When Is It Time for Long-Term Care?

If you’re caring for an older person in your life, realizing that they need additional support outside of your home can bring up a lot of emotions. You may feel guilty or uncomfortable, especially if the person in your care has previously expressed a desire to remain at home for as long as possible. 

That said, if someone’s health and safety needs have become difficult to fully meet, recognizing that they may benefit from a different care setting is another way to be there for them.

An accident, hospitalization, or other health crisis can create an immediate need for long-term care, leaving little time to explore your options. Even if your current arrangement is working well, learning about long-term care now can better prepare you to support the person in your care if their needs change. 

In my 20 years at Hebrew SeniorLife, including my current role as vice president of patient access at Hebrew Rehabilitation Center, I’ve worked with many families navigating the transition to our long-term chronic care hospital. Here is what you should know when considering whether long-term care may be appropriate for your loved one. 

What is long-term care? 

Before exploring the signs that it could be time for long-term care, it’s helpful to understand what the term encompasses.

Some people may only picture nursing homes when they hear the term “long-term care.” However, long-term care today encompasses a range of settings and services intended to support a person’s health, safety, and quality of life.

Hebrew Rehabilitation Center is licensed as a long-term chronic care hospital, providing a higher level of medical care than traditional nursing facilities. Our patients have chronic and complex health needs that require ongoing hospital-level care, including medical monitoring and specialized support for wounds, catheters, specialized care, and respiratory needs. Learn more about what long-term chronic care hospitals are.

In addition to around-the-clock nursing care and medical oversight, long-term chronic care patients receive coordinated clinical services, rehabilitation and therapeutic programs, nutritious meals, social activities, wellness programs, and spiritual care. 

Five signs that it may be time for long-term care 

The following five signs may indicate that someone could benefit from a long-term care setting: 

1. They require a level of supervision that doesn’t feel sustainable. 

When you first began caring for someone, they may not have needed as much support as they do now. If they can no longer be safely alone for an extended period, it may become more difficult to manage other obligations, such as work, family responsibilities, and personal well-being.  

It may be a good time to explore long-term care if you are struggling to keep up with these needs or are feeling burnt out. Recognize that it is not a question of whether you are willing to help, but whether the current arrangement is safe and sustainable for you, the person in your care, and others in the home.

2. They experience growing health and safety concerns at home.

Changes in someone’s ability to live safely at home may occur gradually. Repeated falls, missed medications, or frequent hospitalizations can all indicate that more supervision or medical oversight could be helpful.  

If you are concerned and serving as their activated health care proxy, you can speak with their health care team on their behalf about any changes you notice and what additional support might be appropriate. If they have not yet named a proxy, our blog post on choosing someone to speak on your behalf can help them begin this important part of the advance care planning process. 

3. They have increasingly complex medical needs.  

Helping manage someone’s chronic condition may feel possible with the right support. However, care becomes increasingly complex when someone has multiple conditions, requires ongoing medical monitoring, or needs specialized treatment.

Coordinating medications, treatments, appointments, and changing symptoms — all while learning how different conditions may affect one another — can be overwhelming for anyone. If your loved one’s needs exceed what you can safely provide at home, now could be the time to start exploring a long-term setting with on-site 24/7 nursing care. 

4. They have dementia that is making care more complicated. 

As Alzheimer’s disease or another form of dementia progresses, you may notice the person in your care needs more help with medications, meals, personal care, mobility, and everyday decisions than they used to. Other health conditions can also become harder to manage if they are having trouble explaining how they feel or following care instructions.

A long-term care setting can share those responsibilities by providing around-the-clock oversight, specialized memory care, and meaningful opportunities for engagement. For example, the memory care units at Hebrew Rehabilitation Center include sensory rooms with soothing lights, calming sounds, and other activities that invite people with cognitive decline to engage all five of their senses in a safe and comfortable environment.  

5. They have become socially isolated. 

Consider whether the person in your care has regular opportunities for conversation, activities, and meaningful connection  — or whether they spend much of their day alone. Even when someone regularly interacts with their caregiver, those interactions may focus more on their care needs than on personal connection.

Social isolation alone does not mean someone needs long-term care. If more socialization is an older adult’s main need, community-based programs or an independent living community could be a good fit.  

That said, for those experiencing isolation who also require a high level of medical care, the familiar routines, shared activities, and relationships available in a long-term care setting can support well-being. For example, Hebrew Rehabilitation Center offers group and individual expressive therapies for long-term chronic care patients living with neurological disorders, dementia, pain, anxiety, and other health conditions. Group sessions are one opportunity for socialization and connection. 

Explore long-term chronic care at Hebrew Rehabilitation Center

Planning gives you the space to ask questions, explore appropriate care settings, speak with the person in your care and other family members, and navigate your financial situation. That way, if a health crisis or medical emergency does occur, you’re not considering every part of the decision for the first time.

At Hebrew Rehabilitation Center in Boston and Hebrew Rehabilitation Center at NewBridge on the Charles, we serve older adults with chronic and complex health needs. Our interdisciplinary team provides comprehensive medical oversight, coordinated clinical services, and specialized therapeutic programs for older adults in a home-like environment.

Interested in learning more about long-term chronic care? Contact Hebrew Rehabilitation Center at 617-363-8000 for more information.