Navigating Long-Term Care: Where to Start and Who to Call
Key Insights
- Act early and address warning signs like falls, memory loss, or difficulty with daily tasks before a crisis occurs.
- Work with physicians, care managers, home care providers, and financial advisors.
- Long-term care can be expensive, making financial planning important.
- Medicare covers medical care but generally not ongoing personal care.
- Discuss care preferences, legal documents, and payment options early to reduce stress and increase choices.
No one wakes up expecting today to be the day they need long-term care. It often begins gradually. A parent has a fall, a spouse starts forgetting medications, or everyday tasks like bathing, dressing, and preparing meals become more difficult. When that moment arrives, many families ask the same questions:
- Who do I call?
- Where do I start?
- Will Medicare pay?
- How much will this cost?
Having a plan can reduce stress and help you make informed decisions during an emotional time.
Step 1: Recognize When It’s Time to Ask for Help
Long-term care isn’t just about nursing homes. It includes any ongoing assistance someone needs because of aging, illness, injury, or cognitive impairment. Common signs someone may need additional support include:
- Difficulty bathing, dressing, or using the bathroom
- Problems walking safely or frequent falls
- Memory loss or confusion
- Missing medications
- Poor nutrition or weight loss
- Difficulty managing household responsibilities
- Caregiver burnout from a spouse or family member
The earlier these concerns are addressed, the more options families typically have.
Step 2: Call the Right Professionals
You don’t have to navigate this alone. A good starting point includes:
Primary Care Physician: Your physician can evaluate medical concerns, recommend treatments, and determine whether skilled home health services may be appropriate.
Care Manager or Aging Life Care Professional: These professionals help assess needs, coordinate services, and connect families with local resources.
Home Care Agency: If the goal is to remain at home, a licensed home care agency can help with personal care, meal preparation, transportation, companionship, and other daily activities.
Financial or Insurance Advisor: If you own long-term care insurance or have planned for future care, contact your advisor or insurance company early. Understanding your available benefits before services begin can simplify the claims process.
Step 3: Understand the Cost of Care
One of the biggest surprises for many families is the cost. According to the 2025 national Cost of Care Survey, median annual long-term care costs include:
| Type of Care | Approximate Cost |
|---|---|
| Home Care (44 hours/week) | $80,080/year |
| Assisted Living | $74,400/year |
| Nursing Home (Semi-Private Room) | $114,975/year |
| Nursing Home (Private Room) | $129,575/year |
These are national averages. Costs may be significantly higher or lower depending on where you live.
Step 4: Know Where Medicare Fits In
One of the most common misconceptions is that Medicare pays for long-term care. Medicare generally covers medical care but not ongoing custodial or personal care. Medicare may pay for:
- Hospital stays
- Physician visits
- Rehabilitation after a qualifying hospital stay
- Limited skilled nursing facility care
- Short-term skilled home health services ordered by a physician
Medicare generally does NOT pay for:
- Ongoing assistance with bathing, dressing, or eating
- Long-term supervision due to dementia
- Extended stays in assisted living
- Custodial nursing home care
- Personal care provided over months or years
Because most long-term care consists of personal assistance rather than skilled medical treatment, families often discover that they must pay for these services themselves unless they have another funding source.
Step 5: Review Your Payment Options
Depending on your situation, care may be funded through:
- Personal savings and investments
- Long-term care insurance
- Hybrid life insurance with long-term care benefits
- Short-term care insurance
- Veterans’ benefits (for eligible veterans)
- Medicaid (for those who meet financial eligibility requirements)
Understanding these payment options before a crisis occurs provides more flexibility and more choices.
Step 6: Involve the Family Early
One of the most valuable conversations isn’t about money; it’s about preferences. Ask your loved one:
- Where would you prefer to receive care?
- Who would you want involved in making decisions?
- Do you have important legal documents completed, such as a healthcare power of attorney?
- Have you discussed your wishes with family members?
These conversations are often easier before an emergency forces quick decisions and limited options.
The Value of Planning Ahead
Families often focus on how they will pay for care, but many later say the bigger challenge was knowing what to do next. A thoughtful care plan can provide:
- Clear direction during stressful situations
- Access to professional resources
- More choices about where care is received
- Financial predictability
- Less burden on spouses and adult children
Needing long-term care is not something most people plan for, but it is something many families will eventually face. Whether care lasts a few months or several years, knowing who to call, understanding what Medicare covers, and having a financial plan in place can make an overwhelming situation much more manageable.
The best time to learn about your options is before you need them. Planning today gives you and your family greater confidence, more choices, and peace of mind for whatever tomorrow may bring.
Helpful Resources for Families
If you or a loved one is beginning the long-term care journey, these organizations can provide valuable information and support:
Medicare
Learn what Medicare covers, compare plans, and find answers to questions about healthcare benefits.
- https://www.medicare.gov
- 1-800-MEDICARE (1-800-633-4227)
Eldercare Locator
A free public service of the U.S. Administration on Aging, this tool connects families with local services, including home care, transportation, caregiver support, meals, and senior programs.
- https://eldercare.acl.gov
- 1-800-677-1116
National Institute on Aging
Get trusted information on aging, caregiving, dementia, home safety, and long-term care planning.
Alzheimer’s Association
Take advantage of education, support groups, care planning resources, and a 24/7 helpline for families affected by dementia.
- https://www.alz.org
- 1-800-272-3900
Family Caregiver Alliance
Obtain practical tools, caregiver education, planning guides, and emotional support for family caregivers.
BenefitsCheckUp® by the National Council on Aging
Identify benefits programs that may assist with healthcare, prescription drugs, food, housing, and other expenses for older adults.
LongTermCare.gov (Archived Resource)
Although no longer updated, this government resource still contains useful educational information about long-term care planning and care options.
Need Help Understanding Your Options?
Every family’s situation is unique. Whether you’re planning ahead or responding to an immediate need, speaking with an experienced advisor can help you understand your options, estimate potential costs, and determine whether long-term care insurance or other planning strategies may fit your goals.
The earlier you begin the conversation, the more choices you’ll have and the greater peace of mind you’ll provide for yourself and those you love.
