Medical and Long-Term Care << Planning Your Future << Healthy Aging << womenshealth.gov

About Medical and Long-Term Care

It's a smart idea for any woman to plan for her health and long-term medical needs. It becomes even more important as you age. It's important to put decisions about how much care you want on paper. That way, if you get sick, your family and health care providers will know exactly what you want.

You may have heard of "living wills" or do not resuscitate (DNR) orders. But you may be confused about what they mean for you. Living wills and DNR orders are types of "advance care directives." These are instructions, prepared ahead of time, that direct a person's medical care should she become unable to do so herself. You can also make a directive that appoints someone to make health care decisions for you.

Types of advance care directives:

Verbal instructions – The patient tells her doctor and family members her wishes. It's good to discuss your wishes with your doctor and family. But in an emergency, your family may be too upset to remember your instructions. Or, they may not get to the hospital in time to make sure they are carried out.

Organ donation – A person fills out an organ donation card and keeps it in her wallet. Many states let you choose to become an organ donor when you get your driver's license. It's also a good idea to tell your family that you definitely want to be a donor.

Living will – This is a written, legal document that spells out the wishes of the patient in the event of terminal illness or life-threatening injury. A living will usually includes specific situations and treatments the patient does not want (such as CPR, tube feeding, hydration, etc.).

Special medical power of attorney – This is a legal document in which a person names someone else to make her health care decisions for her should she become unable to communicate.

Do not resuscitate (DNR) order – This document states that CPR is not to be performed if the person stops breathing or the heart stops beating.

Long-Term Care

Most of us want to remain independent and in our own homes for as long as possible. But that isn't always possible. That's why you need a plan for long-term care — and how to pay for it.

Long-term care doesn't necessarily mean a nursing home. Other possible options include community services, home health care, or assisted living. For instance, a person who can't make it out to the grocery store might get community-based "meals on wheels." Someone who needs help with daily activities but wants to stay at home might have part- or full-time home health care aides come in. Other options are retirement and assisted-living committees.

Most of these options cost a lot of money. And regular insurance plans and Medicare don't usually cover these costs. Medicaid pays for long-term care, but only after you have used most of your money and assets.

Another option is long-term health care insurance. These policies can be expensive, but if you think you may need services, they may be a good option. According to AARP, the best time to buy these policies is middle-age. The premiums will be cheaper and you are more likely to be eligible for a policy.

Additional Resources

Publications

Age Page: Getting Your Affairs in Order — This brochure discusses the steps you can take to prepare for the future. In addition, it includes information about important legal documents such as wills and trusts, advanced directives, power of attorney, and living wills.

http://www.niapublications.org/agepages/affairs.asp

Dollars and Sense — Paying for Aging Services (Copyright © AAHSA) — This publication gives an overview of long-term care insurance, Medicaid, and the Program of All-inclusive Care for the Elderly or PACE and explains how each one can provide financial assistance for aging services.

http://www.aahsa.org/article.aspx?id=654

Medicare Hospice Benefits — This is the official government publication for Medicare hospice benefits with important information about: The hospice program and who is eligible, your Medicare hospice benefits, how to find a hospice program, and where you can get more help.

http://www.medicare.gov/Publications/Pubs/pdf/02154.pdf

Steps to Choosing Long-Term Care — This web page is a guide to help Medicare beneficiaries choose a long-term care facility for quality care.

http://www.medicare.gov/LongTermCare/Static/StepsOverview.asp

BenefitsCheckUp (Copyright © National Council on Aging) — BenefitsCheckUpRx is a useful web site for caregivers, seniors and people with disabilities. This resources helps individuals reduce their prescription costs and save money on their medications by calculating entered information by the web site user.

http://www.benefitscheckup.org/link/caregiving

Organizations

= Indicates Federal Resources

Content last updated March 5, 2009.