Extended care facilities are designed to care for those who need assistance with activities of daily living or with medical needs. A nursing home is one type of extended care facility, but not all extended care facilities are nursing homes. An extended care facility is needed when someone has a condition that is likely to last for a long period of time or for the rest of his or her life.

What are some of the likely reasons that someone will need an extended care facility? One of the most common is advancing Alzheimer's disease. People with early or mild Alzheimer's can initially live at home with another person, with family, or in a retirement community. However, as the disease progresses, they need a higher level of care. Medical conditions that cause someone to be unable to bathe, dress, or toilet independently will often result in a need for an extended care facility.

Sometimes the person is expected to recover to some extent or even completely. This is often the case after surgery, or after certain types of heart attacks or strokes. Someone may not be ill enough to be in the hospital, but she or he is not in good enough shape to return home. He or she may also need special treatment, like speech therapy or physical therapy. In this case, you need an extended care facility that is aimed at rehabilitation. These are often referred to as "rehab" centers or institutes. Medicare and other insurance plans often cover these services.

Another care option is a board and care facility. These are small facilities, usually run by one or two main caretakers. They are designed to be as homelike as possible but are licensed and monitored by state or local authorities. Many times insurance will not cover this type of care.

The last type of extended care facility is the nursing home or skilled nursing facility. These are for people who need a higher level of medical care or who must be monitored closely. Nurses and other medical personnel are available. A primary health care provider may see patients once a month or so. Very few insurance plans pay for nursing homes for very long. Some will cover short stays.

Contact your health plan social worker or your local senior citizens' center for information about local facilities.

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