Through Family or Friends

First make a detailed inventory of any assets individual family
members and friends can contribute, including the assets of the
impaired elderly person needing the care. Assets include available
time, skills, space, equipment, the strengths of the person in need
care, and most important money. Sit down with all the family members
(or at least as many as are agreeable)and work out a plan for giving
help. This involves defining and agreeing upon what tasks will be
performed, by whom, on whichdays, and so forth. For example, Aunt
Martha can cook, Uncle Peter can mow the lawn and Mary can check on
Mom twice a day.

Caregiving Exchanges:

Some situations may allow for exchanging support services such as
the Caregiver Exchange through Area Agency on Aging. A friend who
has similar caregiver responsibilities may care for both impaired
individuals one day a week in exchange for your providing the care
on another day. Another exchange situation might includemaking a
spare room available to a college student for his/her help with care
of the care-receiver, in return for free room and board.

4. When Community Agency Help in Needed:

When family or other volunteer help is not available or cannot meet
your needs, caregivers or care-receivers may wish to seek help from
agencies.

A wide range of help may be available. Some may be covered by
private insurance, Medicare (and/or a supplemental program of your
State). All of it can be purchased. Sometime the service costs may
be based on the income of the care-receiver. Each agency has its own
fee structure; you may want to ask about their arrangements before
ordering the service.

5. Types of Services Available to Impaired Elderly

Note:See Appendix A for a list of names and telephone numbers of the
agencies mentioned below. (Mike: Appendix A is presented in this
SeniorNet version minus the telephone numbers which are only
applicable to San Diego County. Users of this Handbook might want to
identify counterpart agencies in their county or.service region and
list them in the Appendix by name and telephone numbers.)

Adult Day Health Care:

This is for people who are physically and/or mentally frail. It
offers a range of therapeutic, rehabilitative, and support
activities, including nursing, rehabilitation, assistance with life
activities, social work services, meals, and possible
transportation, provided in a protected setting for a portion of the
day, one to five days a week, usually during weekdays.

Chore Workers/Handy persons Services:

Includes heavy-duty housecleaning, minor home repairs, yard work,
installing safety devices, and winterizing homes.

Companionship Services: Companions visit isolated and homebound
individuals for conversation, reading, letter writing, and general
light errands.

Escort Services for the Elderly: These services provide personalized
accompaniment to service providers as well as personal assistance.

Geriatric Assessment Units and Special-Care Units: Specialized
geriatric units, both inpatient and outpatient, exist in some
hospitals and medical centers; e.g., SOCARE, API They provide
coordinated multi-disciplinary diagnostic services to older
patients.

Home Delivered Meals: Some nutritional programs as well as well as
specialized *meals-on-wheels* programs offer home delivered meals to
the frail, homebound aged. Subsidized programs ask for voluntary
contributions, while others may require full payment cost for
delivery of a hot, well balanced lunch, and sometimes cold evening
meal.

Home Health Aides: Provide personal care to individuals at home
(These services may be covered by health insurance if ordered by a
physician.) Aides assist with eating, dressing, oral hygiene,
bathing, colostomies, administering medications, etc., as well as
light household tasks.

Home Health Care: Organized programs of nursing, social work,
occupational therapy, physical therapy, and other rehabilitation
services to individuals in the home.

Homemaker Services: Provided by non-medical personnel, services
include shopping, laundry, light cleaning, dressing, preparation of
meals, and escort services on medical visits. Homemakers can be of
great help in supplementing help provided by family members, or
providing relief when family caregivers need a break. Homemakers can
be secured through in-home health care agencies, the Area Agency on
Aging, the Department of Social Services, and religious groups and
organizations. Some agencies provide bonding and training for their
homemakers while others provide only a registry of homemakers' names
and phone numbers, in which case you must thoroughly check
references and draw up a contract for the required services.

Hospital and Surgical Supply Services: Supply houses rent or sell
medical supplies and equipment like hospital beds, canes, walkers,
bath chairs, oxygen and other equipment. Consult you Yellow Pages.

Housekeeping Services: These usually include cleaning, shopping,
laundry, and meal preparation.

Housing Assistance: Housing assistance programs exist to help in the
search for senior housing, shared housing, and finding emergency
shelters, such as Heartland Human Relations and Area Agency on
Aging.

Nutritional Programs: Congregate meal programs feed many older
adults as a group in a senior center, community center, or school. A
noonday meal is provided, containing one-third of the recommended
USDA dietary allowance, usually for a voluntary contribution.
Additionally, some centers provide recreational and educational
activities.

Occupational Therapy: Occupational therapy, or OT, is restorative,
to enhance or restore skills necessary for daily living. It should
be provide by a qualified occupational therapist who is referred by
your doctor.

Physical Therapy: Physical therapy, or PT, is rehabilitative therapy
to maximize mobility. It should be provide by a qualified physical
therapist, usually recommended by your doctor or hospital.

Respite Care Services: Respite care programs provide temporary and
in some instances up to twenty-four hour care to give relief to
primary caregivers. The care may be provided in the person's home,
at an adult day care center, or other facility.

Senior Service Teams: Regional/County Mental Health teams working
together to provide mental health screening, needs assessments, and
short-term counseling services to seniors.

Skilled Nursing Services: These specialized services are provided
for specific medical problems by trained professionals through local
home care agencies. Your doctor must prescribe nursing services.

Speech Therapy: Speech therapy is provided by a qualified speech
therapist to overcome certain speech and communication problems. The
doctor usually recommends this.

Social Day Care: Provide supportive but not rehabilitative services
in a protected setting for a portion of the day, one to five days a
week. Services may include recreational activities, social work
services, a hot meal, transportation, and occasionally, health
services.

Telephone Reassurance: Friendly telephone calls are provided by
agencies or volunteers offering reassurance, contact and
socialization. Telephone reassurance can be a lifeline for older
people who must be left at home alone during the day.

Transportation: Transportation services provide travel by automobile
or specialized vans to and from medical care. Community agencies and
service providers such as Dial-a-Ride, Red Cross Wheels, Cancer
Society, and Life Line are but a few.