According to 2017 estimates, 46% of living U.S. veterans are over the age of 65 (National Center for Veterans Analysis and Statistics). Many of them will end up needing some type of long-term care in their remaining years.
What Is Long-Term Care
People who require long-term care often have chronic health conditions, disabilities or cognitive impairments. The care can be non-medical (custodial) care, medical (skilled) or a combination of both.
Custodial (non-medical) care typically involves assistance with daily living activities (ADLs) like bathing, dressing, eating, toileting and transferring, and/or support with Instrumental daily living activities (IDLs) like housework, meal preparation, transportation and medication management. The extra help enables the person to remain independent for as long as possible. Most custodial care takes place at home or an assisted living facility.
Skilled care is provided by licensed nurses, certified nursing assistants and other medical professionals. The purpose of skilled care is to maintain “the quality of health of patients or to slow the deterioration of a patient’s condition.” (ACM Skilled vs. Custodial Care). Although some skilled care services are available to people still living independently, the majority of seniors who require medical care reside in a skilled nursing facility.
Long-Term Care At Home
In-home long-term care is generally provided by family members, friends or home care aids. The care usually centers around help with the basic tasks of daily living. You do not have to be licensed or certified to assist someone with personal care.
Another type of home caregiver is a home health aide. A home health aid is formally trained to provide assistance with personal care as well as some medical care like administering medication and checking vital signs (temperature and pulse). The national average for a home health aid is $3,861 per month (Genworth 2016).
Sometimes a person living at home will need skilled medical services, including various therapies, treatment and testing Skilled care is provided by registered nurses (RN), licensed practical nurses (LPN) and licensed vocational nurses (LVN), and is the most expensive type of home care.
Adult Day Care
Adult day care refers to community-based centers for the elderly and adults with disabilities. Centers often specialize in care for a chronic condition like dementia or Alzheimer’s. Most centers provide meals, special programs and activities for individuals that would otherwise be at home by themselves. Other services can include medical care, medication management, physical therapy, education and counseling. Adult day care is often used in combination with home care and as an alternative to facility care. The average cost for adult day care is $1,473 per month (Genworth 2016).
Board & Care Homes
A board and care home (also known as adult foster care, adult family homes and residential care) provides services that are similar to an assisted living facility, except in a smaller home environment with fewer residents. Services include meal preparation, medication management and help with personal hygiene, toileting and transferring. Staff live at the home and are available 24 hours a day. Board and care homes are usually licensed and regulated by state agencies, but requirements can vary depending on their location. Residency in a board and care home is usually less expensive than an assisted living facility.
Assisted Living Facility
An assisted living facility is a housing option for individuals who are unable to live on their own, but do not need skilled nursing care. Living spaces can range from shared rooms to private one or two bedroom apartments with complete kitchens.
Facility staff assist residents with personal care as needed. Other services include meals, transportation, laundry, medication management and social activities. Some facilities also provide basic health services. Supervision is provided 24 hours a day. Similar to board and care homes, assisted living facilities are state licensed and regulated.
Most facilities charge a flat rate for basic services, with additional fees for extra services. The average assisted living cost per month is $3,628 (Genworth 2016).
Skilled Nursing Facilities
Skilled nursing facilities are residential centers for individuals with complex care needs. Most residents in a skilled nursing facility require some level of medical assistance. Skilled nursing care is provided by licensed health care professionals such as registered nurses, licensed practical nurses, licensed vocational nurses and licensed physical therapists. A medical doctor oversees the care.
The services provided by skilled nursing facilities include dispensing and monitoring medications, providing intravenous injections, catheter and feeding tube assistance, pharmaceutical, laboratory and radiology services; personal care, laundry assistance and social activities.
The average monthly cost of a skilled nursing facility is $6,844 for a semi-private room and $7,698 for a private room (Genworth 2016).
Veterans Long-Term Care Benefits
Veterans who are enrolled in the VA health care system may be eligible for some types of long-term care services at home, in the community or at a care facility. Eligibility is generally based on clinical (medical) need and availability (not all long-term care services are available at every location). There may also be income and other types of financial requirements depending on the service. In some cases, the veteran may need to pay for part of the service.
Another important criteria for determining eligibility is the veteran’s service-connected (disability) status. The VA’s health care program has a priority system that gives enrollment preference to certain groups of veterans. The highest priority groups (there are eight total) are for veterans with a service-connected disability. Former prisoners of war and veterans who have received a Purple Heart or Medal of Honor are also included in these top priority groups.
One of the best veterans benefits for long-term care is a special Veterans Administration pension called Aid & Attendance. This tax-free, lifetime benefit is a reimbursement for home care, adult day care, board and care, assisted living and skilled nursing facility care. Benefit amounts range from $1,794 per month to $2,846 per month.The veteran does not need to be enrolled in the VA health care system to apply for and receive the Aid & Attendance benefit. Surviving spouses can also qualify for the pension if they meet certain requirements.
Want to find out more about the VA Aid & Attendance pension? Contact one of our benefit consultants who can explain how the benefit works in more detail.