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Aging Services Overview

Understanding the Network of Aging Services

The Center for Positive Aging understands that during crisis it can be difficult to find the right services and providers to fit you and your family’s needs. Listed below you’ll find an index of the different classification of Aging Services Providers and a brief explanation of the types of the products and services they offer.

What is Long-Term Care?

Long-term care is a variety of services that includes medical and non-medical care to people who have a chronic illness or disability. Long-term care helps meet health or personal needs. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom. Long-term care can be provided at home, in the community, in assisted living or in nursing homes. It is important to remember that you may need long-term care at any age.

National Clearinghouse for Long-Term Care Information was developed but the U.S. Department of Health and Human Services to provide information and resources to help older adults and their families plan for future long-term care(LTC) needs. This website will help you understand what long-term care is, how and where you can get information and services you need – now or in the future, and how to pay for services.

Visit www.longtermcare.gov to learn about long-term care costs in Georgia.

Medicare and Long-Term Care: While there are a variety of ways to pay for long-term care, it is important to think ahead about how you will fund the care you get. Generally, Medicare doesn’t pay for long-term care. Medicare pays only for medically necessary skilled nursing facility or home health care. However, you must meet certain conditions for Medicare to pay for these types of care. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom. Some Medicare Advantage Plans (formerly Medicare + Choice) may offer limited skilled nursing facility and home care (skilled care) coverage if the care is medically necessary. You may have to pay some of the costs.

For more about Medicare Advantage Plans visit Medicare Personal Plan Finder.

Medicaid and Long-Term Care: Medicaid is a State and Federal Government program that pays for certain health services and nursing home care for older people with low incomes and limited assets. In most states, Medicaid also pays for some long-term care services at home and in the community. Who is eligible and what services are covered vary from state to state. Most often, eligibility is based on your income and personal resources.

Visit www.medicare.gov/longtermcare/static/home.asp to learn about your options.

Assisted Living / Personal Care

Assisted living is for individuals who need some assistance with normal activities of daily life, but who do not need the medical care provided in a nursing home. A primary goal of assisted living is to limit the loss of independence that often results from institutionalization. Another goal, however, is to protect the individual’s safety and well-being by providing an active, supportive and watchful environment where assistance is available as and when needed.

Residents of assisted living range from very impaired to very healthy. The average age is the early 80’s. Part of the reason that the health status of residents varies is because many individuals are able to avoid nursing home care for quite a long time by entering assisted living at a time when they are still relatively healthy. The help they receive in assisted living keeps them more independent for longer than they would be if they had continued to live alone in the community.

A growing number of facilities are offering “Alzheimer’s units,” which are designed to care for those with moderate to severe dementias but few other medical problems. These normally are locked facilities that specialize in the unique kinds of supervision, structure, support and personal care required by those with serious dementia problems.

Visit www.eldernet.com/options/assisted.htm to learn more about Assisted Living

Assisted Living\Personal Care: 11 Things To Ask Yourself Before Moving In

35 Questions to check off to insure you are choosing the right Assisted Living Community

Affordable Housing

(Also called Public Housing / HUD Subsidized Housing / LIHTC Sponsored / Section 8)

Affordable Housing are senior housing complexes, subsidized by the U.S. Department of Housing and Urban Development (HUD), for low income seniors. Keep in mind that depending on the area, waiting lists can take years, so it’s a good idea to plan well in advance for this option.

Affordable (income based) housing encompasses all types of housing communities where either some type of financial assistance is available or the rents are controlled for those who live there. Some examples are HUD Section 202/8, tax credit and rural development communities.

Eligibility is determined by:  annual gross income;  whether a person qualifies as elderly, a person with a disability, or as a family; and  U.S. citizenship or eligible immigration status. Income limits vary from area to area. All affordable housing communities comply with federal fair housing regulations, accepting income-qualified residents without regard to race, color, religion, sex, disability, familial status, or national origin.

Tenants who qualify for government subsidized retirement housing will have their rent adjusted so that a maximum of 30% of monthly income is spent on rent.

HUD Approved Housing Counseling Agencies in Georgia. HUD sponsors housing counseling agencies throughout the country that can provide advice on buying a home, renting, defaults, foreclosures, and credit issues.

Visit www.hud.gov/local to learn more about HUDs in Georgia.

Independent Living Communities

(Also called Retirement Communities / Retirement Homes / Senior Housing / Senior Apartments / Congregate Housing)

Generally speaking, an Independent Living Community refers to any housing arrangement designed exclusively for older adults (usually defined as persons over age 55), in which the resident does not need daily assistance with medical or personal care.

There are many types of independent living facilities, from apartment complexes to separate houses. They come in a range of costs, including subsidized housing for low income older adults. Continuing Care Retirement Facilities (CCRC) provide independent living as well as other housing with more services at the same facility. The definition also includes a variety of smaller-scale senior housing facilities often referred to as “congregate housing” or “senior apartments,” which may be subsidized by local charities instead of by municipalities.

A retirement community or independent living facility will work for you if:  you generally are healthy, such that any daily medical or personal care assistance can be provided by visiting nurses or minimal visits by a home health aide;  you have the ability to keep in touch with your doctors or other caregivers as needed, possibly with the help of family or friends but without assistance from trained staff on site;  if you are thinking about a community with great location and lots of amenities, you must have the means to pay for it; and  if your financial means are limited, you must be able to accept the limitations in the lifestyle you will able to afford if you choose a subsidized facility.

Visit www.eldernet.com/options/retire.htm for more about Independent Living Communities.

Retirement Housing

(Also called Market Rate Housing / Non-HUD)

Retirement housing is an umbrella term for many types of housing and services. Retirement communities are groups of housing units for those aged 55+. These housing units can be single family homes, duplexes, mobile homes, or townhouses or condominiums. If you decide to buy a unit, additional monthly fees may cover services such as outside maintenance, recreation centers, or clubhouses.

Retirement homes are privately owned and operated by for-profit companies and/or non-profit groups. Reasonable independent mobility is a requirement for entry into many homes. The different types of housing options offer a wide range of services and activities for a variety of ages. There are several ways to pay for these types of housing, including market-rate rental or purchase. Residential accommodations may also offer government subsidized units or rent-geared-to-income (RGI) accommodation.

Visit www.eldernet.com/options/retire.htm for more about Retirement Housing.

CCRCs / Life Plan Communities

Continuing Care Retirement Communities (CCRCs) Life Plan Communities offer service and housing packages that allow access to independent living, assisted living, and skilled nursing facilities in one community. If residents begin to need help with activities of daily living, they can transfer to an assisted living or skilled nursing facility on the same site.

CCRCs strive to provide an optimum mix of independence, comfort and security for their residents. Due to the need to control health care costs, residents must be relatively healthy at the time they join. As a result, most CCRCs have a substantial community of healthy and active residents who participate in both structured and unstructured activities, and who provide opportunities to interact socially with peers.

CCRCs also have special advantages for married couples who are concerned about being separated by illness. A certain amount of assistance is available in a CCRC without moving from the main residential areas. Such assistance may be provided by nursing staff or home health aides employed by the facility. This also varies depending on the policy of the facility.

A CCRC will work for you if:  you and your spouse presently do not need any medical or personal care assistance on a daily basis;  you have the resources to purchase a unit and to pay the monthly maintenance fee;  you and your spouse don’t want to move again for the rest of your lives, regardless of changes in your health; and  you and your spouse enjoy the company of other seniors for meals, activities and socializing.

Visit www.eldernet.com/options/lifecare.htm for about CCRCs.

Nursing Care Facility (NCF) / Nursing Home

(Also called a Convalescent Home / Long-Term Care Facility)

A nursing care facility or nursing home is a residential facility for persons with chronic illness or disability and require 24 hour nursing assistance. Resident care includes room and board, basic and skilled nursing care, rehabilitation, and a full range of other therapies, treatments, and programs. People who live in nursing homes are referred to as residents.

Skilled Nursing Facility (SNF) is a type of nursing home recognized by the Medicare and Medicaid systems as meeting long-term health care needs for individuals who have the potential to function independently after a limited period of care. A multidisciplinary team guides health care and rehabilitative services, including skilled nursing care.

Law requires that the skilled nursing facility policies designate which level of caregiver is responsible for implementation of each policy, that the care of every patient be under the supervision of a physician, that a physician be available on an emergency basis, that records of the condition and care of every patient be maintained, that nursing service be available 24 hours a day, and that at least one full-time registered nurse be employed.

Click here for more about Nursing Homes.

Alzheimer’s and Dementia Care

Alzheimer’s Care Unit is a special care unit in a designated, separate area for individuals with Alzheimer’s disease or other dementia that is locked, segregated, or secured to prevent or limit access by a resident outside the designated or separated area. For the purpose of these rules, an Alzheimer’s care unit is referred to as a memory care community.

Alzheimer’s Disease is a type of dementia that gradually destroys an individual’s memory and ability to learn, reason, make judgments, communicate, and carry out daily activities.

Dementia is the loss of intellectual function of sufficient severity that interferes with an individual’s daily functioning. Dementia affects an individual’s memory, ability to think, reason, speak, and move. Symptoms may also include changes in personality, mood, and behavior. Irreversible dementias include but are not limited to:  Alzheimer’s disease;  Vascular dementia;  Lewy body dementia;  Frontal-temporal lobe dementia;  Alcohol dementia;  Huntington’s disease; and  Creutzfeldt-Jakob disease.

Visit Alzheimer’s Association webpage to learn more Alzheimer’s and Dementia.

Home and Community Based Services (HCBS)

Older adults may prefer to live in their own homes. Yet, at some point, almost every aging person can benefit from some type of supportive community service. Community services help with personal activities or daily living chores, provide health care assistance or make social opportunities more readily available/accessible.

Family members supporting a relative’s chronic illness or disability may benefit from community services. Daily caregivers who work or have other major demands on their time may find such help invaluable. Though many different community services exist for older adults, not all are available in every community.

Click here to learn more about Home and Community Based Services in Georgia.

Most common community services available:

Home Health Care offers a variety of useful services to people living at home. Home health aides may assist with personal hygiene, prescribed exercise, meal preparation, and some shopping and light housekeeping all under the supervision of a licensed nurse. Homemaker services or concierge services may help with daily household activities, such as laundry, shopping, housekeeping, errands, driving and companionship. Physical, occupational and speech therapies may be provided in the home.

Adult Day Services and Care enables people to spend their daytime hours in organized and supervised social activities. They may include physical and mental activities as well as exercise and an array of other services.

Health Education and Wellness Programs maintain people’s health through direct teaching, counseling and similar services.

Caregiver Support or Training instructs family caregivers in techniques that improve their ability to assist an older relative or spouse.

Hospice Care provides nursing care services to the terminally ill as well as counseling for their families. Hospice care can be offered in nursing homes or in the individual’s home, where nurses and social workers can visit regularly.

Respite Care allows family caregivers to have a brief rest by providing temporary, overnight care for the ill or disabled for a few days or weeks.

Home-Delivered Meals, often called Meals-on-Wheels, bring nutritionally balanced meals to those unable to prepare their own food.

Congregate Dining Programs offer low-cost, nutritious meals served in group settings.

Telephone Reassurance provides regular telephone contact and a sense of security for people living at home.

Transportation Services help individuals keep appointments and enjoy recreational opportunities.

Senior Centers offer individuals a place to visit daily for a variety of social and recreational services to reduce isolation and keep life interesting and satisfying.

Information and Referral Programs help identify and locate services in the community.

Home and Community Based Services PAYMENT: Older adults and their families may pay for home and community based services (HCBC) out of their own private funds. Although Medicare covers few of such services – it is worth checking eligibility guidelines. Medicaid pays for health-related community services for those who qualify.

Currently, both Medicare and Medicaid offer limited coverage for hospice care. Medicare, Medicaid and some forms of private insurance provide limited coverage for home health care services. And some programs, such as telephone reassurance, various senior care activities, and information and referral programs, are operated by local governments or other organizations with little or no cost to participants.

Hospice

Hospice is not a place. It is a special kind of healthcare focused on keeping the patient comfortable once the patient and physician have decided that the underlying disease can no longer be treated or cured. Hospice helps the patient, their families, and other caregivers. Hospice care can occur in a variety of settings. It neither hastens nor postpones death and is focused on the belief that quality of life is as important as length of life. Hospice staff members help manage pain and symptoms and provide emotional and spiritual support so patients can make the most of each day.

Visit www.hopehospice.com/faqs.html to learn more about Hospice.

Palliative care is specialized medical care for people with serious illnesses. It is focused on providing patients with relief from the symptoms, pain, and stress of a serious illness—whatever the diagnosis. The goal is to improve quality of life for both the patient and the family. Palliative care is provided by a team of doctors, nurses, and other specialists who work together with a patient’s other primary care doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment.

Visit www.getpalliativecare.org/whatis to learn more about Palliative care.

Respite Care

Respite care helps families by providing temporary, short-term assistance with caring for loved ones who require specialized care or supervision. Respite care may include in-home assistance, a short-term nursing home stay or adult day care and can vary from a few hours to several weeks.

Visit www.helpguide.org/elder/respite_care.htm to learn more about Respite care.

Active Adult Communities

An active adult community is targeted towards people 55 years of age or older and offers a number of comfortable housing options. Each community is designed differently and may include single-family homes, condominiums, town homes, multi-family dwellings, or manufactured housing units. Residents can participate in the activities they enjoy while benefiting from many recreational, educational and social opportunities.