Home Helpers

Health Care Considerations - Long-term care? Acute Care?

"Overwhelmed, uninformed and unprepared are words we commonly hear from new clients and their family members as they encounter chronic or life-threatening illnesses, serious injuries and age-related limitations," said Vicki Crow, president of Home Helpers, Northern Lehigh Valley. Due to a lack of first-hand experience and being unfamiliar with the various health care options, many people struggle to make sense of the system.

While often thought of as being one in the same, did you know how acute care and long-term care are different?

Acute care refers to medical care associated with illness or injury. The acute care system is made up of hospitals, primary care providers, medical specialists and skilled nursing facilities. With acute care, the focus tends to be on treating medical conditions.

The long-term care (LTC) system, in contrast, refers to on-going assistance and support with daily living activities. The LTC system is made up of caregivers, both formal (e.g., paid, professionals) and informal (e.g., unpaid, family and friends), assisted living communities, nursing homes and community resources (e.g., elderly services programs, senior centers). With LTC, the focus is on quality of life and maximizing independence.

Another important distinction between acute care and LTC is the payee source. For acute care, private health insurance, Medicare and Medicaid are the primary payment sources. In addition to co-payments, which are the responsibility of the insured, certain medical services have payment limits or may not be covered by insurance.

For LTC, the primary payment sources include "Private pay", meaning the person receiving the services has responsibility to cover the costs, long-term care insurance, and under certain circumstances and for a limited period of time - Medicare. Refer to the Medicare and You Handbook for details on what is and is not covered by Medicare.

"While it is estimated that seven out of ten people will need LTC, studies indicate that only three out of ten people believe they will ever need on-going assistance and support at some time during their lives," Crow added. Needless to say, many people are caught by surprise when they encounter age or illness-related limitations that make independent living a challenge.

When considering what type of care arrangement may be most appropriate, it can be helpful to consider a person's ability to perform daily living activities. When assessing a person's need for assistance, it can be helpful to understand what the acronyms ADL's and IADL's encompass.

ADL's is short for Activities of Daily Living and refers to basic self-care including eating, bathing, dressing, grooming, transferring, and toileting.

IADL's is an acronym short for Instrumental Activities of Daily Living and refers to complex activities associated with independent living. IADL's are the everyday tasks people perform on a regular basis. They include handling chores in and around the home, shopping, preparing meals, driving, managing personal affairs, taking medications as prescribed, refilling prescriptions, and maintaining a safe living environment.

As people encounter limitations, it is often assistance with IADL's that is needed. When people reach the point that they need on-going assistance with personal care activities and/or medical care, they tend to be experiencing significant limitations often due to advanced age, chronic illness and serious injury.

In our ever aging society, people are continually trying to make sense out of the complex health care system. Additionally, we welcome to opportunity to discuss specific care needs and consider it a privilege to help make life easier for our clients and their families.