Homecare & Hospice

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Introduction

I. Starting The Conversation
    1. Playing Out "What If" Scenarios
    2. How To Talk About Advance Planning Documents
    3. Power of Attorney, Durable Health Care Power of Attorney, Will, Living Will and POLST

II. Determining What Kind of Care is Needed to Remain at Home
    1. Identifying Caregiving Needs and Tasks
    2. Creating A Game Plan

III. Understanding Who Does What in Homecare
    1. Home Health
    2. Personal Care/Private Duty Homecare
    3. Hospice
    4. Geriatric Care Manager

IV. Finding Other Care Options
    1. Adult Day Services
    2. Living Independence for the Elderly (LIFE) Program
    3. Personal Care Homes
    4. Assisted Living Facilities
    5. Continuing Care Retirement Communities (CCRCs)
    6. Skilled Nursing Facilities or Nursing Homes

V. Making Home Safe and Livable
    1. Safety Tips Throughout the Home
    2. Assistive Devices
    3. Durable Medical Equipment
    4. Personal Emergency Response System (PERS)
    5. Technology for Better Healthy Living
    6. How To Keep Your Home From Looking Like A "Sick Room"

VI. Paying for Care
    1. Medicaid
    2. Medicare
    3. Veterans Administration
    4. Long-Term Care Insurance
    5. Reverse Mortgages
    6. Caregiving Tax Credits and Deductions

VII. Other Resources
    1. Pennsylvania Homecare Association - We're just one call or click away!
    2. My Learning Center
    3. Area Agency on Aging
    4. Benefits Check-Up
    5. Helpful Websites


Bringing Care Home...


Beginning the important

conversation about

what we want as we age

Introduction


At the Pennsylvania Homecare Association, we hear every day from our members about the thousands of families throughout the state who are looking for ways to enable their aging loved ones to remain at home.  more

I. Starting The Conversation


It is a simple fact that many families avoid having that conversation - the one centered on getting their affairs in order. We don't like talking about money or wills, nor do we like thinking about what life could be like if our health declines as a result of a broken hip, a stroke or heart attack.  more

1. Playing Out "What If" Scenarios


One of the best ways to begin the advance work of caregiving is to play out "what if" scenarios when your parents or family members are not yet facing them. Imagining hypothetical situations is not nearly as stressful as the "real deal," and people are much less defensive because they aren't being forced to make an all-or-nothing decision on the spot.  more

2. How To Talk About Advance Planning Documents


Some parents hesitate to talk about a will and other legal documents because it's a sign that their role in the family is changing and diminishing, or they interpret the discussion as a signal that their health is declining and they are becoming more dependent. Or maybe they feel that it's bad manners to talk about personal finances on their part and yours.  more

3. Power of Attorney, Durable Health Care Power of Attorney, Will, Living Will and POLST


These five documents are very important tools when it comes to planning ahead so your loved ones can remain in control of their independence and living options. Let's go over each.  more

II. Determining What Kind of Care is Needed to Remain at Home


The majority of people want to continue living at home for as long as possible. And given the great number of community and home health services, telehealth devices and universal design features to make living at home easier, more people are able to enjoy staying at home as they age while managing their chronic conditions.  more

1. Identifying Caregiving Needs and Tasks


Rarely is there a shortage of topics when it comes to identifying caregiving needs among older relatives. Social workers use extensive assessment tools to identify the needs of older clients and the level of help they need to address each. You'll hear geriatric professionals reference two basic categories: activities of daily living (ADLs) and instrumental activities of daily living (IADLs).   more

2. Creating A Game Plan


Once you've identified the care needs required to enable your parent or loved one to remain independent, you'll then be in a position to explore solutions that address each need. It's good to think through what a workable solution should do. For example, it should be safe and acceptable to both the person receiving the care and family members providing or arranging it. It should also be affordable and not endanger the well-being of either caregiver or care receiver.  more

III. Understanding Who Does What in Homecare


It's not surprising that most people prefer to be cared for in the comfort and dignity of their own homes. Many healthcare treatments that were once offered only in a hospital or a doctor's office can now be done at home. Homecare is usually less expensive, more convenient and just as effective as the care you get in a hospital or skilled nursing facility.  more

1. Home Health


Home health provides skilled services, including nursing care and physical, occupational, speech and respiratory therapy. The agency provides a licensed professional to assess needs, develop a care plan and educate the patient. These services are usually short-term, as in the case of a person recovering from surgery or other health issues.  more

2. Personal Care/Private Duty Homecare


Personal care/private duty homecare provides assistance with activities of daily living, such as bathing, grooming, preparing meals, remembering to take medications, transferring from a chair, toilet or bed, light housekeeping or transportation.  more

3. Hospice


Hospice is designed to give supportive care to a person at the end of life. It focuses on comfort and quality of life, rather than cure. The goal is the make people free of pain so that they live their last days as fully as possible. Hospice care brings together medical care, pain management and emotional and spiritual support for terminal patients and their families. Eighty percent of hospice care is provided in the patient's home, however there are also inpatient hospice facilities.   more

4. Geriatric Care Manager


The Pennsylvania Homecare Association's "Bringing Care Home" video introduced us to a geriatric care manager, who can be a valuable resource as you navigate what resources are available for your loved one. A geriatric care manager is a health and human services specialist who works with families and others to provide assistance to those who are caring for aging parents or other loved ones.   more

IV. Finding Other Care Options


Although the majority of people want to remain in their homes as long as possible as they age, sometimes staying at home just isn't possible and families must look at other care options. You must determine what's the best and most appropriate care for your parent or loved one given their needs and resources.  more

1. Adult Day Services


Adult day services, also called adult day care centers, are non-residential facilities that specialize in providing activities for older adults with cognitive (thinking) and/or physical disabilities. Many participants have Alzheimer's disease or another form of dementia.  more

2. Living Independence for the Elderly (LIFE) Program


The Living Independence for the Elderly (LIFE) program offers medical and supportive services to enable older Pennsylvanians to maintain their independence in their homes for as long as possible. LIFE is a managed care program and provides a comprehensive all-inclusive package of services.   more

3. Personal Care Homes


Personal care homes are residential facilities that offer personal care services, assistance and supervision to four or more persons. Sometimes they are advertised as "assisted living residences" or "boarding homes." A personal care home must have a license in order to operate in Pennsylvania.  more

4. Assisted Living Facilities


Assisted living facilities provide residents with services that assist them with the tasks of daily living such as providing meals, housekeeping, laundry and medication reminders. They may also assist with grooming, bathing, managing bills and providing transportation. You'll often hear these services referred to as activities of daily living (or ADLs).  more

5. Continuing Care Retirement Communities (CCRCs)


Part independent living, part assisted living and part skilled nursing home, Continuing Care Retirement Communities (CCRCs) offer a tiered approach to the aging process, accommodating residents' changing needs.   more

6. Skilled Nursing Facilities or Nursing Homes


Although most of us want to remain in our homes for as long as possible, it is possible that your parent or loved one may eventually need this level of care if it is unsafe for them to remain at home. Skilled nursing facilities, also known as nursing homes, provide 24-hour nursing care for residents who demand much higher levels of care than those residing in assisted living facilities.  more

V. Making Home Safe and Livable


Given a choice, nine out of 10 people want to remain at home for as long as possible. This is especially true for a generation that takes great pride in owning their homes. Living on their own, whether it's in an apartment or a house, also represents independence and self-reliance - two hallmark traits of the older generation. It's no wonder, then, that even when illness or physical disabilities befall your loved ones, they'll likely want to stay at home. The challenge is doing so safely and without becoming isolated when getting out is difficult.  more

1. Safety Tips Throughout the Home


A "fall-safe" home is one that has been set up to avoid falls, a major cause of injury in older adults. Every year, one in three women 65 years of age and older and one in three men 80 to 84 years old experiences a fall. The result - fractures and broken hips - can be life-altering, as they strip people of their independence. Worse yet, half of the injuries caused by falls result in death. The good news is that taking just a few senior safety measures in our checklist can go a long way toward elderly fall prevention.  more

2. Assistive Devices


The assistive devices industry has created thousands of products to make the activities of independent living easier for seniors. Yet, far too many people don't know that assistive technology exists or where to find assistive devices. Here's what you need to know.  more

3. Durable Medical Equipment


Medicare refers to devices and items that provide independence for individuals with an illness or injury that can withstand repeated use in the home and serve a medical purpose as durable medical equipment (DME).  more

4. Personal Emergency Response System (PERS)


Personal emergency response systems (PERS) give older adults and other at-risk individuals around-the-clock access to assistance at the press of a button. If your parent or loved one lives alone, PERS enable continued independence while at the same time allowing both of you to feel secure in knowing that in case of a fall or accident, emergency assistance can be easily summoned.  more

5. Technology for Better Healthy Living


Technology is going gray and that's a good thing. Technology can enable your parent or loved one to live at home even when he is unwell. It can detect a fall and dispatch help even when he is unconscious, help restore his balance to actually prevent him from falling, keep his brain in tiptop shape, dispense medications on time each and every day and allow him to receive email from the grandkids without using a computer.   more

6. How To Keep Your Home From Looking Like A "Sick Room"


When someone is chronically ill, it's very easy for the bedroom to look and feel like a "sick room," which doesn't help to make anyone feel better. This guide provides tips on how to convert a "sick room" into a "living room."  more

VI. Paying for Care


There are several options available to help pay for long-term home care and lighten your family's financial burden while helping your loved one remain at home.  more

1. Medicaid


Medicaid is a jointly-funded, federal/state healthcare program for lower income residents. In 2012, the income limit for an individual applying for Medicaid was $2,094 per month. For a couple, the limit was $3,033 per month. If one spouse is applying for Medicaid and the other is not, joint income can be shifted to help the applicant qualify.  more

2. Medicare


Medicare is health insurance for people 65 years and older and for people who are younger with certain disabilities. It also covers anyone no matter what their age if they suffer from permanent kidney failure that requires dialysis or a kidney transplant known as End-Stage Renal Disease (ESRD).  more

3. Veterans Administration


According to the Veterans Health Care Eligibility Reform Act, any veteran who wants to receive Veterans Administration healthcare services must enroll.  more

4. Long-Term Care Insurance


Long-term care policies usually offer one or all of the following kinds of care: home health care, personal care/private duty homecare, respite care or nursing home care.   more

5. Reverse Mortgages


A reverse mortgage is essentially a loan against your parent's home that she doesn't have to pay back for as long as she lives in it. Thus, she can turn the value of her home into cash, giving her the ability to afford the remodeling she needs or maybe long-term care services that are not covered by Medicare. When she moves, sells the home or dies, the money is then paid back.   more

6. Caregiving Tax Credits and Deductions


Tax deductions for caregiving expenses can be deductible.  more

VII. Other Resources


Tracking down services and identifying financial resources that make living at home possible and affordable is no easy task, especially when it comes to getting through the Medicare maze or navigating long-term care insurance. Yet, it's definitely worth the effort as a little bit of research can yield much-needed resources.  more

1. Pennsylvania Homecare Association - We're just one call or click away!


The Pennsylvania Homecare Association is a statewide organization of more than 500 home health, hospice and homecare providers.  more

2. My Learning Center


My Learning Center is a collection of more than 40 free, online training videos for family caregivers. Topics include Alzheimer's and dementia care, seniors and aging, infection control and safety and handling emergencies. Each video ranges from five to 25 minutes and features first-hand accounts of families, seniors, caregivers and experts on the issues caregivers face each day.  more

3. Area Agency on Aging


Area Agencies on Aging (AAA) receive funding from states and the federal government through the Older Americans Act. They act as your county's centralized advocate for issues facing older people and chief planners for aging services in your community. They also act as a major provider and subcontractor of aging services dedicated to giving older adults the option to live at home and remain in their communities.  more

4. Benefits Check-Up


The National Council on Aging (NCOA) offers a helpful screening service that will help you find and enroll in federal, state, local and private programs that help pay for prescription drugs, utility bills, meals, health care and other needs.  more

5. Helpful Websites


The Internet is amazing, if not overwhelming, when it comes to finding out all kinds of information on just about every topic imaginable. As baby boomers age and become Internet savvy, websites on aging are popping up faster than the speed of light. A simple keyword search on "caregiving" will pull up millions of hits. Where to begin?!   more
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600 N. 12th Street - Suite 200 - Lemoyne, PA 17043
Phone: 800-382-1211 - Fax: 717-975-9456

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