by Attorney Joseph L. Matthews

Understand the different types of long-term care facilities -- and how planning ahead can help you choose the best option.

Despite significant recent growth in home care and alternative seniors' residences, nearly one of every two women and one of four men over age 65 will enter a long-term care facility (a.k.a. "nursing home") at some time in their lives. Many nursing facility stays are short ones, to allow a senior to recuperate from an illness, injury, or surgery. But many other stays are extended: More than a third of all nursing facility stays last more than a year, and many last three years or more.

Many people would prefer to remain outside a care facility. However, some seniors, because of their condition, circumstances, or the unavailability of in-home services or affordable assisted living residences, can receive adequate care only in a residential care facility.

Most residents in long-term care facilities cannot function without 24-hour monitoring, extensive personal assistance, and nursing care because of illness or physical or mental limitations. Other residents are in relatively good physical and mental health, but too frail to live alone at home. If they had more family or resources, many of these people might be able to make do with home care or living in an assisted living facility. For lack of an alternative, they become long-term care facility residents.

Skilled nursing facilities provide short-term, intensive medical care and monitoring for people recovering from acute illness or injury. Other facilities -- called nursing homes, board and care homes, sheltered care homes, or something similar -- provide custodial care, long-term room and board, and 24-hour assistance with personal care and other health care monitoring, but not intensive medical treatment or daily nursing.