For many seniors, there comes a time when they require additional support to properly care for their needs. While this can be an inconvenience for some families, it does not have to be catastrophic. In fact, although there are many things to consider when the need for a caregiver arises, it is possible to make a gentle transition if equipped with good information. In addition to the information on this site, JacksonWhite Elder Law maintains and operates the Arizona Senior Law Web site and blog both of which contain more information on these and other issues involving seniors.What options are available for senior living?
The lowest level of care for seniors requiring assistance is home and community based services.
Arizona has a program by the name of Home and Community Based Services (HCBS). Financial assistance is provided for this program through ALTCS (Arizona Long Term Care System or Medicaid) for seniors who qualify both medically and financially; and by DES for seniors who qualify financially but do not meet ALTCS medical requirements. To determine whether an individual qualifies for financial assistance it is best to speak with an attorney who understands ALTCS rules and regulations.
HCBS benefits are substantially the same whether provided through ALTCS or DES. Benefits provided include:
• Adult Day Care: Consists of daily supervision in a group setting.
• Attendant Care: Assists individuals with routine daily tasks such as eating and bathing. Attendant care may be provided up to daily, depending upon the individual’s needs.
• Personal Care: Assists individuals with routine daily tasks but is generally only provided once a week or less.
• Home Health Services: Includes more intensive nursing needs such as occupational and physical therapy.
• Homemaker Services: Assists individuals with household chores and shopping.
• Home Delivered Meals: Lunchtime meals are delivered to the individual’s home Monday through Friday.
• Hospice Care: Consists of spiritual and emotional counseling for terminally ill individuals and their families.
• Respite Care: Provides caregivers with short-term relief from caring for their loved one.
• Transportation: Offered to and from certain health care facilities.
The next option for senior housing is assisted living facilities. Assisted living facilities provide an intermediate level of care for seniors requiring support.
Assisted living facilities are a less expensive and less restrictive alternative to nursing homes. Depending upon the individual’s specific needs, assisted living facilities can provide support for a wide range of activities. Types of assistance offered can range from laundry services all the way up to caring for Alzheimer’s or dementia patients.
In Arizona, there are three basic types of assisted living facilities:
• Adult Foster Care Homes: Adult foster care homes provide care for up to four residents, and are generally much like a typical foster home. The caregiver operates the residence from his or her family home in a residential neighborhood and the patients become a part of the household.
• Assisted Living Homes: Assisted living homes provide care for up to ten residents and are generally situated in a residential neighborhood. These homes have trained staff members who are under the supervision of a manager.
• Assisted Living Centers: Assisted living centers are the largest of the assisted living facilities, housing eleven or more residents. These homes are generally structured in a campus setting with each patient residing in a private room or suite.
Skilled nursing facilities provide seniors requiring support with the highest level of care.
A skilled nursing facility is a good option for those requiring more supervision than that provided at assisted living facilities, but who do not require hospitalization. While the distinguishing factor of skilled nursing facilities is that they provide around-the-clock care, not all facilities are equal. It is very important to research the various facilities before making a commitment. A good way to find information about nursing homes is to check the Arizona Department of Health Services quality rating system.
Will Medicare cover nursing home costs?
Medicare does not pay for long-term care. As such, nursing home expenses are only covered for a limited time, and only under limited circumstances. For example, Medicare will only consider paying for a stay at a nursing home if the individual entered the nursing facility straight from a hospital, and even then, Medicare will never cover more than 100 days. Also, Medicare requires deductible payments which could be over one hundred dollars a day. In short, Medicare is probably not the best means of receiving assistance for nursing home care. A better alternative, if you are eligible, is to apply for ALTCS, which specializes in long-term care.
Are there any programs that offer assistance if I remain in my home?
Arizona’s Home and Community Based Services (HCBS) provides financial assistance to qualifying low-income seniors for costs relating to in-home care. For seniors who qualify both medically and financially, the ALTCS program provides HCBS benefits. HCBS benefits provided through ALTCS include:
• Adult Day Care: Adult day care consists of daily supervision in a group setting.
• Attendant Care: Attendant care assists individuals with routine daily tasks, such as eating and bathing. This care could be provided from several times per week up to daily, depending upon the needs of the individual.
• Personal Care: Personal care also assists individuals with routine daily tasks, but is generally provided only once a week or less.
• Home Health Services: Home health services include more intensive nursing needs, such as occupational therapy and physical therapy.
• Homemaker Services: Homemaker Services assists individuals with household chores and shopping.
• Home Delivered Meals: Lunchtime meals are delivered to a person’s home Monday through Friday.
• Hospice Care: Hospice care consists of spiritual and emotional counseling for terminally ill individuals and their families.
• Respite Care: Respite care is offered to provide caregivers with short-term relief from caring for their loved one.
• Transportation: Transportation is offered to and from certain health care facilities.
For individuals who do not meet ALTCS eligibility requirements, Home and Community Based Services are also offered through Arizona’s Department of Economic Security (DES). The DES program does not have any medical requirements, but participants must still be financially eligible to receive benefits. The services offered through DES are substantially the same as those offered through ALTCS.
If you do not qualify for HCBS through ALTCS or DES, you can hire a personal caregiver. Many home care agencies and referral companies specialize in caregiving and could assist in finding a caregiver that works for you. Keep in mind that your caregiver will be spending a lot of time in your home so you should be very selective. If you have any reservations about a particular caregiver, do not hesitate to find somebody who is better suitable.
Will Medicare help with the costs of a caregiver?
Medicare only covers in-home care in limited circumstances. For instance, if a doctor determines that home health care is medically necessary, Medicare may help with the costs of a caregiver, but coverage will not exceed one hundred days. If you require a caregiver for non-medical services, Medicare will not help with the costs.
Are there any services available to caregivers?
The Arizona Department of Economic Security offers a Family Caregiver Support Program designed to assist caregivers. This program provides assistance in five basic areas:
1. Obtaining information about services in the community;
2. Gaining access to supportive services;
3. Counseling, training and support groups;
4. Respite care;
5. Supplemental services to complement care provided by the caregiver.
For more information about caregiver support, contact the Area Agency on Aging at (602) 264-HELP.
What are assisted living facilities?
As mentioned above, assisted living facilities provide a less expensive alternative to nursing homes, and they are generally less restrictive than nursing homes as well. Assisted living facilities provide supervision and assistance with various activities, depending upon the individual’s specific needs. Assistance can range from laundry services all the way up to caring for individuals with Alzheimer’s or dementia. Arizona has three basic types of assisted living facilities:
1. Adult Foster Care Homes: Adult foster care homes only provide care for up to four residents. Generally speaking, adult foster care homes are much like a typical foster home. The caregiver operates the residence from his or her family home in a residential neighborhood, and the clientele become a part of the household.
2. Assisted Living Homes: Generally speaking, assisted living homes are also situated in a residential neighborhood, but up to ten residents are permitted to reside in them. Assisted living homes must have trained staff members who are under a manager’s supervision.
3. Assisted Living Centers: Assisted living centers are the largest of the assisted living facilities. Eleven or more residents reside in a campus-type setting, each with a private room or suite.
What is a skilled nursing facility?
As mentioned above, skilled nursing facilities provide a higher level of care than assisted living facilities. These facilities provide around-the-clock skilled nursing care. A skilled nursing facility is a good choice of long-term care for those who require more supervision than an assisted living facility offers, but do not require hospitalization.
Where can I find information about nursing homes or skilled nursing facilities?
If you are considering nursing home care, you should definitely do your research. You want to know what you are getting you and your loved one into before committing to anything. The Arizona Department of Health Services licenses and monitors Arizona’s nursing homes to ensure quality care. Information and quality ratings of all licensed facilities are published on the web here. The Area Agency on Aging’s 24-hour helpline might also be useful: (602) 264-HELP.
Will Medicare cover nursing home costs?
Medicare does not pay for long-term care. As such, nursing home expenses are only covered for a limited time, and only under limited circumstances. For example, Medicare will only consider paying for a stay at a nursing home if the individual entered the nursing facility straight from a hospital, and even then, Medicare will never cover more than 100 days. Also, Medicare requires deductible payments which could be over one hundred dollars a day. In short, Medicare is probably not the best means of receiving assistance for nursing home care. A better alternative, if you are eligible, is to apply for ALTCS, which specializes in long-term care.
