For Seniors
Boston ElderINFO can answer
your questions about home care services, public benefits, housing
options, support for care givers and much more. The following
on-line Guide to Services provides information on over 50 services.
For most services, we have tried to answer five questions:
- What is it – what can the service/program
offer you?
- Who pays for it?
- What are the average costs?
- Why is it important to know about the service/program?
- What should the consumer consider in selecting
a provide
|
 |
We have provided you with information on various
programs and services. If you require additional information, visit
the Resources and/or
FAQ/INFO section of
this site OR feel free to call us at 617-292-6211. We invite you to
call and tell us about your particular situation so that we can provide
information specific to you as well as tell you who provides the services
you need.
Our Information and Referral Specialists can provide:
- Information on community, state and national resources
- Referrals to appropriate programs and services
- Free printouts from our 5000+ record database
The following is a list and description of programs
and services available for seniors and caregivers. Click
here if you would like a print version of our 36 page guide Eldercare
in Massachusetts, "A Guide to Services"
Active
Adult Retirement Community
Adaptive Equipment
& Design Service
Adult Day Health
Adult Foster Care
Adult Foster Care Fact Sheet
Alzheimers/Dementia
Service
Assisted Living Residence
Why People Leave Assisted Living
Case Management
Congregate Housing
Continuing Care Retirement
Community
Geriatric Assessment
Hearing Impaired Services
Home Care Meals
Home Health and Medical Care
Homemaker, Personal Care
Homemaker
and Home Health Aide
Homeowners Services
Hospice
Legal Services
Lifetime Learning
Educational
Programs
Mental Health
Alcohol
Services for Older Adults
Geropsychiatry
Support Groups
Money Management
Nursing Facilities
Ombudsman Programs
Rest Home
Second Career
Senior Rental
Services & Requirements
Social Activities
Transportation
Vision-Impaired Services
What
is it and what
services does it provide?
An active adult retirement community,
while more often found in warm weather climates like Florida or
Arizona, can also be found to a more limited extent in Massachusetts.
These communities are built for active, independent persons, aged
55 and up. They may be rentals or condominiums, and complexes may
consist of 25 units or several thousand. They are often built where
there is enough land to add a golf course, tennis courts, swimming
pools, etc. For the most part, the services offered in these communities
are recreational, such as clubhouse, trips, etc., versus support
services that less independent persons may need.
Who
pays
for the service?
Active Adult Retirement Communities are market rate.
What
are the average costs for the service?
The costs vary greatly depending upon whether they are rentals or
condos, what the community offers, and where they are located.
Why
is it important to know about the service?
For some retirees, these communities may offer opportunities to
be active as well as be with people of similar interests.
What
is it and what services does it provide?
An adult day health program offers a supervised setting where elders
receive medical, social, and nutritional services. This program
typically runs five days a week, six hours a day and transportation
is usually arranged. The medical services may include health screening
and monitoring, supervision and administration of medications, assistance
with personal care and rehabilitative therapies. Social services
may include recreational and cultural activities, as well as counseling
and support for the elder and family. Nutritional services include
a hot noon meal and snacks. There are also some adult day health
programs which specialize in the Alzheimer's or dementia patient,
the blind or visually handicapped person, or those with mental health
problems. Also, some programs offer bilingual and bicultural staff
as well as ethnic food.
Who
pays for the service?
Depending upon the elder's income, there are several sources of
reimbursement for adult day health programs. If the elder is Medicaid
eligible and is determined medically to need the service, then Medicaid
pays the cost. If the elder is ineligible for Medicaid but meets
the requirements of ASAP's* Home Care or Respite Program, then they
may subsidize the service. Some long term care insurance policies
now also pay for day care. If none of these situations applies,
the elder or family may pay privately. Medicare does not pay for
adult day health services.
What
are the average costs for the service?
The cost for adult day health range from $35-$70/day plus transportation.
The upper range includes special programs such as Alzheimer's, etc.
Why
is it important to know about this service?
Typically, elders who need this kind of service are frail and already
receiving care from family members and others. And because the care
of a frail elder may be emotionally and physically exhausting, the
day program may offer the caregiver not only needed assistance with
care, but may provide respite from it as well. For elders, adult
day health programs help meet daily personal care, medical, social
and nutritional needs, and in some cases, provide a better quality
of life. Finally, an adult day health program may even forestall
the need for a nursing facility.
What
should the consumer consider in selecting a provider?
Considerations in selecting a provider include determining whether
there are a lot of activities, caregiving support services, comprehensive
planning that includes the elder's home needs, etc. Certainly, location
and environment are also important.
*Aging Services
Access Points
What
is it and what services does it provide?
Adult Foster Care provides elders, unable to live alone and who
wish to live with a family, with room, board and personal care.
These are usually long term arrangements, but some programs will
consider short-term placements as well. Through regular home visits
by a nurse and social worker, close supervision and support are
provided. 24-hour coverage by the team is also available for consultation
or emergencies.
Who
pays for the service?
Medicaid will pay the cost for Medicaid-eligible elders. Those not
eligible may pay privately.
What
are the average costs for the service?
Average cost on a private basis is $1500/monthly.
Why
is it important to know about this service?
It is important to know about Adult Foster Care simply because it
can be a good housing alternative for elders who need assistance
and who wish to live in a family environment.
What
should the consumer consider in selecting a provider?
The consumer should always make sure that the Adult Foster Care
program is licensed by the state.
The Commonwealth of
Massachusetts
Executive Office of Health and Human Services
Division of Medical Assistance
600 Washington Street
Boston, Massachusetts 02111
Summary:
Adult Foster Care services are community based services which provides
means for elder and physically compromised individuals who are imminent
risk of institutionalization to receive personal care in a family-like
atmosphere.
Qualifications:
- Must be 16 years of
age or older.
- Must meet the financial
criteria established to be eligible for Community
- Medicaid (Contact
the local MassHealth Enrollment Centers/MEC for further information).
- Requires a physician's
authorization confirming the appropriateness of AFC services.
- Requires daily assistance
with at least one Activity of Daily Living (ADL).
- Requires clinical
approval from the designated Aging Services Access
- Points (ASAP): Coastline
Elderly Services, Inc.
Setting:
Participants in the Program reside in a host family's home. No more
than three unrelated MassHealth Members can reside in one particular
home setting.
Payment:
- Medicare does not
pay for this service.
- The Division of Medical
Assistance reimburses the Providers $19.00 a day for personal
care services.
- The Division reimburses
the Providers $18.39 on average per MassHealth
- Member per day for
administrative services, which includes paying for professional
staff and administrative costs and overhead.
Supplemental
Services:
Participants are eligible for up to two days a week of Adult Day
Health Services or eight hours a week of Home Health Aide Services
provided that they receive prior approval from the designated medical
screening agent.
Medical
and Non-Medical Leave of Absence:
Members are allowed 40 medical leave of absence days per calendar
year and 15 non-medical related absence days per calendar year.
Statistics:
As of May 2001, there were 18 AFC providers statewide, of which
9 are ASAPs, 2 are hospitals and 7 are other human service agencies.
There are currently 3 pending applications. Approximately 627 MassHealth
Members receive Adult Family Care services on a monthly basis.
AFC Fact Sheet
July/2001
What
is it and what services does it provide?
Assisted Living Residences must be licensed in Massachusetts. They
are required to provide or arrange for socialization, assistance
with activities of daily living such as bathing and dressing, up
to three meals a day, housekeeping, self-administered medication
management, 24 hour per day staff, personal emergency response system
and laundry services, at a fee if necessary. The size of the living
unit may be a studio or one or two bedroom apartment. There may
be other amenities as well including activity room, library, hair
salon, etc. Some Assisted Living Residences have a special wing
and program for those with Alzheimer's or other dementia.
Who
pays for the services?
Presently, most Assisted Living Residences are paid for privately
by the elder or family. However, for those eligible for Medicaid,
there is assistance available to help meet the cost for services
under the Group Adult Foster Care (GAFC) program. Also, for those
eligible, the SSI-G program under Social Security can pay the housing
portion.
What
are the average costs for the service?
On a private basis, the costs for housing plus services range from
about $1800-$6000 monthly depending on the facility. The special
Alzheimer's programs are at the high end of this range.
Why
is it important to know about this service?
It is important to know that there now exists this important new
option in the continuum of care for elders that addresses both household
as well as personal care needs.
What
should the consumer consider in selecting a provider?
Selecting an Assisted Living Residence will depend in large part
on the elder's finances and the location desired. But once the search
is narrowed by these factors, there are other considerations as
well. Of primary importance is whether the facility can meet the
current needs of the elder and, in looking to the future, what would
be the maximum service the facility would provide and at what point
would they consider the elder no longer appropriate for assisted
living.
Many people are interested in knowing whether assisted
living facilities will reduce the utilization of nursing homes.
Since assisted living is less expensive than nursing home care,
many states are exploring ways to move people who qualify for Medicaid
and who need nursing home care into assisted living facilities instead.
In addition, people who would "rather die than move into a
nursing home" are hoping to find that assisted living will
reduce the chance that nursing home care is in their future.
A recent study done by researchers from Texas A&M
University System Health Science Center and Myers Research Institute
addressed some of these issues. These researchers studied what happened
to people who were discharged from assisted living facilities, including
those who died in them, to help identify ways to keep people in
the facilities longer. They looked at the reason for the discharge,
and found that most (80%) occurred because the resident needed more
care. Those who were transferred often had cognitive problems, and
many had been in the facility only a short time, which may indicate
that the original placement was inappropriate or that the facilities
need to be able to provide more cognitive care services. Researchers
noted that the single most important factor in preventing discharge
was the presence of a full-time registered nurse (RN), since facilities
with RNs on staff were able to provide a broader spectrum of care.
An interesting finding in the study was how the expectations
of family members involved in placement decisions changed over time.
When they first looked for facility, most family members thought
that the availability of private bedroom and bath was the most important
aspect of a facility. By the time a family member was discharged,
many family members said that the most important criteria was the
ability of a facility to adapt to changing care needs, possibly
because that might have avoided the need for a transfer.
Many people are concerned about the cost of assisted
living, which is overwhelmingly paid for out-of-pocket and is not
covered by Medicare and generally not covered by Medicaid. However,
only 8% of the transfers in the study were made because the resident
ran out of money.
Researchers found that about 24% of assisted living
facility residents were discharged each year, including about 8%
who died in the facility or immediately after discharge. Of those
who were discharged and did not die, about 1% was able to return
home and another 7% ended up moving into the home of a relative.
28% moved into another assisted living facility and 64% moved into
a place that provided more care, like a nursing home, hospital,
or sub-acute unit.
* Found on www.elderweb.com
What
is it and what services does it provide?
Geriatric Case Management is a service that includes making home
visits to elders to assess needs, setting up service plans, coordinating
and implementing services. Managing services on an ongoing basis
may also be provided for additional costs.
Who
pays for the service?
If elders are eligible for subsidized services through state-funded
ASAPs*, they are also eligible for case management. Otherwise, a
person may need to pay privately for the service.
What
are the average costs for the service?
The costs for the services of a private geriatric case manager range
from $75-$125/hour. Some may also offer a flat fee for the assessments
and service plan.
Why
is it important to know about this service?
This service is important for families who live at a distance.
What
should the consumer consider in selecting a provider?
One should consider credentials including degrees and licensure.
Experience in working with the elderly as well as length of time
in the field is very important. Costs should always be compared
and personal recommendations secured.
*Aging Services
Access Points
What
is it and what services does it provide?
Congregate housing combines shelter with services. There is either
shared physical space such as a livingroom, or shared services such
as meals. Some facilities offer a private bedroom while others consists
of full apartments with kitchen. Congregate housing may be a cluster
of units within a building or a freestanding facility. Services
typically offered are meals, housekeeping, transportation, activities,
and security. For those needing help with bathing, dressing, etc.,
they would have to be purchased separately or may even be covered
by insurance.
Who
pays for the service?
State-funded and nonprofit facilities offer subsidies for eligible
persons. The elder pays market rates in private facilities.
What
are the average costs for the service?
Costs for private housing range between $1500-$3000/month. For state-funded
and nonprofit, the cost is usually 30% of income.
Why
is it important to know about this service?
Many who choose congregate housing are in their 70s and 80s, a time
when they begin to need services, security, and opportunities for
socialization.
What
should the consumer consider in selecting a provider?
Selection of a facility should depend on location, cost, and matching
services with needs.
What
is it and what services does it provide?
Continuing Care Retirement Community (CCRC), also known as Life
Care, combines housing, services, and health care. In exchange,
there is an entrance fee as well as monthly charges. The difference
between CCRC and Life Care is that the latter always guarantees
some prepaid health care while a CCRC may offer only access to it.
The care may be home health, assisted living, or nursing home. The
independent living units may be apartments or townhouses. Services
include housekeeping, laundry, meals, transportation, 24-hour security,
as well as social, education, and wellness activities.
Who
pays for the service?
This type of housing is paid privately.
What
are the average costs for the service?
The entrance fees are between $100,000 and $300,000, and monthly
fees range between $1500 and $5000.
Why
is it important to know about this service?
For those who can afford them, Life Care and CCRC's are the one
option that can address all needs that may arise in later years.
What
should the consumer consider in selecting a provider?
Because of the substantial financial investment, it is essential
that the buyer consults an attorney or financial advisor first.
What
is it and
what services does it provide?
Geriatric Assessments usually refer to comprehensive evaluations
by a team of health care providers trained in geriatric medicine.
This multidisciplinary team provides evaluations for problems such
as memory loss, falling, incontinence, overmedication, multiple
medical problems, changes in behavior, and many other problems of
the elderly.
Who
pays for the service?
The service is covered by Medicare, Medicaid and most private insurances.
Why
is it important to know about this service?
The evaluation is very comprehensive because it is performed by
a team of doctors and health care professionals who have a range
of medical specialties.
The team performs these diagnostic evaluations every day and so
gains a great deal of experience and skill in evaluating these different
problems.
On the other hand, some primary care physicians may not take a broad
approach to assessing the problems of older patients, and some may
even dismiss the symptoms as "old age".
What
is it and what services does it provide?
Diagnostic services to determine degree and type of hearing loss
should be performed first. Otolaryngologists as well as licensed
audiologists usually perform these assessments. An audiologist will
also provide consultation in choosing the most appropriate and efficient
hearing aid as well as auditory training to help make use of remaining
hearing. Assistive listening devices include such technology as
visual alerting systems, captioning for TV, amplifiers for the telephone,
etc.
Who
pays for the service?
An otolaryngologist is usually reimbursed by health insurance. The
diagnostic services of a licensed audiologist may be reimbursed
if there has been a referral from the primary care physician. Medicaid,
but not Medicare, will usually pay for hearing aids.
What
are the average costs for the service?
The cost for hearing aids may range from $600-$2000.
Why
is it important to know about this service?
Because hearing loss can be so isolating, it is important to know
about assistive listening devices and hearing aids.
What
should the consumer consider in selecting a provider?
When purchasing a hearing aid, several options should always be
considered, and there should be at least a 30-day trial period for
the one selected.
What is it
and what services does it provide?
Congregate meals for those 60+ are found in senior centers,
housing, etc. They provide a noon meal five days a week. Some provide
kosher or ethnic meals.
Home delivered meals are for elders unable to prepare
adequate meals, lack a support system and cannot attend a meal site.
Some programs provide ethnic meals, a cold supper bag and/or frozen
meals for the weekend.
There are also private catering services and restaurants
that will prepare and deliver meals. Homemakers may also prepare
meals.
Who pays
for the service?
Many congregate and home-delivered meals' programs are federally
funded. Homemaking service may be subsidized through state funded
home care.
What are
the average costs for the service?
For federally funded meals, the suggested donation is $1.50
per meal or whatever the person can pay. Meals through caterers,
restaurants and homemaking agencies vary.
Why is it
important to know about this service?
It is important to know that some elders
suffer form poor nutrition due to inability to prepare nutritious
meals, inadequate income, or living alone, etc.
What
is it and what services does it provide?
There are a range of health and medical services available to elders
who are in need of such services but are unable to leave their homes.
These include the services of a physician, nurse, home health aide,
physical, occupational, speech and respiratory therapist, as well
as a social worker. The services are usually provided through a
hospital home care department or a certified home health agency
in the community.
The hospital home care programs may provide the services of a physician
or nurse practitioner. If there is a need for other health services,
such as home health aide, PTs or OTs, they will be contracted through
a certified home health agency. Certified home health agencies usually
do not have a physician on staff but have registered nurses who,
in collaboration with the elder's own physician, coordinate all
services
Who
pays for the service?
Because these are health services, they are almost always reimbursed
by Medicare, Medicaid and private insurance. However, the amount
of service as well as length of time provided, are often limited.
If insurance does not cover the particular service or does not cover
it for the length of time desired, one may also pay privately. If
the service is not reimbursable under Medicare or Medicaid and if
elder meets the eligibility requirements of ASAPs*, it is possible
that the service may be subsidized by them.
Why
is it important to know about this service?
Families who are extensively involved in elder care are often dealing
with a frail elder who would probably have need of health services
as well as require them to be delivered in the home. Families should
always discuss with the elder's physician whether home health service
is needed.
*Aging Services
Access Point
|
What
is it and what services does it provide?
A homemaker is someone who performs certain tasks in an elder's
home including meals, cleaning, shopping, laundry and errands.
A personal care homemaker may do all of the above as well
as assist with some light personal care. A home health aide,
on the other hand, usually provides mostly personal care
|
 |
such as bathing, dressing,
helping the person transfer out of bed, etc. The above apply to agencies
whose business it isto provide these services. However, people who
work independently and contract directly with the elder or family
may perform all tasks agreed to by the parties. While the service
is usually more costly through agencies, they will recruit, interview
and screen applicants, provide training and supervision, and attempt
to replace a worker who is out sick or on vacation. If an elder wishes
to hire privately, the best way is through personal recommendation.
Otherwise, an ad may be placed in the local newspaper.
Who pays for the service?
If the elder meets all eligibility criteria of the ASAPs* home care
program, then much of the cost of homemaking would be subsidized.
Because home health aide service is reimbursable by insurance, it
is often covered by Medicare, Medicaid or other private insurance.
If an elder is not eligible under ASAP* or through insurance, then
one may pay privately.
Why
is it important to know about this service?
Homemaking/home health aide is one of the first services an elder
or family turns to if an elder has problems carrying out activities
of daily living. Because of distance, work and family responsibilities,
it is sometimes difficult for families to provide the service, and
contracting for a homemaker, personal care homemaker or home health
aide is often the best solution.
*Aging Services
Access Points
What
is it and what services does it provide?
REPAIR: includes simple work in carpentry, plumbing, or electrical.
REHABILITATION: involves large projects that address health and
safety problems (repair to the roof or installation of an outdoor
ramp for access)
COUNSELING: includes refinancing options, sale and leaseback, reverse
mortgages, and equity lines of credit and tax deferrals
ENERGY SAVING: services offer free home audits and for those income
eligible, the provision of insulation as well.
Who
pays for the service?
For some, repair services may be free except for materials. Low-interest
loans and grants for rehab. Are available for eligible persons.
Counseling about refinancing is provided by nonprofit agencies.
What
are the average costs for the service?
Costs for repair and rehab depend on the type of work being performed.
More than one estimate should be secured.
Why
is it important to know about this service?
The goal for most people is to remain at home. Sometimes, however,
this is jeopardized by long-standing inattention to the upkeep of
a home, which then creates health and safety problems.
What
should the consumer consider in selecting a provider?
Seniors should first check eligibility for subsidized services.
What
is it and what services does it provide?
Hospice is care, usually in the home, for those who are terminally
ill. The focus of hospice is palliative care, care that helps lessen
the pain without actually curing.
Hospice's goal is to deliver comprehensive services that address
the physical, emotional, and spiritual needs of patients as well
as caregivers. Most hospice programs provide medical and nursing
services, homemaker/home health aide, counseling, volunteers, respite,
and coordination of inpatient care if needed. Most programs require
that there be present a primary caregiver.
Who
pays for the service?
Hospice-certified programs are reimbursed by Medicare, Medicaid,
some HMOs, and private insurances. For those without insurance some
programs also provide services according to ability to pay.
Why
is it important to know about this service?
Some terminally ill elders would prefer to remain at home rather
than be cared for in a hospital.
What
should the consumer consider in selecting a provider?
One should make sure that the program is Medicare and Medicaid certified.
Other considerations are whether they provide daily home health
aide service, continuous 24-hour care when death is imminent, and
a quick response time in emergencies.
What
is it and what services does it provide?
WILLS are legal documents that describe how individuals wish their
property to be distributed upon death. All, regardless of net worth,
should have a will.
LIVING WILLS, while not formally recognized in Massachusetts, are
documents describing persons' wishes regarding the use of life-prolonging
methods.
HEALTH CARE PROXY is a document that appoints someone to make medical
treatment decisions if one loses the ability to decide for oneself.
DURABLE POWER of ATTORNEY is a legal document designating someone
to act on another's behalf in business and personal affairs. It
is probably the easiest and least costly legal way for a caregiver
to assume complete responsibility without having to account to anyone.
However, the elder must be competent at the time a durable power
of attorney is drawn up.
CONSERVATOR is a court-supervised person who has been appointed
to manage a person's property, i.e. handle finances and pay bills.
The elder retains the right to make his/her own decisions.
GUARDIAN is a court supervised person that has been appointed to
handle the person's personal and financial affairs when he/she becomes
unable to do so.
ESTATE PLANNING consists of legal techniques, which allow for capital
preservation, sheltering of assets, minimization of taxes, and transfer
of property to children. Included also is planning for long term
care.
CONSUMER SERVICES are often services provided by the government
to hear complaints and provide information regarding consumer problems.
Who
pays for the service?
Some of these services require elders to pay privately while others
may be subsidized by government-funded agencies.
What
are the average costs for the service?
Average hourly rates for private legal services are $150. However,
some elderlaw attorneys may charge a flat fee for the initial legal
assessment and written recommendations.
Why
is it important to know about this service?
Planning, especially for those with assets, becomes very important
as one faces the later years. Consulting an attorney or financial
advisor, while persons are still healthy and know how they wish
to handle their affairs, may help avoid both financial as well as
family problems later. It is also important to remember that guardianship
is a strong remedy and that less restrictive alternatives should
always be considered first, especially if the problems are in very
specific areas, such as bill paying, etc.
What
should the consumer consider in selecting a provider?
When selecting an attorney one should give weight to how knowledgeable
and experienced the lawyer is in issues that affect the elderly.
One guide should be what proportion of their law practice is devoted
to elder law, estate planning or guardianship, etc. Elderlaw attorneys
should also be familiar with all government programs like Medicare,
Medicaid, SSI, etc. Elderlaw attorneys should be able to advise
their clients when they may be eligible for government benefits
and refer them accordingly.
What
is it and what services does it provide?
There are special programs and tuition policies at colleges and
universities as well as adult education programs for retirees. These
programs, especially created for older students, typically include
lecture and discussion as well as social activities and trips. Special
tuition policies often are low or free for persons 62 or 65+ in
either credit or noncredit courses. There are also education/travel
programs which have been designed especially for the retiree.
Who
pays for the service?
The elder pays privately although some programs offer scholarships.
What
are the average costs for the service?
The costs are variable, they may range from no cost to thousands
of dollars.
Why
is it important to know about this service?
It is important to know that there are special programs that offer
both educational as well as social opportunities at affordable rates.
What
should the consumer consider in selecting a provider?
One should look for a program that meets their need for education,
whether that be for personal enrichment, career change, or a degree.
What
is it and what services does it provide?
Alcohol services for older adults account for the special needs
of elderly substance abusers. They recognize that some older alcoholics
do better in treatment with peers and that they may need more support
because the level of shame may be greater. Also, these programs
recognize that elders may need services such as money management,
transportation, meal preparation, etc. The services provided may
include counseling, support groups, detox, and alcohol education.
Who
pays for the services?
Most programs accept Medicare, Medicaid, and private insurance.
For those without insurance, services are often available at government-funded
programs.
Why
is it important to know about this service?
Unfortunately, some family members and even doctors regard alcohol
as the only pleasure left for elders. But caregivers should know
that older people can and do stop drinking and that there is hope
even for long term drinkers.
What
should the consumer consider in selecting a provider?
Specialization in substance or alcohol abuse should be the primary
consideration. It is also important for the provider to be specialized
in treating the older alcoholic, and should be able to coordinate
different levels of treatment for the patient. The elder should
always feel comfortable with the counselor.
What
is it and what services does it provide?
INPATIENT: Services are provided to older patients usually in a
separate wing of the hospital designed to meet their particular
needs. Services include evaluation, testing, medication adjustments,
individual and group treatment, family education, and support groups.
OUTPATIENT: Services
usually include diagnosis, testing, medication, evaluation, individual
and group therapy, family counseling and crisis intervention.
PARTIAL HOSPITALIZATION:
Services are for older adults who are in need of treatment intervention
but do not require 24-hour, continuous inpatient care. The program
usually runs 5 days a week, 5-6 hours a day. Services provided are
evaluation, medical management, behavioral treatment, counseling,
group programs, and family counseling.
ADULT DAY CARE: Some
may be specialized in psychiatric services for older adults.
IN-HOME: Services may
include evaluation, counseling, medication management and supervision,
and training of the patient's activities of daily living.
Who
pays for the services?
These medical services are insurance reimbursable.
Why
is it important to know about this service?
Geropsychiatry services, mental health services for the elderly,
are usually provided by a team of professionals trained to treat
the older person. Many seniors respond favorably to treatment.
What
is it and what services does it provide?
Support groups consist of persons with mutual concerns who come
together for discussion and support. These may be groups formed
around the specific illness of the elder, such as Alzheimer's disease,
or they may be support groups for any person experiencing stress
from caregiving.
Who
pays for the services?
Support groups offered by an organization such as the Alzheimer's
Association generally do not charge for the service. If the group
is offered by a hospital, agency, or private practitioner, there
is usually some cost involved. However, a sliding scale may also
be offered.
What
are the average costs for the service?
The cost on a private basis may range from $20-$70 per group.
Why
is it important to know about this service?
Support groups provide a forum where participants may talk about
concerns that few others can relate to. It is important to know
that there is a place to go for mutual support and understanding.
What
should the consumer consider in selecting a provider?
One should look for a support group whose issues are similar to
one's own.
|
What
is it and what services does it provide?
Money management services may include bill paying, balancing
checkbooks and help with budgeting. Volunteers from nonprofit
agencies, trained and
|
 |
supervised by the agency,
visit elders monthly to assist with these matters. Private individuals
also provide this service. For elders who require a higher level of
assistance, volunteers may be named as Representative Payees by the
Social Security Administration. The volunteer then assumes all responsibility
for paying the bills, including the writing and signing of checks.
Who
pays for the services?
There is usually no charge to the elder who is low income and meets
the eligibility criteria.
What
are the average costs for the service?
The costs range from $40-$70/hour for private pay.
Why
is it important to know about this service?
It is important for elders without family to know that they may
receive assistance with managing finances in later life.
What
should the consumer consider in selecting a provider?
First, find out if the elder is eligible for a subsidized service.
Otherwise, issues to consider in selecting a private person are
whether they are bonded, have references, and how long they've been
in business.
What
is it and what services does it provide?
Nursing homes are both long-term and short-term care facilities.
Long term care in nursing homes provides shelter, meals, social
activities, assistance with activities of daily living, as well
as 24-hour skilled nursing and rehabilitative services. Some nursing
homes have special wings for those with Alzheimer's disease and
their staffs are especially trained in the care of people with dementia.
Other homes target certain ethnic groups and accommodate those who
speak different languages. Usually nonprofit homes are associated
with religious groups that offer religious services. The state-funded
Nursing Home Ombudsman program oversees patients' rights in nursing
homes; it is the clearinghouse for information about nursing homes
and receives complaints from elders and families about nursing homes.
Who
pays for the service?
Persons entering nursing facilities for custodial or chronic care
usually are not eligible for Medicare reimbursement. However, if
the elder is entering the home after an acute medical episode that
requires skilled nursing or rehabilitation services, it is important
to check out eligibility for short term coverage under Medicare.
For the most part, payment for long term care in a nursing home
is paid privately by the elder or by Medicaid. Medicaid is a government
subsidized insurance program for those who have low income and little
assets. For those seeking reimbursement from Medicaid, it is necessary
to secure a screening to determine that they meet certain medical
criteria and that no reasonable and appropriate community services
are otherwise available. This is coordinated through the state-funded
ASAPs. The requirements for nursing facility reimbursement by long
term care insurance vary depending upon the policy.
What
are the average costs for the service?
The average costs for nursing homes are $45,000 annually.
Why
is it important to know about this service?
While most families have heard of nursing homes, probably many do
not know that 3rd party reimbursement has strict requirements, whether
for short or long-term care or whether by Medicare, Medicaid, or
long-term care insurance.
What
should the consumer consider in selecting a provider?
In general, families want to make sure that the home can meet all
of the elder's physical, emotional, and safety needs and that the
staff does this in a caring and responsive way. When visiting homes,
families want to check for cleanliness and odors, how the staff
interacts with patients, the appearance of the residents, the range
and quality of activities, and how appetizing and nourishing the
food.
What
is it and what services does it provide?
ASSISTED LIVING
The purpose of the Assisted Living Ombudsman Program is to maintain
or improve the quality of life for assisted living residents in
the areas of health, safety, welfare, or resident rights. The Assisted
Living Ombudsman acts as a mediator and attempts to resolve problems
or conflicts that arise between an assisted living facility and
one or more of its residents. The Ombudsman serves as an advocate
for residents' rights, promoting the dignity, autonomy, and respect
of residents. Assisted Living residents and their families may call
the Assisted Living Ombudsman Program for information and assistance,
to register a complaint, or to have a complaint investigated. Complaints
may be brought on behalf of a specific resident or on behalf of
residents as a whole.
LONG TERM CARE
The Ombudsman Program was also developed to assist residents of
nursing and rest homes. Services include: complaint investigation
and resolution; information and referral; and advocacy for change
in the long term care system. The program provides training and
assignment of volunteer ombudsmen to facilities to enable the access
of services to all nursing and rest home residents. Information
on selecting a nursing home is also provided.
Who
pays for the service?
The services are free.
What
is it and what services does it provide?
Rest Homes are long term care facilities licensed by the state that
are for semi-independent elders who do not require routine nursing.
They provide supervision, meals, housekeeping, activities, bathing,
dressing, and intermittent medical services. Rest Homes may have
as few as 10 residents or as many as 80. Some specialize in residents
with mental illness, while others cater to residents who speak a
language other than English. Residents of Rest Homes are covered
by the state Ombudsman Program which oversees residents' rights
and protections.
Who
pays for the service?
Rest Homes are not reimbursed by insurance. If the home accepts
Supplemental Security Income (SSI), those eligible for it may be
subsidized. Otherwise, one pays privately.
What
are the average costs for the service?
The monthly rates for rest homes are about $1,000.
Why
is it important to know about this service?
Rest Homes are an option for those elders who are reasonably independent
in self-care but are unable or unwilling any longer to take care
of the home. They also offer both the elder and family the assurance
of knowing that there is 24-hour staff available for any problem
that may arise. Elders must be prepared, however, to forfeit some
privacy in exchange for services, security, and socialization.
What
should the consumer consider in selecting a provider?
After location and cost, one should consider what services are included
in the monthly charges and what happens if an elder's assets run
out. Also, families should also inquire about ancillary services
such as hairdressers, transportation, as well as request a calendar
of monthly activities and a sample menu. Elders and families should
always visit the rest home first not only to view the facility itself
but also to spend time with residents to get a feel for the home.
What
is it and what services does it provide?
Special services for the older worker include second career counseling,
job placement, retraining, search and interviewing skills, job clubs,
etc. In addition, there is assistance for starting a business, something
that may interest early retirees. There are private counselors who
offer life-planning services to middle aged and older persons deciding
what to do next in life. Finally, there are services available to
workers age 40-70 who believe that they have been discriminated
against in employment.
Who
pays for the services?
Services offered through nonprofit or government agencies are often
provided free or at reduced cost.
What
are the average costs for the service?
Average fees for private practice counselors are $50-$75/hourly.
Why
is it important to know about this service?
It is important to know that older workers have unique needs regarding
employment and that services exist to address them.
What
should the consumer consider in selecting a provider?
One should consider the counselor's credentials, length of time
working, and particular experience working with older persons. Personal
recommendations should be secured, if possible.
What
is it and what services does it provide?
Senior Rentals may be an entire building or it may be units set
aside for seniors. These are rentals that have different age and
income requirements due to the fact that they are built by government
as well as private developers. The buildings often have a coordinator
to assist tenants in obtaining needed services but do not offer
them directly. In some buildings there may be meals programs brought
in by another agency. Often, the tenant's council will plan social
activities.
Who
pays for the service?
Seniors who are income eligible for subsidization in either public
or private housing would pay 30% of income. All other persons in
private complexes would pay market rates.
Why
is it important to know about this service?
Senior Rentals offer some seniors greater opportunity for socialization
and a feeling of security. Subsidized housing is an important resource
for elders who are low to moderate income.
What
should the consumer consider in selecting a provider?
Senior Rentals, especially subsidized ones, have long waiting lists
and so it is wise to apply early in as many places as possible.
What
is it and what services does it provide?
There are many programs that are designed to provide socialization
for seniors. These may be at senior centers, senior housing, social
service agencies, congregate meal sites, churches, schools, or other
locations in the community. Activities are usually at the center of
the programs and these may include classes, trips, cards, arts and
crafts, speakers, discussions, bingo, movies, etc.
Who
pays for the services?
Participation in senior social activities often costs nothing, although
there may be fees associated with a class, trip, or some other activity.
Why
is it important to know about this service?
It is not unusual for those in their early 70s, 80s and 90s to find
that they lost many friends. Therefore, structured social programs
for people of the same age may facilitate socialization. It is important
that everyone, including those who are older, have friends with
whom they can share similar life experiences.
What
should the consumer consider in selecting a provider?
Selecting a social program should always depend upon the interests
and needs of the person. While location and costs will always be
considerations, the primary one should be matching interests with
activities.
What
is it and what services does it provide?
Transportation service for elders exists in many forms. It may be
special lift-equipped vans, taxis, shuttle vans, buses, or a discount
card for the MBTA. The service may be provided by the government,
taxi companies, social service agencies, etc. Depending upon the
program, transportation may be limited to medical appointments,
or it may be for any purpose including shopping, visiting, etc.
For Medicaid eligible elders who have been certified by their physicians
to not be able to use public transportation, a taxi to doctor's
appointments may be provided. State-funded ASAPs* may provide eligible
elders transportation for lifesaving treatments such as dialysis,
radiation, or chemotherapy. It is important that, while they are
unable to admit a person just for transportation service some programs
may be able to provide the service once the elder is admitted for
other reasons. This applies to such programs as adult day health,
social day care, congregate meals program, state-funded Home Care,
etc.
Who
pays for the services?
The cost of the transportation services varies with each program.
Some are free to older residents of the town or city in which they
live, while others are offered at a discount or are subsidized.
What
are the average costs for the service?
Paying privately for transportation varies with the type of service
and provider. Chair van service, for example, from a social agency
may range from $40 round trip (for medical appointments only) to
$100 round trip plus mileage from a private ambulance company (for
any type of transportation). For those eligible for The Ride, a
service of the MBTA, the cost is $1.00 each way.
Why
is it important to know about this service?
Transportation is needed to carry out a range of activities, including
shopping, visiting, attending meetings, keeping appointments, etc.,
and because many elders no longer drive or have a car, it is vital
that they know about transportation resources that will provide
them with a link to the community. Not only will these services
permit elders to remain independent in their travel, but also it
will help relieve families who may not have the time to provide
the transportation.
What
should the consumer consider in selecting a provider?
Older consumers should always check first for eligibility to subsidized
services. When paying market rates, it is wise to call a few companies
to compare prices.
*Aging Services
Access Points
What
is it and what services does it provide?
First, it is important to know that information services are provided
by many programs that deal with the visually impaired.
Other services include assistive products and low-vision aids such
as talking and large-print books, low-vision watches and clocks,
magnifiers and lamps, large telephone dials, etc.
Special social day care and adult day health programs for persons
with visual handicaps are also provided in the community.
Rehabilitation services, including assessments and recommendations
for independent living, are provided by government and nonprofit
agencies. This may include orientation and mobility training.
Social services for visually impaired may include case management,
counseling, advocacy, and housing assistance.
Volunteer services such as support groups, reading, help with errands,
etc. are offered for the visually impaired.
Who
pays for the services?
Many of the social and volunteer services are provided at no charge
from government and nonprofit agencies. Adult day health and social
day care charge a fee but an elder may be eligible for subsidization
through state-funded ASAPs* or through Medicaid. Elders must often
pay privately for assistive aids.
What
are the average costs for the service?
The cost for vision aids depends on the type of device needed. There
are catalogues that list products and prices.
Why
is it important to know about this service?
It is important to know that if elders are visually impaired or
legally blind, there are services in the community that assist them
to make maximal use of their remaining vision and enhance their
daily living capabilities.
What
should the consumer consider in selecting a provider?
As there are a number of choices for services, it is best to request
information about each to determine which one best meets the elder's
needs.
*Aging Services
Access Points
|
Service
|
All Ages
|
60+
|
Income Limit
|
Need Based
|
Free
|
Donation
|
| Boston ElderINFO |
X |
|
|
|
X |
|
| Home Delivered Meals* |
|
X |
|
X |
|
X |
| Congregate Meals |
|
X |
|
|
|
X |
| State Home Care
Program* |
|
X |
X |
X |
|
|
| Protective Services/Elder
At-Risk |
|
X |
|
|
|
|
| Boston Money Management
Program |
|
X |
X |
|
X |
|
| SHINE (Serving Health
Information Needs of Elders) |
X |
|
|
|
X |
|
| Caregiver Advisor |
X |
|
|
|
X |
|
| Care Coordination |
X |
|
|
|
|
|
| Transportation*
|
|
X |
|
X |
|
X |
| *May
be purchased on a fee basis without eligibility restrictions. |
Contact us: Telephone
617-292-6211 or e-mail your questions and comments to:
info@elderinfo.org
|
