Long-term Care for People with Medical or Physical Disabilities

What is a Medical or Physical Disability?

People who have medical or physical disabilities are unable to do some things for themselves, including:

  • Caring for themselves (dressing, bathing, eating)
  • Performing manual tasks (cleaning, cooking)
  • Walking
  • Seeing
  • Hearing
  • Speaking
  • Breathing
  • Learning
  • Working

Who Can Get Help?

Each service has its own rules. Most programs require that:

  • You have limited income and assets.
  • You show a need for services.
  • You be a U.S. citizen or a qualified legal alien who lives in Texas.

Some services have age limits, such as those for children. Others are for people of all ages.

To learn more, visit the Medicaid for the Elderly and People with Disabilities Handbook. This handbook has details about income and resources limits as well as other information about who may be eligible for services.

Where Can I Get Services if I Have a Medical or Physical Disability?

If you have a medical or physical disability, many options are available to you. You can get services in

  • Your own home
  • A daytime program in your community
  • A residential setting, such as a nursing home or assisted living facility

In Your Own Home

Given the choice, most people would prefer to live in their own home or with their family. Sometimes if you have help with everyday tasks, this can happen. Some types of services you may be able to get are:

  • Personal care services — Help with housekeeping, cooking meals or personal care tasks, such as bathing and dressing.
  • Medical services — Provides medical supplies or equipment to help you be independent. These might include reachers to help you get things off high shelves or a scooter to help you move around. You also might get nursing care in your home.
  • Transportation services — Rides to medical appointments if you do not have a car or can't drive.
  • Caregiver services — Provides a break and other help for family members who help take care of you.

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A Daytime Program in Your Community

Whether you live alone or stay by yourself when your family goes to work, you do not have to be lonely. If you go to a daytime program, also called adult day care, you can have fun, learn and be with others. You also may get help with some tasks, such as taking medicine.

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In a Residential Facility

Sometimes it's not possible to live by yourself or with your family. In those cases, assisted living or a nursing home might be right for you. These facilities are professionally staffed businesses that provide different levels of care, depending on what you need.

Assisted Living Facility

If you choose to live in assisted living facility, you will usually have your own room or apartment. You can bring your things with you to make it feel like home. You will usually eat with others. Services might include:

  • Help bathing or getting dressed.
  • Someone to make sure you get your medicine.
  • Employees checking on you to make sure you are doing OK.
How do People Pay for This?

Two programs may pay for assisted living — Community Based Alternatives and Deaf Blind with Multiple Disabilities. Not all facilities offer CBA and DBMD services.

People who don't qualify for one of those programs will need to use their own money or possibly long-term care insurance to pay for assisted living. You can learn more about long-term care insurance at LongTermCare.gov.

Who Monitors Assisted Living?

HHS licenses assisted-living facilities and inspects them once a year. The agency also looks into complaints made about facilities.

Many times residents have access to a volunteer long-term care ombudsman who can help resolve issues. Ask the facility staff who your ombudsman is.

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Nursing Home

If your doctor says you need full-time care from a nurse, a nursing home may be right for you. Nursing homes are the highest level of care most people will receive outside of a hospital. This type of care is sometimes called custodial care. In additional to a high level of medical care, residents get help getting into and out of bed and with feeding, bathing and dressing and other activities.

The cost of a nursing home in Texas ranges from $3,000 to $4,000 a month (University of Texas). If you do not have much income or other resources, Medicaid may pay for a nursing home. You can talk to a DADS worker about Medicaid. You will have to live in a nursing home for 30 consecutive days before you can apply for DADS services.

Will Medicare Pay for a Nursing Home?

Many people think that Medicare will pay their nursing home expenses. That is not always true. Medicare pays for up to 100 days in a skilled nursing facility following a hospital stay. Skilled care includes physical and other types of therapy. The goal is to help you return home as soon as possible and keep you from being readmitted to the hospital.

Who Monitors Nursing Homes?

DADS licenses and certifies nursing homes, and the agency inspects them once a year. The state also looks into complaints against nursing homes.

Many times residents have access to a volunteer long-term care ombudsman who can help resolve issues. Ask the facility staff who your ombudsman is.

Learn More

Where Do I Call to Get These Services?