Notes from the Author
Why Is This Long-Term Care Decision So Difficult?
There are so many uncertainties and emotions involved in making a long-term care decision. Does the senior adult agree with the decision? Is there insurance or private funds available to pay for the level of care required? What other changes does this long-term care decision require to adjust to this new reality.
Click here to learn more why 70% of Americans aged 65 or older will need some form of long-term care
No matter the level of precision exercised, a nursing home placement is painful. “Don’t send me to the Poor House” expresses the emotional apprehension and uncertainty that the nursing home is the right place to live. The cost of a nursing home stay has a rippling effect on the financial resources of all the parties involved. Medicare covers just a portion of a nursing home stay with approval from the insurance company. Medicaid pays for nursing home care after all the senior adults’ assets have been exhausted. Long term care insurance is the best option for covering this care otherwise the expense must be covered by the senior adult and family.
Skilled Home Health Care Verses Custodial Home Care Keep More People Aging at Home
Home health care helps seniors live independently for as long as possible, given the limits of their medical condition. It covers a wide range of services and can often delay the need for long-term nursing home care.
More specifically, home health care may include occupational and physical therapy, speech therapy, and even skilled nursing. It may involve helping the elderly with activities of daily living such as bathing, dressing, and eating. Or it may include assistance with cooking, cleaning, other housekeeping jobs, and monitoring one’s daily regimen of prescription and over-the-counter medications.
Help with Activities of Daily Living
Whether you arrange for home health care through an agency or hire an independent home health care aide on an individual basis, it helps to spend some time preparing for the person who will be doing the work. Ideally, you could spend a day with him or her, before the job formally begins, to discuss what will be involved in the daily routine.
If nothing else, tell the home health care provider (both verbally and in writing) the following things that he or she should know about the senior:
- Illnesses/injuries, and signs of an emergency medical situation
- Likes and dislikes
- Medications, and how and when they should be taken
- Need for dentures, eyeglasses, canes, walkers, etc.
- Possible behavior problems and how best to deal with them
- Problems getting around (in or out of a wheelchair, or trouble walking for example)
- Exercise routine
- Special diets or nutritional needs
Could your aging loved one be eligible for a significant amount of assistance through the Medicaid and Medicare Program of All-Inclusive Care for the Elderly (PACE)? According to the National PACE Association, more than 60,000 elders with significant care needs currently take advantage of the services provided by this little-known program.
What Is PACE?
PACE is an optional Medicare and Medicaid benefit that serves older adults who meet their state’s standards for nursing home-level care. PACE offers comprehensive medical and social services that can be provided at an adult day health center, in a participant’s home, and/or in an inpatient facility. For most patients, these services enable them to continue living in their own homes, rather than moving to a long-term care facility.
A multidisciplinary team of PACE doctors, nurses, therapists, social workers and other professionals assesses each participant’s needs and delivers all services via an integrated elder care plan. Studies have shown that participation in PACE programs reduces family caregiver burden and decreases emergency room visits, hospital admissions and readmissions, and nursing home admissions for seniors. There are currently 146 PACE programs provided at 273 PACE centers in 31 states.
PACE Eligibility Requirements
Enrollment in a PACE program is voluntary and participants can leave at any time.
To be eligible for PACE, an individual must:
- Have Medicare, Medicaid or both;
- Be at least 55 years old
- Live in a PACE service area
- Be certified as requiring their state’s nursing home-level of care
- Be able to safely live in a community setting with the addition of PACE support at the time of enrollment.
PACE Services for Seniors
PACE offers and manages all the medical, social and rehabilitative services enrollees need to maintain or regain their independence, remain in their own homes and communities, and enhance their quality of life. Not only do these services directly benefit vulnerable elders who wish to age in place, but they also indirectly benefit family caregivers.
The PACE service package must include all Medicare services. If a state has chosen to extend PACE to its Medicaid beneficiaries, then all services covered by the state’s Medicaid program are also included. In addition, PACE provides any service determined necessary by a senior’s interdisciplinary care team.. Minimum PACE covered services that must be provided include the following:
- Adult day health care to offer nursing care and physical, occupational, and recreational therapies
- Nutritional counseling
- Social work counseling
- Social services (e.g., caregiver training, respite care, support groups)
- Medical care provided by a PACE physician who is familiar with the patient’s history, needs and preferences
- Home health care and personal care
- All necessary prescription drugs
- Laboratory and imaging services
- Medical specialty services as required (e.g., audiology, dentistry, optometry, podiatry)
- Transportation to and from the PACE center and some community medical appointments
Monica Stynchula – CEO / REUNIONCare, Inc.