Today, family caregivers have options to choose from when they need assistance or respite. And, highly trained and experienced social workers are available to help caregivers sort through the range of available options. Below is a brief description of some of the caregiving services commonly available.
Adult Day Care Centers are designed to provide care and companionship for seniors who need assistance or supervision during the day. The program offers relief to family members or caregivers and allows them the freedom to go to work, handle personal business or just relax while knowing their relative is well cared for and safe.
The goals of these programs are to delay or prevent institutionalization by providing alternative care, to enhance self-esteem and to encourage socialization. There are two types of adult day care: Adult social day care provides social activities, meals, recreation, and some health-related services. Adult day health care offers more intensive health, therapeutic and social services for individuals with severe medical problems and those at risk of requiring nursing home care.
These centers are usually open during working hours and may stand alone or be located in senior centers, nursing facilities, churches or synagogues, hospitals, or schools. The staff may monitor medications, serve hot meals and snacks, perform physical or occupational therapy, and arrange social activities. They also may help to arrange transportation to and from the center itself.
Assisted living facilities offer a residential alternative for older adults who may need help with dressing, bathing, eating, and toileting, but do not require the intensive medical and nursing care provided in nursing homes.
Assisted living facilities may be part of a retirement community, nursing home, senior housing complex, or may stand-alone. Licensing requirements for assisted living facilities vary by state and can be known by as many as 26 different names including: residential care, board and care, congregate care, and personal care.
Assistive technology is any service or tool that helps the elderly or disabled do the activities they have always done but must now do differently. These tools are also sometimes called "adaptive devices."
Such technology may be something as simple as a walker to make moving around easier or an amplification device to make sounds easier to hear (for talking on the telephone or watching television, for instance). It could also include a magnifying glass that helps someone who has poor vision read the newspaper or a small motor scooter that makes it possible to travel over distances that are too far to walk. In short, anything that helps the elderly continue to participate in daily activities is considered assistive technology.
Government housing assistance is available to low-income older persons through three major programs: public housing, Section 8, and Section 202. Public housing and Section 8 programs are managed by local housing authorities, and Section 202 housing is sponsored on a complex-by-complex basis by non-profit companies. Most of these programs are over-subscribed, with waiting lists that vary in length. This fact sheet is designed to provide basic information about housing programs and the procedures for obtaining housing assistance.
Three basic types of government housing assistance are:
- Public housing — low cost housing in multi-unit complexes that are available to low-income families, including the elderly and disabled, typically requiring tenants to pay no more than 30 percent of their monthly income for rent. Eligibility: Public housing authorities that receive funding from the federal government own and operate public housing complexes, available to applicants that do not exceed published income levels (dependent on the size of the household).
- Section 8 rental certificates — allows very low-income families (including the elderly and disabled) to choose where they want to live, subject to HUD standards, by providing rental certificates that limit tenants’ rent to 30 percent of their adjusted monthly income. Eligibility: Very low-income families with incomes not exceeding 50 percent of the median income for the area.
- Section 202 housing — senior citizen housing, usually with supportive services such as meals, transportation, and accommodations for the disabled. Eligibility: Private, non-profit organizations and consumer cooperatives. Occupancy is open to very low-income households with at least one person 62 years of age or older, and the disabled.
Home health care helps seniors live independently in their own homes for as long as possible. It covers a wide range of services and can often delay the need for long-term nursing home care.
More specifically, home health care may include occupational and physical therapy, speech therapy, and even skilled nursing. It may involve helping older adults with activities of daily living such as bathing, dressing, and eating. Or it may include assistance with cooking, cleaning, other housekeeping jobs, and monitoring one's daily regimen of prescription and over-the-counter medications.
At this point, it is important to understand the difference between home health care and home care services. Although they sound the same (and home health care may include some home care services), home health care is more medically oriented. While home care typically includes chore and housecleaning services, home health care usually involves helping seniors recover from an illness or injury. That is why the people who provide home health care are often licensed practical nurses, therapists, or home health aides. Most work for home health agencies, hospitals, or public health departments that are licensed by the state.
Home modifications are changes made to adapt living spaces to meet the needs of people with physical limitations so that they can continue to live independently and safely. These modifications may include adding assistive technology (see the fact sheet on Assistive Technology for details) or making structural changes to a home. Modifications can range from something as simple as replacing cabinet doorknobs with pull handles to full-scale construction projects that require installing wheelchair ramps and widening doorways.
Other examples of home modifications include:
- Grab bars in the bathroom (including by the bathtub, shower, and toilet)
- Handheld, flexible showerheads
- Handrails on both sides of staircases and for outside steps
- Lever-operated faucets that are easy to turn on and off
- Sliding or revolving shelves for cabinets in the kitchen
- Walk-in showers
Hospice programs are available to help terminally ill individuals live their remaining days with dignity. These programs can assist the family (or other designated caregiver) in making the patient as comfortable as possible, and assistance is available around the clock, seven days a week.
Hospice is primarily a concept of care, not a specific place of care. Hospice care usually is provided in the patient's home. It also can be made available at a special hospice residence. Hospice is a combination of services designed to address not only the physical needs of patients, but also the psychosocial needs of patients, their loved ones.
Hospice combines pain control, symptom management and emotional and spiritual support. Seniors and their families participate fully in the health care provided. The hospice team develops a care plan to address each patient's individual needs. The hospice care team usually includes:
- The terminally ill patient and his or her family caregiver(s)
- Doctor
- Nurses
- Home health aides
- Clergy or other spiritual counselors (e.g., minister, priest, rabbi)
- Social workers
- Volunteers (if needed, and trained to perform specific tasks)
- Occupational, physical, and/or speech therapists (if needed).
Millions of Americans provide unpaid assistance each year to older family members, friends, and neighbors to help them remain in their own homes and communities for as long as possible. Sometimes these caregivers need time off to relax or take care of other responsibilities. This is where respite care can be helpful. It provides family caregivers with the break they need, and also ensures that their aging loved one is still receiving the attention that he or she needs.
Respite care is not all the same. Respite can vary in time from part of a day to several weeks. Respite encompasses a wide variety of services including traditional home-based care, as well as adult day care, skilled nursing, home health, and short term institutional care. More specifically respite care may take any one of the following forms:
- Adult Day Care: These programs are designed to provide care and companionship for frail and disabled persons who need assistance or supervision during the day. The program offers relief to family members or caregivers and allows them the freedom to go to work, handle personal business or just relax while knowing their relative is well cared for and safe.
- Informal and Volunteer Respite Care: This is as simple as it sounds. It is accepting help from other family members, friends, neighbors, or church volunteers who offer to stay with the elderly individual while you go to the store or run other errands. Sometimes your local church group or area agency on aging (AAA) will even run a formal "Friendly Visitor Program" in which volunteers may be able to provide basic respite care, as well.
- In-home respite care: Generally speaking, in-home respite care involves the following four types of services for the more impaired older person:
- Companion services to help the family caregiver supervise, entertain, or just visit with the senior when he or she is lonely and wants company.
- Homemaker services to assist with housekeeping chores, preparing meals, or shopping.
- Personal care services to help the care recipient bathe, get dressed, go to the bathroom, and/or exercise.
- Skilled care services to assist the family caregiver in tending to the care recipient's medical needs, such as when administering medications.
Source: The U.S. Department of Health and Human Services Eldercare Locator, www.eldercare.gov
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