Certified Home Health Agencies (CHHAs) provide a wide variety of services in an individual's home when they are prescribed by a physician. Services can include nursing and rehabilitation visits and some assistance with activities of daily living while the person is receiving the skilled care. These services are generally reimbursed by Medicare, Medicaid or other insurance.
Licensed Home Health Agencies (LHCSAs) are a good resource for personal care specialists, such as home health aides and companions, who can make it possible for an elderly person to stay safely in their home. Personal care services are covered under the state Medicaid program, but are most frequently paid by private funds.
Long Term Home Health Care (Lombardi Program/Nursing Home Without Walls) is a coordinated plan of medical, nursing, and rehabilitative care provided at home to disabled persons who are medically eligible for placement in a nursing home. The program offers patients an alternative to institutionalization, and is available to individuals who are medically eligible for placement in a nursing home and choose to receive services at home. This service is reimbursed by Medicaid.
Hospice is a focused, team approach to providing healthcare and other needed services to patients nearing the end of life. The hospice team is comprised of physicians, nurses, social workers, therapists, pastoral representatives, home health aides, volunteers, and family caregivers. Its mission is to provide comfort care to patients and their families in less institutionalized settings and with less strict routines.
Most hospice care is provided in a person’s own home or nursing home, but care in a facility is also available for brief periods. The emphasis in on symptom management and emotional and spiritual support for the patient and family. Hospice services are reimbursed by Medicare and other insurance carriers.
Adult Day Care is a structured program featuring meals, health services, activities, socialization, and personal care for elderly individuals. Social Adult Day care is designed to engage cognitively or physically frail adults through activities, meals and exercise. Medical Adult Day programs can also supervise medication and provide some nursing and therapy. Some programs have flexible hours and respite services. Medicaid or private funds will pay for Adult Day Care
A geriatrician specializes in the care of older and aging adults. They have additional training and certification in addition to their medical training to help meet the special needs of older adults. Geriatricians become experts in dealing with and treating the multiple medical problems that many seniors suffer from. They treat the spectrum of geriatric syndromes from Alzheimer’s Disease to chronic pain and help elderly patients and their families make decisions about health and personal care.
A Palliative Medicine specialist has the additional training and certification in addition to their medical training to help meet the special needs of people with advanced illness and the associated physical and emotional distress. Palliative medicine specialists provide consultation in hospitals and oversee the care of patients in hospice care.
A Skilled Nursing Facility, or nursing home, provides 24-hour nursing care or therapies to persons whose physical/mental health needs require constant supervision and assistance. This may be on a short-term or long-term basis. For those eligible, Medicare may pay a portion of costs if such a stay is required after a hospital stay for an acute condition. Medicaid, long-term care insurance or private funds pay for long-term care in a skilled nursing facility.
Rehabilitation services, following illness or injury, can be provided in different settings, depending on the person’s needs. Many patients can obtain maximal benefit from progressing through different levels of the available continuum of care, beginning their rehabilitation in an acute inpatient facility, then continuing treatment at a sub-acute program until they are able to return safely to home. Once discharged from an inpatient setting, a person can continue to receive rehabilitation in their home, and once able to travel to/from home can receive outpatient rehabilitation.
Geriatric Psychiatrists have additional training and certification in the mental and cognitive disorders of the elderly. They diagnose and treat patients with depression, memory disorders and other behavioral disorders in out-patient, hospital and day treatment settings.
If you are unable to visit your own physician, house call physicians who come to your home provide consultations to your doctor or serve as your private doctor. Because of changes in medical technology, a physician can come to your home with portable medical equipment and provide high-quality medical care. The physician will work closely with home health agencies and hospice organizations to make sure that comprehensive care is provided.
A Caregiver's responsibilities vary from helping a loved one with everyday chores, to providing full-time personal care. Taking care of someone in need, whether that person is a spouse, parent, other relative, or friend, can be one of the most challenging tasks you will ever take on. The challenges can come from many sources, such not knowing what is expected, trying to be the best you can be, dealing with your own emotional ties to the person you are caring for, and sometimes being reluctant to ask for help or to even admit that what you are doing is not always easy for you.
On the other hand, providing care can also be one of the most personally satisfying tasks you ever undertake. It provides a unique opportunity to serve, to support, and to make life better for a person who needs your help, and leaves you with a sense of accomplishment that you have made a difference in the quality of his or her life.
Some elderly people are fortunate to live in a community that is served by a NORC Support Program. These are partnerships among organizations, housing and government entities that provide residents with social work services and health, transportation and recreational programs.
These programs allow seniors to remain in their neighborhoods and live independently while receiving essential services in their homes that are not reimbursed by traditional funding streams. New York State and New York City have been on the forefront of NORC support program development.