Long-Term Custodial Care: What Families Should Know
If you've started researching care for an aging parent, you've probably run into the term “custodial care” — often without a clear explanation of what it means. Understanding it matters, because the type of care your loved one needs shapes everything from the right community to how the care is paid for. This guide explains what long-term custodial care is, who it's for, how it differs from skilled care, and what families in Los Angeles should keep in mind.
What is custodial care?
Custodial care is non-medical help with the activities of daily living — things like bathing, dressing, eating, using the bathroom, and moving safely around the home. It also includes support with everyday tasks such as preparing meals, managing medications, and getting to appointments. The key word is non-medical: custodial care is provided by trained caregivers rather than licensed nurses, and it's about helping a person live safely and comfortably day to day.
“Long-term” simply means the care is ongoing rather than a short recovery period. Many older adults need custodial care for years, especially as mobility, memory, or chronic conditions make independent living unsafe.
Custodial care versus skilled care
It's easy to confuse custodial care with skilled care, but the difference is important. Skilled care is medical care that must be provided or supervised by licensed professionals — wound care, IV medications, physical therapy, and similar services. Custodial care is non-medical daily support. A single person may need both, and the mix can change over time. Knowing which type of care is central to your loved one's needs helps you choose the right community and understand what will and won't be covered by insurance.
Who needs long-term custodial care?
Families typically begin considering custodial care when a loved one:
Needs regular help with bathing, dressing, or moving safely
Is no longer able to prepare meals or manage medications reliably
Is at risk of falls or wandering when left alone
Has memory changes that make daily life unsafe without support
Has a caregiver who can no longer provide the level of help needed
Custodial care can be provided at home, in an assisted living community, in a memory care setting, or within a skilled nursing facility, depending on how much support a person needs and whether any medical care is also required.
Not sure whether your loved one needs custodial or skilled care? Speak with our team at Solheim — we can help you understand the difference and the options.
How long-term custodial care is paid for
This is where many families are caught off guard. Because custodial care is non-medical, it is paid for differently than medical care:
Medicare. Medicare generally does not cover long-term custodial care. It may cover short-term skilled care or rehabilitation after a qualifying hospital stay, but not ongoing help with daily living.
Medi-Cal. California's Medicaid program may cover certain custodial care services for those who qualify financially, particularly in a skilled nursing setting. Room and board in assisted living is generally not covered. Confirm specifics with the state and the community.
Long-term care insurance. Policies that include custodial care can offset a meaningful share of the cost. Review the daily benefit and elimination period closely.
Private funds and veterans benefits. Most families use a combination of savings, pensions, and home sale proceeds, sometimes supplemented by the VA's Aid and Attendance benefit for eligible veterans and surviving spouses.
What to look for in a community providing custodial care
When custodial care will be ongoing, the community matters as much as the care itself. Look for:
Consistent, well-trained caregivers. Familiar faces who know your loved one make daily care safer and more dignified.
A warm, engaging environment. Custodial care shouldn't feel institutional. Notice whether residents are active, comfortable, and treated with respect.
A continuum of care. If medical needs grow, a community that also offers skilled nursing can provide it without a disruptive move.
Transparency. A community that explains its services and costs plainly is showing you how it will treat your family over the long term.
Custodial care at home versus in a community
Custodial care often begins at home, and for many families it does. Over time, though, home care can become harder to sustain — the hours add up, caregivers wear out, and safety concerns grow. Moving into a community that provides custodial care can offer more consistent support, social connection, and peace of mind. Signs it may be time to consider a community include:
Home care hours keep increasing without keeping a loved one fully safe
A family caregiver is exhausted or unable to continue
Isolation at home is affecting mood and wellbeing
Medical needs are beginning to appear alongside daily-living needs
Why families choose Solheim
Solheim Senior Community is a nonprofit Life Plan Community in the Eagle Rock neighborhood of Los Angeles that provides daily custodial support within assisted living and memory care, with skilled nursing and rehabilitation available on the same campus if medical needs increase. That continuity means a resident can receive the right level of care over time while staying in a familiar place with a familiar team. Solheim was recognized by U.S. News and Newsweek among 2024's best continuing care and nursing home facilities, and its care is guided by an experienced staff focused on dignity, safety, and personalized support.
Frequently asked questions
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Custodial care is non-medical help with daily living, provided by trained caregivers. Skilled care is medical care provided or supervised by licensed professionals.
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Generally no. Medicare may cover short-term skilled care or rehabilitation after a qualifying hospital stay, but not ongoing custodial care.
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At home, in assisted living, in memory care, or within a skilled nursing facility, depending on how much support a person needs.
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Usually through a combination of private funds, long-term care insurance, veterans benefits, and — for those who qualify — Medi-Cal for certain services.
