The goal in taking up community services courses is to understand the need of the community for the common good. Sometimes it is difficult to identify needed community resources to help with an elderly person’s care. Professionals in related fields may find that caregiving resources grow and change quickly, and it can be difficult to keep up with these changes. Family members are even more confused as they try to discover and then access appropriate resources. Some of the confusion comes from not knowing what types of resources to research, and what payor sources are required.
A. Older Adult Services: The Big Picture
The “backbone” of community services for the elderly has been the Administration on Aging funded federal Title XX services for older adults authorized by the Older Americans Act.. The Older Americans Act, was initially passed in 1965, and reauthorized most recently in 2011. It establishes the federal Administration on Aging to oversee and fund older adult services. The law provides the policies, defines the services, and describes the funding parameters for older adults in every U.S. state and territory.
In 1973-1974, the federal Administration on Aging established Area Agencies on Aging and funding for social services for older adults through the states. In the early 1980s, the Administration on Aging was involved in nursing home reform through an omnibus reconciliation act. And, later, it dealt with the growing demand for and regulation of caregivers, discrimination against the elderly and elder rights.
B. Core Administration on Aging Funded Community Services
Core social service, nutrition, transportation and home care programs at the community level are often funded through Administration on Aging grants to the states. Many of these services are offered through a county or local city Senior Center. Senior Centers are often nonprofit agencies, however some centers are run by local government entities. In larger communities, one can find more than one Title XX funded organization.
For more information about Title XX funded services, contact the Administration on Aging’s website by typing in those words, and/or contact your state’s Agency on Aging.
C. Other Local Community Services
There are a number of services in many local communities. The large the community, the greater and more diverse the programs and services. The following represent some of the most frequently found local resources.
- Senior Centers – These provide a range of services to older adults, usually age 60 and older. They are usually funded for a range of social, educational and fitness activities; lunch and nutrition services; transportation, and often some level of visiting and/or home care services. Many centers that are nonprofits receive additional funding from grants, contracts and donors which allows them to further develop and expand services beyond core services funded by AoA.
- Visiting Nurse Services (VNS) – Located in most major metropolitan areas, Visiting Nurse Services is a nonprofit home health care agency founded almost 100 years ago. It provides home health care and hospice services in many communities. Services to older adults comprise a large portion of many local VNS agencies. VNS home care services allow many older adults to remain in their homes by providing assistance to help people with basic activities of daily living (ADLs).
- Meals on Wheels – Local Meals on Wheels programs provide home delivered meals to home bound people five days a week. Services to older adults represent a significant part of home delivered meals.
- Local Hospice Organizations – Many communities have a freestanding local hospice nonprofit agency or a hospice program related to a local hospital or other large organization. Large metro areas may have multiple hospice programs. Hospice care is a critically needed part of the service mix, and a growing need.
- Caregiving – nonprofits and businesses provide a range of caregiving services. Some of the strongest in the field have excellent quality records. Check thoroughly, as there is a large difference among local providers and with the quality of care provided.
- Counseling – available in many different settings, and there are therapists with expertise in family counseling as well as working with adult children of frail elderly. Look for this expertise.
- Legal Issues – these often include developing financial and health care Power of Attorney or general Power of Attorney. Other issues can include developing wills and trusts, identifying affairs that need to be handled by the adult children, and, in some cases guardianship. In some communities, there are Senior Citizens’ Law resources that provide pro bono and/or sliding fee scale services. Find attorneys with expertise in elder law.
- Financial Issues – in addition to those mentioned above, many families find that the costs for elder care can be excessive, sometimes stripping family resources. Resources can include nonprofit sliding fee scale services, dual eligible Medicare/Medicaid coverage, and county health care funds in many states
I’ll provide more information in later articles.
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