Understanding Levels of Home- and Community-Based Services and Residential Care
Diane Breslow, MSW, LCSW
CurePSP is committed to providing its constituents— patients, families, caregivers, and healthcare providers— with up-to-date educational information about topics relevant to living with PSP, CBD, MSA, and other neurodegenerative diseases.
Among the ever-increasing population of older and disabled adults and their caregivers and family members, confusion and misunderstanding abound with regards to the broad spectrum of available choices for home- and community-based services, residential facilities, long-term care, and rehabilitation. Part of the reason for this confusion is that, throughout the 50 states, a lack of consistency exists in terminology, regulations, licensing, on-site services, costs( up-front and add-ons), amenities, and more.
This article will help you understand the spectrum of services and care options for adults with physical impairments or chronic disease. You will become aware of questions to ask when searching for a type of care or care facility.
Each of the services and care levels discussed are potentially appropriate for people with PSP and related diseases. That said, it is most important and acceptable for family caregivers to inquire as to a staff’ s experience with prime of life neurodegenerative disorders like PSP. Family members can and should make providers aware of the symptoms and needs of these patients, and offer to ascertain educational materials, speakers, and in-service training for staffs.
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Adult Day Services( also called Older Adult Day Programs, or Adult Day Care Centers)
Adult day services are community-based, daytime group programs for cognitively or functionally limited adults who require supervision, socialization, structure, and some personal assistance. The programs are provided in a safe and secure setting, sometimes in stand-alone buildings and sometimes within hospital campuses or continuing care retirement communities( CCRCs).
Adult day centers feature exercise, socialization, and recreational activities.
Other possible components are:
• Transportation
• Health-related services, such as medication reminders, incontinence care, nurse oversight
• Meal and snack
• Social work services, such as counseling, information, referrals, and care coordination
Features and fees vary from program to program, and state to state. It is important to ask specific questions about what is and is not included in any one center.
Note: In addition to the benefits to participants, adult day programs afford family caregivers much-needed respite from the demands of caregiving full-time for someone who needs constant supervision.