When a senior becomes ill or physically dependent, nursing homes are often thought of as the only long term care option when seeking services. However, for those seniors who do not require 24-hour nursing care, there may be alternatives available that could provide an appropriate level of care while promoting independent living. To help the senior and their family formulate a care plan for their unique situation, a long term care assessment or a medical evaluation could assist in exploring some of the alternatives.
The following is a summary of alternative services to a nursing home.
Many people can remain in their own home with the supportive community services or in-home hired help. Often a temporary crisis will require placement in an institution for a short duration of time. When recovery is underway the person may be able to return home when assistance is in place. (The physician can advise the individual and the family on the feasibility of this situation.) Some in-home community programs are free or low cost. For eligible veterans, the VA has visiting nurse programs. (See our Caregiver Resources page for info and contact numbers for community based programs and services.) Some in-home services costs may be covered temporarily by Medicare or private insurance. Medicaid will temporarily cover long term care for eligible clients. For Medicaid eligibility see: www.health.state.ny.us/health_care/medicaid/ for an application. Albany County residents can call (518) 447-7300.
Community-based services include: home delivered meals, congregate meals, homemaker services, shopping assistance, transportation, and friendly home visits. Alternative supportive housing arrangements (adult homes, assisted living, enriched housing and retirement facilities) can provide varying levels of services and personal care for medically stable residents.
Home health agencies deliver in-home health and medical services and medical supplies as well as homemaker and personal care services. Some of the nursing services include: physical therapy, occupational therapy, respiratory therapy, speech therapy, and nutritional guidance. Non-medical services include: bathing, grooming, ambulation, shopping, cooking, etc.
Consumer Directed Personal Assistance Program CDPAP’s are for Medicaid eligible clients who chronically ill or physically disabled and who are eligible to receive assistance with ADL’s (activities of daily living) or skilled nursing services. The consumer, or the person acting on the consumer’s behalf, must assume full responsibility of the personal assistant (home care worker) including: recruiting, hiring, training, back-up coverage, supervising employment, time sheets and payroll records.
Respite care can give the home caregiver a break from caring for someone who needs constant supervision. Respite care is a short stay (normally no more than two weeks).
Adult day care provides a protective setting and offers therapeutic programs of health services and social activities. Leisure activities, self-care training, rest, nutritional services, and respite care for a portion of a day are some of the services.
Hospice provides coordinated services primarily in patient's home that focus on pain management and comfort, and counseling and support in dealing with issues related to death.