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Types of Long-Term Care

  Summary of Long-Term Care Choices Resources  
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Many communities provide services and programs to help seniors and people with disabilities with a variety of personal activities. These services include Meals-on-Wheels, transportation services, personal care, chore services, adult day care and a variety of activities in senior centers. These services are usually free or at low cost to individuals who qualify. Local organizations, called Area Agencies on Aging, coordinate these services to promote the independence and dignity of older adults. The local community Area Agency on Aging can be found by visiting the Eldercare Locator or calling 1-800-677-1116.

Your State Medicaid program may pay for home health services including skilled nursing care, home health care, personal care, chore services, and medical equipment. You must qualify for Medicaid to receive these services.

The following community-based services may be available in your community:

Adult Day Care Services Overview

Adult day care services provide health, social, and recreational activities in a supportive setting for adults who have functional and/or cognitive impairments that do not need 24-hour care. Some programs offer services in the evenings and on weekends, in addition to standard business hours. Programs may provide services for individuals with specific impairments such as Alzheimer’s or mental illness. Adult day care programs may provide the following services:

Adult Day Care Services
Health monitoring - blood pressures, food or liquid intake, weight
Assistance with walking, toileting or taking medications
Social activities
Mental Simulation
Meals and snacks
Exercise activities
Safe and secure environment
Personal Care - bathing, shampoo or shaving
Alzheimer's or dementia care
Transportation to facility and activities

State Medicaid programs may pay for health care that is provided in State licensed facilities, including therapy services, mental health services, administration of medications, psychological evaluations, dressing of wounds, and assistance with feeding. Private long-term care insurance may also pay some of these costs, but Medicare will not.

Adult Day Care Services Checklist

  • Location of facility

    • Is the facility accessible?
    • Can individual get to facility?
    • Is transportation to the facility available?
    • Is there an extra charge for transportation?

  • How long has the day care facility been in business?

  • What days and hours is the facility open?

  • Is the day care licensed by the state health department or department of social services?

  • Has the state health department received any substantiated complaints about the care provided in the facility?

  • What is the cost of care? Hourly, daily, or weekly? Must you commit to a minimum amount of service, i.e., at least 2 days/week? Are all activities included in the cost?

  • Does the facility accept individuals who:

    • Are incontinent?
    • Are in wheelchairs?
    • Have memory loss?
    • Have difficulties in speaking?
    • Wander?
    • Have special dietary requirements?
    • Have behavioral problems?

  • What is the participant to staff ratio? Does this ratio meet state standards? What professional staff is available to help with care planning and concerns?

  • What activities are provided?

    • Are there individual and group activities?
    • Are the activities stimulating? Exercise, music, crafts, memory sharing, etc.
    • Are individuals with dementia separated from other participants or included in activities?

  • Does the facility provide other conveniences/benefits such as blood pressure checks, annual immunizations, hair styling services, bathing, dental check-ups, etc.?

  • What is the policy concerning late arrival or late pick-up?

  • Are the meals well-balanced and enjoyed by participants? Are meals included in the cost?

  • Is staff willing to spend time finding out what you want and need? Were the programs and activities explained?

  • Is the day care facility clean, odorless, and pleasant to visit? Does the facility have comfortable furniture for activities and for relaxation?

  • Do participants interact with each other? Do they seem to enjoy their time at the facility?

  • Is the staff pleasant to the participants?

  • Can the facility accommodate the following special physical or medical requirements:

    • Dispense medicine?
    • Give reminders about taking pills?
    • Assist with toileting or handle incontinence?
    • Provide total access and participation to wheelchair-restricted clients?
    • Effectively communicate with hearing impaired participants?

  • Is financial assistance available? Is there a sliding scale, Medicare, Medicaid, or other funding available to help you pay the cost?

  • How do they insure safety? How are behavior problems handled? Are there specific behaviors or care needs which would require your loved one's withdrawal from the program?

Telephone Reassurance

Individuals who live alone and have medical or other health needs may fear that they would not be able to summon help in an emergency. Several types of emergency telephone response systems address this concern.

Emergency response systems use the telephone to check on an individual on a regular basis. A family friend, relative, or professional service may make a daily call at one or more set times throughout the day. This telephone reassurance program may be free to you because a family member or friend provides this service or it is provided by your state or local aging organization.

If you did not answer the phone, the check-in caller would be alerted to a possible problem. If the caller detected a change in condition or voice based on regular contact with you, the caller would take appropriate action.

Commercial emergency response systems may also available. These services require that you wear a “beeper” on your wrist or around your neck. If you have a fall or other emergency, the press of a button would alert the 24-hour response system. This system requires that you pay an initial fee and a monthly fee of $25 to $40 for this service.

Senior Centers Overview

Senior centers are located in many communities to provide a wide range of services to you. The Administration on Aging, U.S. Department of Health and Human Services estimates that there are from 10,000 to 16,000 senior centers located throughout the U.S. Senior centers provide a varying array of services, including nutrition, recreation, social and educational services, wellness and fitness activities, information and program referral services, and Internet training. Most of the services are provided free or at low cost to participants.

Transportation Services Overview

Transportation services are available in many communities through aging services programs, regional mass transportation systems, and private sources. These services may include door-to-door taxicab services, public bus transportation, or vans with wheelchair accessible transportation.

Medicare does not pay for any transportation services except ambulance services, but Medicaid may pay for transportation services to get you to a medical appointment if you are eligible. Fees for transportation services are generally small and often people pay out-of-pocket for transportation services.

To find transportation services in your area, contact your local Area Agency on Aging. Your local community area Agency on Aging can be found by visiting the Eldercare Locator or calling 1-800-677-1116. Many telephone books have a special section in the front of the book with the names and addresses of various service organizations that provide transportation for special needs.

Page Last Updated: April 10, 2007

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