Consumer Information

Home and Community-based Services
Like most older people, you may want to live in your own home. But you may also need help and support in order to stay there. Home and community-based services can help you with personal care (help with things like bathing, dressing, going to the bathroom, and more) or chores. They may include health care services, social activities, or even just someone to call and check on you if you live alone. Also, if you are taking care of a family member or friend, these services can give you the help and support that you need as well.

While there are many different community services for older people, not all are available in every community. Check with your local area agency on aging for what services are in your area.

The most common services are:

• Adult day care provides a variety of health, social and related support services in a safe setting during the day. Some day care programs are designed especially for people with Alzheimer's disease.
• Care management can help you and your family find the help that you may need. A care manager will work with you and your family to help you figure out what you need and what services we can offer. Together you come up with a plan of care that best fits your life, and then the care manager will arrange for your services.
• Congregate meal programs offer free or low-cost meals in group settings (often in a senior center or senior housing).
• Financial counseling programs can help you balance your checkbook, file your taxes and pay bills. They also help with Medicaid, Medicare or other insurance forms.
• Friendly visiting or companionship services provide volunteers who will come to visit and talk with you in your own home.
• Home health care services are provided in your home. They can include part-time nursing services; personal care (help with things like bathing, dressing, going to the bathroom, and more); homemaker or chore services; medical supplies or equipment and different kinds of therapies (physical, occupational, and speech) to help you recover after you've been ill or had surgery.
• Homemaker or chore services help with different chores around your house, such as cleaning, preparing meals or doing laundry. They also help with harder tasks such as washing floors, windows and walls and shoveling snow.
• Hospice care provides comfort, nursing care and other services, such as grief counseling, to people who are dying (and their families). Hospice care is provided in your home, in a nursing facility or in a free-standing hospice.
• Home-delivered meals often called "meals-on-wheels", bring you meals in your home, if you cannot prepare your own meal.
• Information and assistance services offer you and your family information about services and resources in your area.
• Personal care services provide help with things like bathing, dressing, going to the bathroom, and more.
• Respite care gives families a break from caring for older people who are unable to care for themselves. Respite care can take place in the older person's home or the caregiver's home.
• Rehabilitation services offer different kinds of therapies (physical, occupational, and speech) to help you recover after you've been ill or had surgery.
• Senior centers provide a place for older people to come together and offer many different social and recreational services.
• Telephone reassurance provides a volunteer to call and check on you on a regular basis to be sure you are okay.
• Transportation services help you get to and from shopping centers, doctor's appointments, senior centers and other places.

Senior Housing
You may want to think about senior housing if you want to live on your own, but do not want to have all the chores that go along with owning a single-family house. Senior housing works best for people who may not need as much help as assisted living or nursing homes provide.

Most often these are apartments that you can rent. Often they are specially designed for your needs as you get older. This includes things like having railings in bathrooms or having power outlets higher up on the wall. They may also offer a 24-hour emergency call service if you need help right away. Some places may also offer different kinds of services to the people who live there. These include meals, transportation, social services, counseling, social activities and other programs.

Continuing Care Retirement Communities
Continuing care retirement communities, or CCRCs, provide many different types of services - skilled nursing, assisted living, and/or independent living - all in one location, which gives you the chance to stay in one place as your needs change. CCRCs offer a range of services such as: nursing and other health services; meals; housekeeping; transportation; emergency help; and personal care (help with things like bathing, dressing, going to the bathroom, and more). They also usually have lots of social and educational activities on site.

CCRCs are also different from other types of housing options for older people because they offer you a contract, a legal agreement that says the CCRC will provide you with housing and services for life. Most CCRCs require a one-time entrance fee and then monthly payments thereafter. These fees vary by community, depending on the type of housing and services they offer. Other CCRCs operate on a rental basis, in which you would make monthly payments, but would not have to pay an entrance fee.

Assisted Living
If you need some help every day but do not need constant nursing care, assisted living may be a good choice for you. Assisted living residences provide help with the things people need to do every day, such as bathing or getting dressed, taking your medicine, cooking, shopping, housekeeping, laundry, and getting around. But they do all of this while still giving you the chance to stay active and control your own life.

Assisted living facilities may be part of a retirement community or nursing home, or they may stand alone. They offer single or double rooms, or sometimes even suites or apartments, depending on what your needs are and how much you can afford.

Nursing Homes
Nursing homes offer round-the-clock care if someone is too sick to live on their own, or if they need to recover after having an illness or operation. Some people stay for a short time in a nursing home and then go home. Other people may be sicker and need more care for a longer period.

Nursing homes are licensed by the state to provide nursing care, personal care (help with things like bathing, dressing, going to the bathroom, and more), and medical services. They also offer different kinds of therapies (physical, occupational, and speech) to help you get back on your feet after you've been ill or had surgery. They provide your meals, and do your laundry and housekeeping. Finally, nursing homes offer different kinds of activities you can get involved with - such as art classes, parties, religious services, and more.

How to choose the most appropriate care setting for you or a loved one: http://www.aahsa.org/consumer_info/how_to_choose/default.asp

What Is A Not-For-Profit Nursing Home?
Not-for-profit nursing homes exist solely to serve the unmet needs of the elderly in society. They spring from a diverse heritage of religious, fraternal, and civic sponsoring entities and local units of government. Despite this diversity, not-for-profit nursing homes share a common benevolent purpose, and are committed to a ministry of service, care, and community benefit.

Positive Characteristics To Observe Directly

• Staff members interact with residents with respect and care.
• Residents are well-groomed and dressed for the season and time of day.
• Residents are involved in meaningful activities.
• Noise levels fit with the time of day and activities.
• Meals are appetizing and served attractively. Alternative choices are provided for religious preferences as well as likes and dislikes.
• The inside and outside of the home are clean and in good repair.
• Outdoor areas are available and safe for resident use.
• There are accommodations for special needs, such as grab bars, ramps, and phones for the hearing impaired.
• Safety precautions are evident, such as wet floor signs, good lighting, and lack of clutter in resident traffic areas, rooms and hallways.
• The home is free of persistent unpleasant odors.
• Toilets are convenient to bedrooms.
• Most residents have personal items in their rooms.
• Furnishings in resident rooms and common areas are pleasant and functional.
• Storage areas are within easy reach in resident rooms.
• There are private areas for residents to see visitors and doctors.
• The home has a good reputation in the community.
• The home is located conveniently for family and friends to visit.
• The community is “home-like” and inviting.

Questions To Ask Staff

• Does the home provide the kind of care specifically required by the prospective resident?
• Under what circumstances would they no longer be able to provide care?
• How are residents and family members involved in planning resident care?
• Does the doctor/dentist come to the home?
• How is medical/dental transportation handled?
• What is the home’s policy on use of restraints?
• How is the community involved in the life of the home and its residents?
• How are resident/family concerns handled?
• What programs are present to allow residents maximum choice in their daily lives?

Documents to Request and Review

• Resident activities for the week or month -
• Are there a variety of activities offered? Are activities of interest to the prospective resident?
• Menu for the week or month - Are meals varied and appetizing? Are residents given choices?
• Daily rates and a list of services included.
• Charges for services not included in daily rates.
• A list of references.