Acute care is the type of care that is usually provided in hospitals and emergency rooms. Your health insurance or Medicare will cover some or all of the expenses for acute care, because it is usually skilled care.

Acute care is usually for conditions that are treatable and you may fully recover with the right medical attention. These conditions initially do not require care for an extended period of time.

Example: Accident, Pneumonia, Heart Attack

Chronic care is the type of care that is usually provided in your home, nursing homes, and assisted living facilities. Your health insurance or Medicare will usually not cover chronic care, as it is not considered skilled care.

Chronic care is usually for conditions that are treatable, but generally not curable. This type of care is usually expected to last longer that 90 days.

Example: Arthritis, Diabetes, Alzheimers, or Stroke

Skilled care is the type of care that is usually delivered in skilled nursing homes, but can also be received in the home. Medicare defines skilled care as services and rehabilitation that requires the skills of technical or professional personnel such as: registered nurses, licensed practical nurses, and physical or occupational therapists.

Example: Bill recently had his knee replaced. He is expected to fully recover, but needs some physical therapy to learn how to safely get up and down stairs. He was admitted to a skilled nursing facility to receive his therapy. He may remain there as long as he needs daily therapy and is showing improvement.

Non-skilled or custodial care is defined as the type of care that is provided to persons who need help on a regular basis with their activities of daily living because of a physical limitation, chronic problem or a cognitive impairment.

This care does not have to be performed by a medical professional as skilled care requires. Many times it is provided by a spouse or family member. Non-skilled care is also known as custodial care.

Example: Alice suffers from arthritis. She needs assistance dressing and bathing herself. Her daughter comes to her house every morning and evening to care for her.

Skilled nursing facilities are usually comprised of two separate components. The first component is a unit that provides skilled nursing care that is paid for by Medicare. The rest of the facility provides non-skilled or custodial care.

The goal of the Medicare Section of the skilled nursing facility is to provide services needed to rehabilitate the patient so that they can return home. Many times, patients are unable to return home and are moved over to the non-skilled or custodial section of the facility.

Example: Joan suffered a stroke 8 months ago. Right after her stroke, she was admitted to a skilled nursing facility in the Medicare Section and received daily therapy.

After 45 days, her therapists determined that she was not showing any more improvement and would need help with her daily living for the rest of her life. Because Joan has no one capable of caring for her at home, she was transferred to the non-skilled wing of the nursing facility. She will live out the rest of her life in the nursing home.

Assisted living facilities provide non-skilled care for people that need help with their activities of daily living, but who are able to provide for a lot of their own care and get through a daily routine with minimal assistance.

The residents live in individual apartments that they furnish and personalize to make home. Meals are usually provided in a community dining room. There are many activities and social events to attend. These facilities can be part of a larger independent retirement community or as a stand-alone facility that only offers assisted living.

Example: Aline was 85 years old and living in her own home. She didn't get out of the house much or socialize with many people. Her daughter, Marty, arranged to have her move to an assisted living facility after she realized that Aline was forgetting to take her medications and was not able to take care of her own personal hygiene.

Aline didn't need skilled nursing care, but someone to help with her activities of daily living. Marty will not worry as much now, as she knows that her mother will receive help when she needs it, and that caregivers will ensure that she takes her medications. Aline is now able to participate in fun planned activities that are helping to keep her vital.

Home care is generally considered appropriate at the custodial and non-skilled care levels. Skilled care can be provided in the home, however, it may be cost prohibitive if extensive care is required.

Home care could consist of a weekly visit by a homemaker that performs housekeeping chores (cooking, cleaning, laundry, taking out the garbage) or a daily visit by a personal care attendant that provides assistance with bathing and dressing. It may even be a daily visit by a home health registered nurse or a therapist.

Example: Paul was diagnosed with Alzheimers two years ago. He cannot be left alone in the house. His wife Susan, is in her 70's, as is Paul. She doesn't have the energy that she did 10 years ago. Taking care of Paul, the housework, laundry, and cooking, gives her no time for herself.

Susan would like to have someone come in a few days a week to stay with Paul and help out with the housework, so that she can go shopping and spend some time with her friends to get a much needed break.

Adult day care is a community-based service that was developed to keep people out of nursing homes and in their homes. Adult day care facilities offer custodial care during the weekdays.

Adult day care centers offer a form of support for those that live in their own homes, or maybe with their children, by providing them an opportunity to get out of the house for social and mental stimulation.

Adult day care centers offer family members who are providing care the much needed break during the day to continue to live their lives and provide care for their loved ones.