Community Services

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WHAT ARE COMMUNITY SERVICES?

It is no surprise that as people grow older they want to continue to live independently in their own homes. Community services refers to the whole array of supportive services that enable older persons to live independently in their homes and communities. Community services can help persons with daily living activities, such as shopping, transportation, bathing, and dressing. Many community services also create opportunities for social interaction--especially important to those who may be isolated. Often, community services are provided by not-for-profit agencies sponsored by religious organizations, fraternal groups, or other community organizations.

WHO CAN BENEFIT FROM COMMUNITY SERVICES?

Many older persons and their caregivers can benefit from some type of community services. All one person may need to be able to stay at home is a little help with shopping. Another person may need a combination of community services, such as help with housekeeping, transportation, and preparing meals. Others may seek social contact through senior centers or volunteer activities, such as the foster grandparent/senior companion program.

Caregivers of older persons who are not able to live on their own also benefit from community services, such as adult day care and respite care. These services enable caregivers to work or take time off from caregiving responsibilities, knowing their loved ones are receiving the care they need.

Just as everyone is different, so are individuals' needs as they grow older. It is the availability of a variety of community service options, which can be put together in many combinations, that can best meet the needs of older Americans.

WHAT TYPES OF COMMUNITY SERVICES ARE AVAILABLE?

While many different community services exist for older people, not all are available in every community. The most commonly available community services are described below:

	Adult day-care services provide a variety of health, social, and related support services, which usually include a nutritious meal, in a protective setting during the day. Some daycare programs are designed especially for those with Alzheimer's disease.
	Care coordination/case management helps older persons and their families gain access to needed services. A care manager works with the older person and family members to determine which available services are most appropriate for their needs, puts together a plan of care, and coordinates the provision of care.

	Congregate meal programs offer low-cost, nutritious meals in group settings, often in a senior center.
	Escort services accompany older people on public or private transportation and help them accomplish the purposes of their trips, such as shopping and appointments.
	� Financial counseling programs help older people balance checkbooks; file income and property taxes; pay bills; and complete Medicaid, Medicare, or insurance forms.
	� Friendly visiting/companionship services provide socialization, supervision, and some supportive services to older persons in their own homes.
	� Health maintenance services are usually provided in a congregate setting, such as a senior center, and include such services as blood pressure checks.
	� Home health care services are provided in a person's own home and can include part-time nursing services; personal care and homemaker/chore services provided under the super�vision of a licensed nurse; medical supplies/equipment; and physical, occupational, and speech therapies provided by licensed professionals.
	� Homemaker/chore services help with general household activities (such as meal preparation and routine household care) and heavy household chores (such as washing floors, windows, and walls, and shoveling snow).
	� Hospice care provides nursing care and a variety of other supportive services, such as counseling and homemaker services, to terminally ill persons and their families. Hospice care is provided in the client's home or in a nursing facility.
	� Home-delivered meals, often called meals-on-wheels, bring nutritionally balanced meals to those who are unable to prepare their own meals.
	� Information/referral provides older persons and their families information about available public and voluntary services and resources. Referrals to services often include contact and follow up with the provider and/or client.
	� Personal care services assist persons with daily living activities, such as eating, bathing, dressing, and personal hygiene.
	� Respite care gives families temporary relief from the responsibility of caring for older persons who are unable to care for themselves. Respite care is provided in a variety of settings including the older person's home, the caregiver's home, or a nursing facility.
	� Rehabilitation services provide medical or remedial care to an older person for maximum reduction of physical or mental disability and restoration of the highest possible functional level.
	� Senior centers offer a variety of social and recreational services to maintain social contacts, reduce social isolation, and improve personal satisfaction with one's own life.
	� Telephone reassurance maintains regular telephone contact and ensures continued social contact between people living alone and the outside world.
	� Transportation services help older people get to and from shopping centers, keep appointments, and have access to a variety of community services and resources.

IS ANY FINANCIAL ASSISTANCE AVAILABLE FOR COMMUNITY SERVICES?

This depends on the type of service, the area in which you live, and the type of insurance you have. Meals and transportation are often available through local senior programs for a suggested contribution.

Medicaid pays for some community services, usually limited home health, hospice, and personal care, depending on the state you live in. Medicare also covers limited home health and hospice care.

Adult day care and respite care are often available through community organizations according to a sliding-fee schedule. Insurance policies are beginning to cover community services such as day care and care coordination.

WHERE CAN I GET FURTHER INFORMATION?

When contacting any organization, it is important to state what you need. For example, state that you need daily help in preparing meals or that you need help getting to places. The agency you contact needs specific information to recommend the most appropriate support.

The best place to start is to check your local phone directory under "county government" for a listing of the area agency on aging. If you have trouble locating your area agency on aging, call the toll-free Eldercare Locator at 1-800-677-1116 for referral to the agency nearest you.

The following publications are also available from American Association of Homes and Services for the Aging (AAHSA) publications:

� Directory of Members gives you instant access to a nationwide network of some 5,000 not-for-profit nursing homes, retirement communities, senior housing facilities, and community services. You'll find complete contact information and facility descriptions, plus a key to the community services each provides. To order, call 1-800-508-9442.

� The Continuing Care Retirement Community: A Guidebook for Consumers. This guidebook, published by the American Association of Homes and Services for the Aging, examines the variety of contractual arrangements offered by CCRCs, which combine health care and health-related services with residential living. A consumer checklist and financial worksheet help you make a decision before signing a continuing care contract. To order, call 1-800-508-9442.

� The Consumers' Directory of Continuing Care Retirement Communities will help you choose the CCRC that's right for you. Over 500 CCRCs are profiled. To order, call 1-800-508-9442.

Source: Community Services for Older People Living At Home, Published by American Society of Homes and Services for the Aging, � 1994.