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Caregiving Forum Local community services for older residents can enable your loved one to live independently for years. What types of service have you found most helpful to your loved one? How did you locate these benefits in your community?
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Learning About Your Community Services

Your mother is recovering from a broken hip, and she is unable to clean her house or do laundry. Your aunt, whose children live across the country, needs daily physical therapy and special medical treatments, but she doesn't want to go to a nursing home. After your uncle's recent illness, he and his wife realized that he'll need a new living arrangement with some health care services. Your neighbor is tired of living alone in her big house and lacks friends or family to move in with. She could use help with meals, transportation, and personal care.

As we age, many of us prefer to stay at home or with our families as these scenarios suggest, but sometimes we need extra help. For the growing numbers of older people who need it, private and public organizations now offer a variety of home and community-based services.

As we age, many of us prefer to stay at home or with our families. . . but sometimes we need extra help.

Help Around the House

  • Home and Personal Care
    Home-care aides do chores such as cleaning the house, grocery shopping, and laundry. Personal care is nonmedical assistance with activities of daily living, sometimes referred to as ADLs, such as bathing, dressing, or using the toilet. Home repair services help with basic upkeep of the home and minor safety changes such as grab bars in bathrooms, seats in the shower, or ramps for a wheelchair.
  • Meal Services
    Home-delivered meal programs offer nutritionally balanced meals to those who can no longer shop or cook. Senior centers often offer lunch and the opportunity to eat with other people.
  • Companion and Telephone Reassurance Services
    Volunteers make regular visits or phone calls to older adults who can't get out of the house. The volunteer checks on the person and keeps him or her company, providing regular contact for older people who are alone.
  • Home Observation
    In some communities, mail carriers or utility workers are trained to spot signs of trouble. They report concerns, such as accumulated mail or trash, to an agency that will check on the older person.
  • Home Health Care
    Home health care is designed to address health care needs. It may include services such as skilled nursing care, personal care, rehabilitative therapy, the administering of medicine, wound care, and medical help prescribed by a physician and provided by licensed professionals.
  • Personal Emergency Response Systems (PERS)
    A PERS is a simple device worn by a person to call for help in emergencies. When the button on the PERS is pushed, it sends a message to a hospital or police station which dispatches someone immediately.
  • Hospice Care
    Hospice services include medical care, counseling, and pain control for terminally ill patients. Hospice services are usually provided at home and help caregivers, family, and the patient cope with the terminal condition.

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Finding the Help

  • Senior Centers
    Many communities offer activitiesórecreation programs, social activities, health screenings, and mealsóin centers designed for older adults.
  • Getting Around
    Many communities offer transportation to medical appointments, senior centers, or shoppingóoften at little or no cost. Discount taxi programs, van services, or volunteer drivers add to the choices.
  • Adult Day Centers
    The older person who needs supervised assistance can visit adult day centers for services in a group setting. These include health care, recreation, meals, and rehabilitative therapy, all designed to meet the special needs of people with mental and/or physical limitations. Many programs offer sliding rate scales or financial assistance to address the added cost.
  • Care for You Too
    Respite care provides much-needed time off for family members caring for someone who is ill, injured, or frail. You'll find it at an adult day center, in the home of the person being cared for, or even in a residential setting such as an assisted living facility or nursing home.

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Finding the Right New Home

  • Home sharing/Shared Housing
    This involves two or more unrelated people living together in a house. Sometimes an older adult rents out a bedroom for additional income. Occasionally, the renter performs chores in exchange for a portion of rent, letting older adults remain in their home and offering the bonus of some help.
  • Congregate Housing/Senior Retirement Communities
    An apartment-style building with individual units, these homes allow residents to care for themselves but share meals in a common dining area. Housekeeping services are provided, along with some personal care and recreational activities.
  • Assisted Living Residences
    For those who may need help living independently, but do not need skilled nursing care, these residences provide a good solution. The level of assistance varies among residences and may include help with bathing, dressing, meals, and housekeeping.
  • Board and Care Homes
    Similar to assisted living residences, these smaller residences offer slightly reduced services. They are sometimes called group or personal care homes.
  • Continuing Care Retirement Communities (CCRC)
    CCRCs meet the changing needs of older people all on one campus. For example, an older person starts out living on his or her own. When daily activities start to require help, he moves to an assisted living unit. Now and then he'll stay in the nursing unit if skilled medical care is needed. A substantial entrance fee is typical, along with a high monthly fee.

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Paying for Services Most people pay for their home and community services out of their own pockets. Some may get help from public funds.

  • Medicare
    This program provides medical coverage for most people age 65 and up. Medicare covers limited skilled nursing home care and home-care benefits. For information about Medicare benefits, visit their website or call 1-800-Medicare.
  • Medicaid
    A state and federally funded program to help people with low incomes pay for medical care. Medicaid may help pay for nursing home care and sometimes services at home. It's important to check with your local Medicaid office for eligibility.
  • Private Long-Term Care Insurance
    This pays for care in nursing homes, assisted living facilities, and/or home care depending on the policy. The older you are when you purchase your coverage, the higher your costs, so it is not affordable for some older adults.

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© 2003, 2004, 2007 AARP. Reprinting by permission only.


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