What is Long-Term Care?

Long-term care includes medical services such as nursing care or therapies. It also includes supportive services, such as help in bathing, dressing, getting in and out of bed, taking medicines, or preparing meals.

In the past, long-term care was thought of as strictly nursing home care. Today long-term care can be provided in a variety of settings, including nursing homes, the person's own home, an adult day care center, or a group living arrangement with supportive services. Community-based long-term care (provided outside of nursing homes) is often given by family and friends, but can also be provided by paid individuals or agencies, some of which are licensed by the state and/or certified by public funding programs like Medicare.

Nursing Home Care

Care in a nursing home includes several different levels of care:

Skilled Nursing Care is care for medical conditions furnished on a physician's order that requires the skills of professional personnel such as a registered nurse or a licensed practical nurse and is provided either directly by or under the supervision of these personnel.

Intermediate Nursing Care is basic care including physical, emotional, social, and other restorative services given under periodic medical supervision. This nursing care requires the skill of a registered nurse in administration, including observation and recording of reactions and symptoms, and supervision of nursing care.

Personal or Custodial Care is care to assist with daily living that can be performed by persons without medical training and that is primarily for the purpose of meeting the personal needs of the patient, including feeding and personal hygiene.

Community-based Long-Term Care

Community-based long-term care can be provided in many settings and by many kinds of providers. If a person is receiving several services from different providers, a professional case manager may be involved in arranging for and managing the services. A few of the specific kinds of services and agencies that provide community-based long-term care are listed below:

Home Health Care provides:

• Skilled nursing services such as providing therapy treatments or administering medication;
• Home health aide services such as checking temperature and blood pressure;
• Personal care such as help with bathing, dressing, walking, and exercise; and
• Physical, occupational, respiratory, or speech therapy.

Residential Care Apartment Complexes (RCACs) (formerly called assisted living facilities) provide supportive, personal, or nursing services. A residential care apartment complex must either be certified or registered by the Wisconsin Department of Health and Family Services. It is a place where five or more adults reside that consists of independent apartments, and that provides not more than 28 hours per week of services.

Adult Day Care programs provide daytime care to individuals who do not need to live in a nursing home. Adult day care is care given in a nonresidential, community-based group program designed to meet the needs of functionally impaired adults. It is a structured, comprehensive program that may provide a variety of health, social, and related support services during any part of a day.

Respite Care is the provision of personal care, supervision, or other services to a functionally impaired person in order to temporarily relieve a family member or other primary caregiver from caregiving duties. Respite care services are usually provided in the impaired person's home or in another home or homelike setting, but may also be provided in a nursing home.

Hospice Care is a specifically designed package of social and medical services that primarily provides, pain relief, symptom management, and supportive services to terminally ill people and their families.

Family Care

Family Care is a long-term care program being piloted in nine Wisconsin counties. As a comprehensive and flexible long-term care service system, Family Care strives to foster independence and quality of life, while recognizing the need for interdependence and support.

Goals of the Family Care Initiative:

CHOICE - Give people better choices about the services and support available to meet their needs.

ACCESS - Improve people's access to services.

QUALITY - Improve the overall quality of the long-term care system by focusing on achieving people's health and social outcomes.

COST-EFFECTIVENESS - Create a cost-effective long-term care system for the future.

Updated information on the LTC Redesign is available on the Department of Health and Family Services's (DHFS) Web site at www.dhfs.state.wi.us/LTCare/INDEX.HTM. If you need information not available on the Web site, you may contact: Family Care Information, DHFS-DDES-CDSD, PO Box 1379, Madison, WI 53701-1379.

Below are several Web sites offering more information on services provided by the community options program:

Home Health Agencies

Residential Care Apartment Complexes (RCACs)

Family Care
Family Care is offered in the following counties in Wisconsin: Fond du Lac, Kenosha (began operating February 2007), La Crosse, Milwaukee, Portage, Racine (began operating January 2007) and Richland.

Adult Day Care Programs

The Alzheimer's Family and Caregiver Support Program: services for people caring at home for someone with irreversible dementia.