August 24

Understanding Long-Term Care: Custodial Care vs. Skilled Care

Earlier this summer, we helped readers explore the term Long-Term Care (LTC) and understand what it means and why it matters as we age.

Within the Long-Term Care world, many smaller issues exist. For example, there is the issue of what care is needed and how it is delivered. For example, there is a difference between skilled care and custodial care. Understanding the differences between the two can help you make the best decision for which care you or a loved one needs. In this article, we will help you understand what each term means, how they are different and why it matters for your health and wellness.

What is Custodial Care?

Custodial care is non-medical care that can be provided by a non-licensed caregiver. It can be provided in the home or in a care facility like a nursing home or assisted living facility. Custodial care involves helping a client with activities of daily living (ADL) such as bathing, dressing, cooking, exercise, grooming and more. The care received may be dependent on the place the care is provided. For example, if you are receiving custodial care at home, the caregiver may help with cooking or folding laundry. In a nursing facility, custodial care might focus more on dressing, bathing and grooming.

What is Skilled Care?

Skilled care is medically necessary care that is provided by or under the supervision of licensed or skilled medical personnel. Skilled care might include wound care, physical therapy, catheter care, injections, speech therapy and occupational therapy and more. According to United Healthcare, skilled care is “…basically the same level of nursing care you get in the hospital.”

What are the differences between skilled care and custodial care?

Skilled nursing care can be more costly than custodial care.

It also often takes place in a skilled nursing facility (SNF) or nursing home vs. one’s private residence; however, this is not always the case. Many people receive skilled care in the home through the use of private caregivers who are medically trained and licensed to provide skilled care.

Another difference between skilled and custodial care is that skilled care is prescribed by a physician, while custodial care does not usually meet this requirement.

How do we determine which type of care is needed?

The reality is the decision for which care is needed is based on the health, emotional and cognitive condition(s) of the individual, their current home environment and support system(s), and the outcomes the physician believes may be achieved through care.

For example, recuperating from a hip replacement for an individual who was active pre-surgery might require custodial care for a few weeks to provide “stand-by” assistance with bathing & dressing, preparing meals, light housekeeping, transportation to appointments, along with PT and OT therapy services in the home. Hip replacement recovery for someone with multiple health conditions and a more complex recovery may qualify for skilled nursing care in a skilled nursing facility for a few weeks. This care would include custodial care services, meals, medication administration, daily access to PT and OT therapies.

Each situation must be assessed individually to achieve the best care outcomes possible.

Next Steps

Understanding Long-Term Care (LTC) can feel confusing and overwhelming. By breaking this topic down into small, digestible chunks, you can better prepare for the future by understanding how the moving parts of LTC all work together. Planning now, before a crisis, is key.

Speaking and connecting with a Care Manager is one way to help navigate the world of LTC. Care Management is not just a temporary service, or a limited service provided by a hospital at discharge. Care managers take the time to understand their client’s goals and priorities. They remain an active part of their client’s life to ensure care needs are provided correctly, whether in the home or in a care community.

Care managers have the expertise to understand medical histories and current diagnoses, medication administration details, family support, and the ability to recommend additional services that will enhance their client’s current and future needs. They understand how to read insurance policies, how to file claims, how to request services from physicians, etc. They also understand how to select services based on the client’s finances.

For more information or to better understand both skilled and custodial care, schedule a consultation with a care manager today.

Insert Call to Action