Medical Scale

Introduction

Long term health care refers to the provision of a number of different services for persons with a chronic illness or disability. Long term medical care includes both medical and non-medical care which assists the patient in the performance of activities of daily living such as dressing, bathing, and using the restroom. Long term care can be provided in the home, community housing, an assisted living home or a nursing home. It is estimated by the Department of Health and Human Services that approximately 12 million Americans will require long-term health care by the year 2020.

Long term Health Care Services

The particular medical care available to a patient is determined in part by the state and community in which they live. However, some of the common types of long term health care which are discussed below include: community services, home care, accessory dwelling units, subsidized housing, board and care homes, assisted living facilities, continuing care retirement communities, hospice care, respite care, and PACE programs.

Community Services. Some community services are provided by volunteer groups. Other services are made available through the Area Agency on Aging, the Aging and Disability Resource Center, or the Center for Independent Living. Some of the services provided to seniors are free, others may be provided at a low cost, and still others are provided in exchange for a voluntary donation. The community services include:Adult Day Care, Meal Programs (Example: Means-on-wheels.), Senior Centers, Friendly Visitor Programs,Assistance with Shopping and Transportation, Legal Assistance,Financial Management (Example: Payment of bills)

Home Care. Assistance with personal activities including laundry, shopping, cooking and cleaning can oftentimes be provided by friends and family members or volunteer groups. However, other professional care providers are available to perform specific functions that may not be performed by family and friends. For example, home health care agencies provide both nursing and attendant care in the patient's home.

Accessory Dwelling Unit (ADU) An accessory dwelling unit can be added to an existing residence for the benefit of a person requiring long term care. It enables an individual to maintain a level of independence. The ADU is a second living space within a home or a separate building a the lot which includes separate living and sleeping area, kitchen and bath. Each city's zoning ordinances will determine if this option is a viable one for the proposed location of the ADU.

Subsidized Senior Housing. Seniors of low to moderate income may qualify for federal and state programs that pay for housing. Some of the programs may also assist with the costs of meals and other activities as well. The individual is often placed in an apartment complex and pays a percentage of their income as the rental payment.

Board and Care Homes. A board and care home is a group living arrangement designed for individuals who do not require the medical services of a nursing home but do require daily monitoring and assistance. The home provides support services including bathing, dressing. These homes are referred to as 'group homes'. The monthly fee is determined by a sliding scale that is based on monthly income. The monthly fee includes rent, meals, and the cost of other shared services.

Assisted Living Facilities. Residents of an assisted living facility may live in a private room or apartment and yet meet with other residents for meals and social and recreational activities. The facility provides help with daily living activities such as bathing, dressing as well as providing medical care medications, and perhaps transportation. The facility may include a health care services unit on site. The resident of the facility pays a rental fee and additional fees dependent on the particular medical services and non-medical services that they require. The services offered by an assisted levity facility vary greatly from one facility to the next.

Continuing Care Retirement Communities (CCRC) A CCRC is a retirement community that offers a number of different kinds of housing and a number of different levels of care. Some residents may be housed in individual homes or apartments while others may reside in an assisted living facility. Still other residents may be placed in a nursing home in order to receive a high level of medical care. As the resident's needs change, they are moved from one level of housing and health care to another. The communities have vastly different requirements in terms of commitments to remain within the facility and the services provided by the facility.

Hospice Care. Only terminally ill patients are cared for by Hospice health care. The care offered includes both that required to meet the patient's physical needs as well as that to meet their emotional needs. The singular goal of hospice is to provide comfort to terminally ill patients and their families. Each patient is assigned a team of doctors, nurses, home health aides, social workers,

Respite Care. Respite care refers to the placement of a patient being treated by hospice care in a hospital for a short stay in order to give the care giver a period of rest.

Programs of All-inclusive Care for the Elderly (PACE). Pace is a Medicare and Medicaid program that manages the medical care, social, and long term care services that are required to enable a very frail patient to remain in their homes and maintain their quality of life. PACE is not available in all locations.

Home and Community-Based Waiver Programs. Individuals eligible for Medicaid may obtain financial assistance with the costs of some home and community-based services. This program helps people maintain their independence while obtaining the care they require outside an inpatient facility.

A number of agencies are available to assist you in evaluating each of the options for long-term care. Some of these agencies are identified below.

Area Agency on Aging (AAA). This agency provides support to adults age 50 and older and their caregivers. The Eldercare Locator at 1-800-677-1116 will assist you in locating the Area Agency on Aging in your area. www.eldercare.gov

Aging and Disability Resource Center (ADRC). ADRC provides assistance to individuals regardless of income or age. www.adrc-tae.org

Center for Independent Living (CILS). CILS assists individuals with disabilities.www.ncil.org/directory.html

State Technology Assistance Project. The project provides information regarding medical equipment and other assistive technology that is available to the patient via the Rehabilitation Engineering and Assistive Technology Society of North American (RESNA). www.resna.org

State Medical Assistance Office (Medicaid). This office provides information regarding assistance programs for low income individuals.

Medical Scale