Aging care in the community for those who require some assistance with everyday tasks is available through a number of different venues. The type of services which are most appropriate depend upon the specific needs and goals of the individual and family, as well as affordability.
If the individual desires to stay in the family home, sometimes care needs can be met by the staff of a home care agency. Such services can provide non-medical assistance which includes housekeeping tasks, personal care (such as bathing and dressing), medication reminders, and transportation.
Most often these services are paid privately, at an average rate of $24-$30 per hour in Central PA. Certain long-term care insurance policies may cover a portion of the cost of home care. Some agencies require a minimum number of hours per visit, which is an important question to ask when inquiring about services.
For individuals who require 24 hour assistance and supervision and have a spare bedroom in their home, a live-in caregiver may be considered. These caregivers are available through two types of organizations – agencies and registries. A caregiver provided by an agency is considered an employee of the agency and is covered through the agency for wages, taxes, and worker’s compensation insurance. A caregiver provided by a registry is considered an employee of the family/care recipient, and therefore the family is responsible for direct payment of wages and employment taxes. In case of injury, the homeowner’s insurance may be responsible. Live-in caregivers generally cost less than hourly caregivers for 24 hour care.
Additional options which are available to support older adults include senior centers and adult day centers. The programming at senior centers is geared toward meals/nutrition, socialization/recreation, health/wellness and education. These centers do not provide assistance with personal care. Senior centers operate using a mix of public and private funds.
Adult day centers provide similar programming, but are equipped to provide personal care and nursing supervision for individuals with more complex health-care needs. Private payment is most common for adult day centers. Both half-day and full-day rates are usually available. Adult day centers are more cost effective than private home care for individuals who may have financial limitations.
Both types of centers usually operate on a Monday-through-Friday schedule and are closed for holidays. Hours of operation vary by center.
The LIFE (Living Independence for the Elderly) program offers a combination of services for frail elderly people who live in the community. The program provides a team approach to health care which includes medical care, home care, adult day services and therapy services.
Medicaid funds may be available to help pay for this program for those who qualify. Participants in the LIFE program must be age 55 or older, live in the service area, and be determined by the county office of aging to require a nursing home-level of care, yet desire to stay in the community. In our area, the LIFE program currently is available in Cumberland, Dauphin, York, and Franklin Counties, and portions of Perry County. On a national level, this program is called PACE (Program of All-Inclusive Care of the Elderly) https://www.npaonline.org/pace-you .
Health-care decisions for older family members are rarely easy. Opportunities for care in the community are available, but may require a bit more flexibility to ensure that all of the care recipient’s needs are addressed. Quality care and peace of mind can be obtained when individuals and caregivers take time to seek guidance and information before difficult decisions need to be made.
Keystone Elder Law has a variety of resources available to assist you on your journey. Articles such as this one, free seminars, two websites ( https://keystoneelderlaw.com/ and https://mypeaceguide.com/ ), and free telephone care coordination consultations are only the beginning!
Karen Kaslow, RN, BSN