When Living Alone Is Not an Option

Due to advancing age, disability or chronic illness, you or a loved one may one day no longer be capable of living alone. What are your options? While nursing homes provide 24/7 highly skilled care, what if you need only minimal assistance with daily activities and want to retain your autonomy and independence? Over the past two-and-a-half decades, two types of assisted living have emerged as popular alternatives in long-term care among the growing senior and disabled community: in-home care and assisted living facilities.


IN-HOME CARE

Often family members care for their senior or disabled loved ones; however, when that is not possible, in-home care may be the solution. In-home care allows your loved one to continue living in his or her residence amid familiar surroundings, while providing assistance with activities of daily living. You may choose to hire an individual or contract with an in-home care agency, which is licensed and insured through your State. Such agencies also provide nursing, occupational and physical therapy, and social services. They also work with your healthcare and insurance providers to ensure that you have the appropriate assistive devices, mobility devices and assistive listening devices for your needs. If you hire an individual, be advised to conduct a credential and background check, for they need not be licensed, bonded or insured.

Also called homemakers, caregivers and personal care aides or attendants (PCA’s), 767,000 in-home care workers in the U.S. provide companionship and assist with housekeeping, laundry, meal preparation, shopping and other errands. They also help with personal care needs, such as eating, toileting, bathing, dressing, remembering to take medications and assistance with transferring, sitting and standing. In-home caregivers may visit a few hours a day or live in, according to your needs as assessed by a social worker in a personal interview and recommended by your healthcare professionals.

In-home care is provided for senior and disabled persons through each state’s Department of Health and Human Resources (Welfare) and the Division of Aging Services, or the Division of Aging and Independent Services (Oregon), or In-Home Supportive Services (California). Although Medicare may or may not pay for in-home care costs, Medicaid and private insurances usually do. Most states will not pay spouses and immediate family members as caregivers and do not pay full-time hours for a single client. Earning low wages, most in-home workers provide only minimal assistance for multiple clients.


ASSISTED LIVING FACILITIES

Ranging from multi-storied buildings to sprawling complexes to large, one-story residential houses, 36,000 nationwide assisted living facilities provide private apartments, meals, housekeeping, communal activities and transportation to stores, entertainment venues and medical appointments for over 650,000 elderly and disabled individuals. Also called residential care facilities, assisted living houses, adult homes or retirement residences, they offer a home-like atmosphere with round-the-clock staffing and nursing to ensure your loved one is safe and receives the level of care that he or she requires, while still maintaining his or her independence. Emergency call buttons in every room enable your loved one to summon immediate help when needed.

Many assisted living facilities also permit small pets, so that your loved one need not be separated from a beloved family member. You may even locate a residential care facility within the community where your loved one resides, so that he or she may maintain established relationships with lifelong friends and local merchants.

Assisted living facilities are strictly governed by Federal regulations for quality of care and service. Medicare, Medicaid and private insurances may cover most or all the costs of assisted living facilities. Other financial solutions may be available to you to meet the high costs of adult residential care.


ADVOCACY AND RESOURCES

Every state has a long-term care ombudsman office to advocate for the quality of care and service for residents in nursing homes and assisted living. You may convey concerns to your ombudsman during regular visits, or locate your local ombudsman office by visiting the National Long Term Care Ombudsman Resource Center (ORC) at www.ltcombudsman.org, or contact the ORC Office at 1828 L Street, NW, Suite 801, Washington, D.C. 20036, [phone].

County senior advocacy and outreach programs offer resources for housing, meals, transportation and social service programs to senior and disabled residents. They also provide information regarding related issues, such as long-term care insurance, living wills, advance directives and power of attorney. Representatives also listen to your concerns and influence local policy makers on issues affecting the elderly and disabled.
For assistance with making choices and planning for long-term care, visit the following Websites:

www.medicare.gov/LongTermCare/static/Home.asp
The official Medicare Site provides information on choosing and paying for long-term care, as well as invaluable links.

www.ncal.org
The National Center for Assisted Living (NCAL) is the assisted living voice of the American Healthcare Association (AHCA) and offers consumer information, resources and publications related to assisted living.

www.longtermcareliving.com/transition/almove/
Sponsored by NCAL and AHCA, this Site offers advice on moving to assisted living residences, including emotional issues, what to bring, finding a facility and tools to determine the type of care you need.

www.healthinaging.org/agingintheknow/research­_content.asp?id=4
The American Geriatric Society (AGS) Foundation for Health and Aging offers advice on choosing an assisted living facility.

www.nlm.nih.gov/medlineplus/assistedliving.html
Sponsored by the National Library of Medicine and the National Institute of Health, this government Site offers guides on moving to assisted living facilities.

www.eldernet.com/assisted/assisted.htm
Created by a Boston attorney and friends, this Website addresses health, housing, financial and legal issues for the elderly and their families.

www.alfa.org
The Assisted Living Federation of America (ALFA) is the largest national association exclusively dedicated to professionally-operated assisted living communities by promoting business and operational excellence and advocating for informed choice, quality care and accessibility.


CONCLUSION

When living alone is not an option, alternatives in assisted living may be the solution for your long-term care needs. Work with your healthcare professionals, government agencies and insurance providers to determine the type of care you require and can afford. County resources may also aid you or your loved one in continuing to live independently and maintaining your quality of life.