There are numerous options to be assessed when medical considerations impact on one’s living arrangements. Home care can refer to health care provided in the home by health care professionals or by family and friends. In many cases, formal care provided by health care professionals is necessary to provide proper care and prevent risk for both the older person and the caregiver.
Those of the co-called “Sandwich Generation” are often caught between the obligation to care for their parents -- who may be ill, unable to perform various tasks or are in need of financial support -- and children, who require financial, physical and emotional support. These obligations demand considerable time, money, resources and energy. With the added burdens of work and personal issues, as well as the need to contribute to their own retirement, the individuals of the Sandwich Generation are under significant stress.
The Sandwich Generation is also aging, with baby boomers now between the ages of 41 and 59, and many adult children of the very elderly in their 60s, 70s, and even their 80s. Also included in this group of informal caregivers are aging spouses and siblings caring for each other, or one spouse or sibling attempting to provide care for the more infirm of the two.
Our professionals are knowledgeable in conditions which include Alzheimer's disease, Parkinson's disease, hip replacement surgery, stroke recovery, heart attack recovery and diabetes, and will weigh the options to reach the most appropriate decision to provide for the comfort and care of our clients.
Employer Assistance Program
The Center for Elder Services works with businesses by providing Employer Assistance Programs to help reduce the burden placed on such employers and their employees. In 2000, the National Family Caregivers Association reported that over 60% of caregivers are working full or part-time; such caregivers dedicate on average 18 hours per week to provide care for parents and other older persons and even more when that person has multiple disabilities. It’s no surprise that nearly 90% of caregivers reveal that their care giving activities have affected their stress level and 80% state it has affected their jobs and personal life.
The Center for Elder Services’ Employer Assistance Program responds to the needs of employers who manage and run busy companies, and whose employees currently or in the future must take time away from their jobs to care for the infirm and aging.These programs are designed to:
- Reduce employee absences by having the Center coordinate and recommend resources. Find concise information on caregiver rights, elder rights, care-giving services and their costs to employees.
- Provide consolidated resources/one-stop shopping for employees.
- Create affordable service packages to be prepaid by Employers as an employee benefit.
- Offer service providers who “translate” industry terms into common language for employees.
- Offer service providers who operate with an employed caregiver’s hours in mind.
By partnering with the Center for Elder Services’ Employer Assistance Program, businesses can create a strategic partnership to better support employed caregivers, thereby providing for a “caregiver friendly” work environment and reducing the impact of an employee’s ability to work and to advance his or her career. Simultaneously, employers benefit in terms of stability, profitability, and the retention of valued workers.
Rehabilitation Services
Rehabilitation Therapists are very important to the home health care team because they provide restorative treatments for patients following an accident, illness or surgery. These services include physical, occupational and speech therapy.
Private Pay
As the term implies, private pay costs are entirely the burden of the senior or the senior’s family. When clients, families, or friends are able to pay for the assistance needed by a loved one, services are offered on a private pay basis. This means the responsible party pays full cost for the services, which can be of great benefit to those who are financially able to pay for their assistance. Private pay allows for immediate access to services; there is no waiting time for lengthy applications. Private pay also allows for services that government programs do not cover. However, private pay may be the only option when there has been insufficient Medicaid planning for nursing home costs, and private payers may have to deplete a substantial portion of their life savings before establishing eligibility for government-financed services.
Lombardi Program/Community Medicaid
The Community Medicaid Lombardi Program, which is also known as Long-Term Home Health Care or “Nursing Homes Without Walls,” was designed to provide care in the home for those who are qualified to enter a nursing home but who have lesser care needs and prefer to remain in their homes. In addition to receiving home nursing care, Lombardi participants receive assistance from home health aides and are often provided with social day care, home delivered meals and transportation to and from medical appointments.
A coordinated plan of medical, nursing, and rehabilitative care is provided at home, offering patients an alternative to institutionalization. Eligible individuals must have care costs which are less than the nursing home cost in the county. Individuals can access this program through our assistance in coordination with a hospital discharge planner, the local Department of Social Services (LDSS), or a Long Term Home Health Care Provider. The county determines eligibility for the program, and the LDSS authorizes all services that are provided.
Social Model Daycare
Social Model Daycare programs offer recreational and socialization opportunities for people with dementia, in a secure environment with trained and dependable staff. Each program is slightly different and has different requirements. Our trained professionals assess the appropriateness of a program based on our client’s functional ability, their need for service, and their financial resources.
Medical Model Daycare
Medical Model Daycare programs are designed for persons with medical problems, including dementia, who may require one or more of the following services: monitoring, nursing care, social work, occupational therapy, physical therapy, nutritional counseling or recreational therapy, as well as socialization. Community Medicaid will provide full coverage for Adult Day Care to qualified individuals. This option is generally available for low-income applicants.
Hospice Care
Hospice programs provide palliative care (moderating pain or sorrow by making it easier to bear) and attend to the emotional, spiritual, social and financial needs of terminally ill patients at an inpatient facility or at the patient's home.
Hospice care occurs in free-standing hospice units, homes, and sometimes within regular hospital units. More than a place, hospice care is a philosophy. It is characterized by concern for symptom relief, general well-being, and spiritual and existential comfort for the dying. The need to maintain quality of life in dying or "quality of dying" is important as the incidence of chronic illness increases with the aging of the Western world's population.
The patient and family are the focus of hospice care, with emphasis placed upon the well-being of family caregivers as well as the patient. Opportunities for caregiver respite are one of the services hospices provide to promote caregiver well-being. Major aspects of hospice care include the relief of pain and management of other symptoms such as nausea and respiratory distress, as well as psychological help for patients and their families to cope with the impending death. Because Medicare usually covers the full cost of hospice services, our staff can help determine if such care is available.
Senior Communities and Assisted Living Facilities
Senior Communities, which are located throughout the United States, provide for active adult living, usually for people 55 or older. Amenities can include state-of-the-art fitness centers, pools and golf courses, and classes and clubs ranging from ceramics to computers to personal investing. Housing can include apartments, townhouses, single-family detached homes and other options. The amenities of some senior communities include flexible dining programs, on and off “campus” events, housekeeping, maintenance and linen service. Others provide a continuum of care for residents who need assistance with health challenges, similar to the care provided by an assisted living home.
Assisted Living usually refers to a facility that is used by people who are not able to live on their own, but do not need the level of care that a nursing home offers. A typical resident of an assisted living facility would be an elderly person or couple who, although not needing the intensive care of a nursing home, would still need some companionship and/or assistance in day-to-day living. Residents of assisted living facilities usually have their own private apartments, without special medical monitoring equipment, nor full time nursing staff that one would find in a nursing home.
Someone who lives at an assisted living facility would not have to be concerned with preparing meals because there is a central kitchen and dining facility. The central dining facility also allows for visiting with others without having to leave home. This greatly reduces the isolation that elderly, disabled or handicapped people suffer when living alone and who are afraid, usually for physical reasons, to leave their homes. Facilities are designed with an emphasis on ease of use by disabled people and are, by necessity, fully compliant with the Americans with Disabilities Act of 1990 (ADA) or similar legislation elsewhere.
Nursing Home Analysis and Rating
Residents of nursing homes require constant medical care. In the United States, nursing homes are required to have a licensed nurse on duty 24 hours a day, and during at least one shift each day, one of those nurses must be a Registered Nurse. Federal, state and local guidelines are in place to ensure proper medical care and sanitary living conditions.
Our professionals are well-trained and highly qualified in analyzing the appropriateness of each nursing home setting and rating their facilities, care-providers and other factors. Our primary goal is to ensure patient well-being. We look at non-profit and for-profit homes; up-to-date government reports; investigations; and the quality-of-care experiences of current residents. We research and assess nursing homes based on neglect and abuse reports, on-site visits, interviews with staff, and Medicare and Medicaid certification.
Nursing Home Placement
Nursing home placement is crucial to thousands of Americans who each year must confront the difficult decision of placing a loved one in a long-term care center. Nursing home placement is an individualized process. What might be an ideal placement for one client may not be desirable for another. Our professionals take into consideration such factors as location, availability, the physical and mental condition of the patient, age, and access to other services and family members. Using the criteria described previously, we make every effort to ensure a successful nursing home placement for our elder clients and their families.
PRI (Patient Review Instrument) Screens and RN (Registered Nurse) Services
The PRI (Patient Review Instrument) is a clinical tool used to assess a person's condition. A PRI is mandated by law before any senior can enter a skilled nursing facility. PRIs are valid for 30 days and are used to determine the level of care and the type of facility required. A PRI assessment, conducted by a Registered Nurse, is very thorough and includes medical conditions, treatments and medications needed, special diets or therapies needed, physical and mental abilities and limitations, ability to perform acts of daily living such as eating, moving and toileting, and behaviors such as aggressiveness and disruptiveness.
RNs (Registered Nurses) are professionals who provide direct care and make decisions regarding plans of care for individuals and groups of healthy, ill and injured people. They often have bachelor degrees or associate degrees in nursing, but regardless of degree, they have many hours of clinical experience. They are the largest group of healthcare workers in the United States, numbering over 2.6 million. RNs are the first-line defense of hospitalized patients against disability or death from infection, cardiopulmonary arrest, and other serious complications. Higher ratios of registered nurses to patients have been shown to decrease certain complications of illness including death in patients. Registered nurses are educators, managers, executives, therapists, intensive care experts, symptom managers, professional mentors, researchers and community members. In hospitals, registered nurses perform diverse roles such as writing policies, responding to emergencies, managing professional, technical and ancillary staff, determining budgets, performing strategic planning, and supervising construction projects. Our office has access to qualified RNs who can independently provide certain services such as home visits for preparing a PRI.
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