Someone with a physical illness or disability often needs hands-on help with activities of daily living (see pages 16-17). People with cognitive impairments usually need supervision, protection, or verbal reminders to do everyday activities.

The way long-term care services are provided is changing. Skilled care and personal care are still the terms used most often to describe long-term care and the type or level of care you may need.

People usually need skilled care for medical conditions that require care by medical personnel such as registered nurses or professional therapists. This care is usually needed 24 hours a day, a physician must order it, and the care must follow a plan. Individuals usually get skilled care in a nursing home but may also receive it in other places. For example, you might get skilled are in your home with help from visiting nurses or therapists.

NOTE: Medicare and Medicaid have their own definitions of skilled care. Please refer to The Guide to Health Insurance for People with Medicare or The Medicare Handbook to find out how Medicare defines skilled care. Contact your local social services office for questions about Medicaid’s definition of skilled care. For copies of these publications, contact your state insurance department or State Health Insurance Assistance Program listed on pages 31-37.

Persona care (sometimes called custodial care) helps one with activities of daily living (ADLs). These activities include bathing, eating, dressing, toileting, continence, and transferring. Personal care is less involved than skilled care, and it may be given in many settings.