your doctor discuss with you or your loved one what kinds of ongoing needs you will have and what assistance you can arrange.

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Medi-Cal is the state health coverage program for those who cannot afford or do not have privately paid health care insurance. Medi-Cal covers long-term care services and might cover your long-term care services if you meet the eligibility rules in California.

For example, it covers people who have low income and few resources. Usually this means that you have only about $2,000 in assets and savings and receive no or a low monthly income.

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No. Your house is exempt and not calculated into your eligibility for Medi-Cal. However, if Medi-Cal pays for your long-term care, those costs can be recovered from your estate after you die.

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The Department of Veterans Affairs (VA) system provides long-term care services to veterans, with highest priority given to those with severe service-related disabilities. Long-term care services from the VA may vary by geographic area. See our Veterans page too.

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Yes, if you apply and are determined to be eligible for the Working Disabled program.

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