Elder Care Guidance 

ADL’s: are the daily skills needed such as self grooming, eating, unassisted bathing, dressing, walking and using the bathroom.

Adult Day Programs:
older programs provide supervision, meals, social interaction and activities
that programs provide supervision, meals, social interaction and activities
that are intended to stimulate the mind.  Fees for this service are usually
paid by Medicaid or through private pay.

Adult Protective Services:
The main focus of Adult Protective Services (APS) is to protect adults who
may be physically, emotionally or financially abused and/or neglected.    
This service is free and is provided by the county in which the older adult
lives. If you or anyone suspects abuse you can call the APS and file a report
over the phone.  Health professionals are mandated reporters who must
notify the APS about any suspected abuse.

Advance Directive:
such as living wills, are legally endorsed documents.  Specifies elder’s
wishes concerning medical care and names someone to make decisions on
behalf of them if and when they are not mentally competent to make medical decisions.  Another term used is Durable Power of Attorney for Healthcare (DPOA).

Area Agency on Aging (AAA)
AAA’s provides information on resources and referrals regarding  the local
community programs.

Assisted Living Facilities:
This is a housing option for those who require some assistance and can
afford paying monthly rent plus any additional fees for the required
assistance. The facility provides congregate meals, laundry services,
transportation to medical appointments and medication monitoring.  Some of these facilities offer a secure Alzheimer’s /Dementia unit.

Continuing Care Facility, Multi-level Facility, Buy-In Facilities:
These facilities provide all levels of care, ranging from independent to skilled care.  Usually the resident has to pay a monthly fee plus a large entrance
fee.

Custodial Care:
This is a term used to refer to a type of care that is non-medical.  An
example of this type of care is hiring an aide to assist a loved one with
activities of daily living.

Directive to Physicians (Living Will):
Permits a person to state their wishes not to receive life-sustaining treatment if they are terminally ill and the treatment would only artificially prolong the dying process.

Durable Power of Attorney for Financial:
Also known as Durable Power of Attorney for Asset Management.   This is a legal document that authorizes an agent to act on behalf on another person in making financial decisions and transactions on their behalf.

Durable Power of Attorney for Healthcare:
Authorizes an agent to act on behalf of another when they are not mentally
competent to make their own medical decisions.

Emergency Response Systems:
Some services may charge a monthly fee plus an installation fee.  The
service uses a safety device located on a necklace or bracelet and an
intercom.  Many of these services offer levels of care which can include
calling the relative at certain times of the day to check on them.  In case of an emergency, the older adult would touch the button on the necklace or on the bracelet.  This would alert the service to notify the designated family member or neighbor of a problem.  If it is an emergency the service would notify the paramedics.

Geriatric Care Manager:
A Geriatric Care Manager (GCM) is a professional social worker or
registered nurse.  Most of these professionals have either a bachelor’s
degree or a master’s degree in their fields.  Many GCM’s may be certified as a Geriatric Care Manager.  They are experienced with the older adult
population and many of them hold GCM membership.  The largest and most well-know organization is the National Association of Professional Geriatric Care Managers.  A GCM can complete a psychosocial assessment in the residence of the older relative to screen for safety, assess level of coping, assess the support systems, assess for the level of cognitive functioning and many other areas.

Home Health Care:
Home health care is usually provided by a nurse, (RN) or a physical
therapist, (PT) who have been ordered by the doctor to follow up with the
patient’s condition on a temporary basis at the home of the older adult.  A
few visits are usually paid by Medicare.

Homemaker/Companion or Chore Services:
Homemaker, companion and/or chore services are not covered by
Medicare.  This is an out of pocket expense for the older adult and family.  
This type of service provides an aide, companion or house cleaner.  
Services are used to assist with companionship, meal preparation and
chores around the house.  This service does not provide any hands on
care.  Many agencies require an hourly or weekly minimum and can also
provide 24 hour care.

Home Sharing:
Many older adults have opened up their homes to roommates.  This can be
an option for either those that have a large house or are looking for a room
to rent in exchange for household chores.  The agreement is between the
individuals and usually requires some time involved to interview and run a
background check.  Some community agencies can assist with locating
possible roommates.

Hospice Care:
Hospice provides care when a person is diagnosed with a terminal illness
and has been given the prognosis of having six months or less to live.  
Hospice is care that manages pain and symptoms, while providing comfort
and emotional support. Hospice services are paid for by Medicare, Medicaid and sometimes supplemental insurance.

Incontinence:  the inability to control bowel and/or urine elimination.

Medical Equipment:
This refers to equipment, supplies and products that are either rented or
paid for to provide assistance to an individual who has a temporary or
chronic limitation which impairs the ability to be independent.

Medicaid:
Medicaid is a program supported by the Federal and the State Government.
Each state administers the healthcare program for those who qualify.

Nutrition Programs:
These programs may consist of meals provided at a local congregate
location for a reduced fee and/or a donation.  Meals on Wheels programs
are available for those who are homebound and unable to cook for
themselves.

Ombudsman:
This is an advocate for the resident who is staying in a nursing home,
assisted living facility or board and care.  The ombudsman assists with
advocating and addressing any concerns pertaining to the care given by the
facility.

Residential Care Facilities, as known as Board and Care Facilities, Adult Foster Care Homes:
This housing option is usually provided in a home that has been approved
by the state to be licensed as a residential care facility.  Most of these
homes must meet licensing standards that regulate the type or level of care
they can provide. The residential facility will usually conduct an assessment prior to determining acceptance. 

Some facilities may be very large and others have only have six residents. Usually the rooms are semi private.
The staff can provide medication monitoring, shared meals, laundry and
assistance with activities of daily living.  These facilities charge a monthly fee for which the older adult is responsible.  Many of these facilities provide care to those residents who have Alzheimer’s Disease, dementia as well as hospice care.

Respite Care:
This service provides temporary relief for the family caregiver either in a
facility or at your own home.  Facilities that may provide respite, consist of
adult day programs, nursing homes and assisted living.  Some in-home
respite may be provided by local community agencies or volunteer
organizations.  This varies by area.

Retirement Communities:
This is a housing option for those who want to be in an environment that
offers social activities and meals but allows them to maintain their
independence.  These facilities require a monthly fee which the older adult
usually pays for out of pocket.

Senior Case Management:
This service is offered many times from the local senior center as a means
of reaching out to those seniors who are homebound or those who are
restricted in some way from resources.  Usually this service is free and it
provides a few visits or phone calls to the older relative.  It also offers
assistance with getting connected to additional resources and low cost
services within the community.

Senior Center:
Senior centers focus on outreach to the older adult population by providing
a location to meet for meals, activities and social support.  Many of the
senior centers also provide case managers that can assist with specific
needs such as home delivered meals.  Many senior centers have volunteers
who can telephone isolated seniors and offer a sense of connection.

Skilled Care:
Daily nursing and rehabilitative care performed or supervised by skilled
medical personnel.  Care must be based on doctor’s orders.

Skilled Nursing Facility, Convalescent Home, Rehabilitation Facility:
These facilities are for those who need additional time to recover from a
medical condition as well as for those who require long term nursing care.  
Medicaid will help pay for long term care and Medicare will pay for a limited stay after hospitalization.

State Health Insurance Assistance Program (SHIP) :
This is a National program that provides telephone assistance with
questions pertaining to Medicare, Medicaid, Medigap and long term care
insurance.

Subsidized Senior Housing:
These apartments are available to older adults who meet age and income
requirements. This is a housing option for those who can safely live
independently. Many of these vary from state to state and may have a long
wait list.

Transportation:
Local and county programs provide transportation to assist the older adults
with medical appointments and errands.  Usually there is a fee for the service.