Long-Term Care Planning: A Practical Guide to Better Medical Care for Older Adults
April 2025 | National Care Planning Council
Quick summary
You have more control over your health and care than you may think.
The right team (geriatric-trained providers, coordinated care, family support) improves outcomes and reduces ER visits.
A simple care plan—appointments, medications, daily routines, and support—can prevent crises and lower costs.
We can help you build your plan in one call.
1. Aging and healthcare in America: Why this matters
Cultural bias: U.S. media and workplaces often see aging as decline. That mindset can lead to missed diagnoses and fewer preventive screenings for older adults.
Impact on care: Seniors are less likely to get certain screenings or timely treatment, and many report feeling “invisible” in clinical settings.
What you can do
Bring a one-page health summary to every visit (conditions, meds, allergies, goals).
Ask directly: “Is this normal aging—or is there a treatable cause?”
Bring a care partner to appointments to listen and take notes.
2. Your mindset, your health
Staying engaged works: Learning, movement, and social connection support memory, mood, and heart health at any age.
Common barriers: “It’s too late to start,” or “slowing down is inevitable.” Evidence shows benefits even when starting later in life.
Try this week
150 minutes of light movement: 20–30 minutes a day (walking, chair yoga, tai chi).
2 brain-engaging activities: puzzles, learning a phone feature, or a new hobby.
Simple nutrition wins: add one protein, one fruit/vegetable to each meal; keep water nearby.
3. Getting the care you deserve
What to expect from providers
Preventive care still matters after 65: screenings, vaccines, fall-risk checks, depression screening.
Ask about coordination: “Who is my point person? How do you share results with my other doctors?”
If you hear “it’s your age”: ask for the differential diagnosis and what tests could rule out treatable causes.
Appointment checklist
Bring: updated med list (include OTC and supplements), BP/sugar logs (if relevant), symptom timeline, goals of care.
Ask: What’s my diagnosis? What are my options? Risks and benefits? What can I do at home? When should I call you?
Leave with: a written plan, follow-up date, and contact method for questions.
4. A holistic approach that works
What “good” looks like: care plan + medication review + movement + nutrition + mood support + family involvement + regular check-ins.
Proven models: geriatrics teams, in-home “house calls,” and systems that coordinate across providers reduce hospital stays and ER use.
How to get it
Ask your insurer or doctor about care coordination, chronic care management, and home-visit programs.
Invite family or a trusted friend into your support circle and share your plan.
5. Depression is common—and treatable
Know the signs
Persistent sadness, loss of interest, sleep changes, low energy, hopelessness, thoughts of self-harm.
What helps
Talk therapy, activity, social connection, and sometimes medication. Ask for a depression screening and a mental health referral.
If you or a loved one is in crisis, call or text 988 (U.S.).
6. Nursing homes and alternatives
Two tracks: rehab (short-term) and long-term care (ongoing support).
Many residents could improve with better activity, therapy, and nutrition.
Before choosing a facility
Tour at mealtimes. Ask about staffing ratios, therapy frequency, activities, falls, and hospital transfer rates.
Consider alternatives: home care, adult day programs, assisted living, Program of All-Inclusive Care for the Elderly (PACE), and “culture-change” models (e.g., Eden Alternative).
Evaluation checklist
Is there a personalized plan with goals? Daily movement? Outdoor time? Family involvement? Clear process to escalate concerns?
7. Safe medication use
Older adults use more medications and face higher risks from side effects and interactions.
Safety steps
One pharmacy if possible. Annual “brown bag” review (bring all meds to your visit).
Use a pill organizer and set reminders (phone, smart speaker).
Keep a current med list on your phone and in your wallet.
Ask: “Do I still need this? Can we simplify my regimen?”
8. Geriatric care and how to find it
Geriatricians specialize in older adults but can be scarce.
Options
Ask your primary doctor who in their practice has geriatrics experience.
Look for hospital-affiliated geriatric clinics, home-visit programs, or telehealth geriatrics consults.
Use directories: health system sites, insurer directories, or your local Area Agency on Aging.
9. eHealth and telehealth
What to try: patient portals (test results, secure messages), telemedicine for routine follow-ups, remote BP or glucose monitoring.
Privacy: use strong passwords and two-factor authentication; designate a trusted proxy user if needed.
10. Build your long-term care plan in 7 steps
List your priorities: health, independence, budget, location.
Appoint decision-makers: healthcare proxy, power of attorney.
Organize your medical info: diagnoses, surgeries, allergies, current meds.
Align your care team: primary doctor, specialists, dentist, eye care, pharmacist; add a geriatrics resource if available.
Plan for daily support: home safety, mobility aids, transportation, meals, social connection.
Understand coverage and costs: Medicare, Medigap/Advantage, Medicaid eligibility, long-term care insurance, VA benefits (if applicable).
Put it on paper: include emergency contacts and how to reach your doctors; share with family and your care team.
FAQs
What is long-term care planning?
It’s a written plan for your medical care, daily support, and financial coverage so you can avoid emergencies and stay independent as long as possible.
Does Medicare pay for long-term care?
Medicare covers medical care and short-term rehab but not long-term custodial care. Medicaid and long-term care insurance may help with ongoing support.
How do I find a geriatrician?
Ask your primary doctor, check your hospital system’s directory, or search your insurer’s network. If none are nearby, ask for a primary doctor with geriatrics experience and consider telehealth consults.
How can I reduce ER visits?
Keep an updated care plan, use telehealth and nurse lines, manage medications, and schedule regular follow-ups. Ask your doctor about care coordination or chronic care management services.
Are there alternatives to nursing homes?
Yes. Home care, adult day programs, assisted living, PACE programs, and small “culture-change” homes. Choose based on your goals, safety, and budget.