Tag: Respite care

  • PACE helps older adults stay in their community

    PACE helps older adults stay in their community

    The Program of All-inclusive Care for the Elderly (PACE) is a home and community-based program designed to keep older adults who are at risk for nursing home placement living in their community.  PACE is a partnership between a local sponsoring organization, and Medicare and Medicaid health insurance programs. To become a PACE “participant,” a person must be nursing home eligible. While a person can pay privately for services, most participants have Medicare, Medicaid, or both insurance programs.

    The PACE philosophy: PACE members are called “participants” because they are encouraged to participate in their care–decision making and active care–whenever possible.  The overarching goal of the PACE Model of Care is to keep people living in the community and out of institutional care.  While an individual does not need to visit the PACE Center, which offers adult day programs with wrap around health services, it promotes socialization and addresses common problems of isolation, loneliness, and boredom.

    Who can get PACE? Programs of All-Inclusive Care for the Elderly (PACE®) serve individuals who are age 55 or older, certified by their state to need nursing home care, able to live safely in the community at the time of enrollment and live in a PACE service area.

    How does PACE work? PACE works by providing care and services in the home, the community, and at the PACE center. It is team-based care that provides everything covered by Medicare and Medicaid if authorized by your health care team.  If your health care team decided you need care and services that Medicare and Medicaid doesn’t cover, PACE may still cover them.  The team provides comprehensive coordinated care and includes the PACE participant, physician, nurse, social worker, recreational specialist, rehabilitation specialists, and transportation specialists.

    Services: Delivering all needed medical and supportive services, a PACE program is able to provide the entire continuum of care and services to older adults with chronic care needs while maintaining their independence in their home for as long as possible. Services include the following:

    • adult day health care that offers nursing; physical, occupational and speech/language therapies; recreational therapies; meals; nutritional counseling; social work and personal care;
    • medical care provided by a PACE physician familiar with the history, needs and preferences of each participant;
    • home health care and personal care;
    • all necessary prescription and over-the-counter medications;
    • medical specialties, such as audiology, dentistry, optometry, and podiatry and speech therapy;
    • respite care; and
    • hospital and nursing home care when necessary.

    See more at: http://www.npaonline.org/policy-advocacy/value-pace#services

    Find a PACE program near you: Currently, there are 144 PACE organizations in 30 states serving 58,000 people. To find out if you or a loved one is eligible, and if there is a PACE program near you, visit www.pace4you.org or www.Medicaid.gov, or call your Medicaid office.

    Beware of for-profit PACE programs: Government audits find for-profit PACE program neglects patients, delays needed care and cancels critical care.

    Learn what to do to ensure safety at home for people aging in their communities. And, see how one new program is helping older adults remain at home with assistance from a handyman, occupational therapist and nurse. For those who like technology solutions, check out how sensors can offer peace of mind to caregivers.

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    This post was originally published on March 2, 2016

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  • Three things to consider about end-of-life care

    Three things to consider about end-of-life care

    If you’re caring for someone at the end of life–with a life expectancy of no longer than six months–Medicare covers either curative care or palliative end-of-life care. It’s important to understand your loved one’s preferences. Here are three things to consider about end-of-life care.
    1. Would the person you are caring for prefer care to ease pain, along with social and emotional supports over aggressive medical interventions?  If so, Medicare will cover palliative nursing and therapy care, as well as home health aides, medical social services, durable medical equipment and drugs, through a Medicare-certified hospice agency.  There is only a small copay. This care is usually provided at home, but sometimes is available through a facility. To receive this coverage, the patient must forego Medicare coverage for medical interventions to treat the terminal condition. (Medical interventions to treat conditions unrelated to the terminal condition continue to be covered.) Also, the patient can end hospice coverage at any time and receive Medicare coverage for curative care to treat his or her condition whenever the patient chooses.
    2. Is care available to the person when the hospice team is not on site? The Medicare hospice benefit covers only a few hours a day of care.  As a general rule, the hospice agency will only accept patients who have someone to care for them when they are not on site.
    3. How do you find a Medicare-certified hospice agency?  Your local hospital should have a list of agencies in your community.  Ask the patient’s doctor to reach out to the hospice on behalf of the patient. The Centers for Medicare and Medicaid Services just launched an online tool for comparing different hospice agencies, Hospice CompareKaiser Health News reports that right now it’s of no real value because it doesn’t do a good job of distinguishing among hospice agencies and suggests that nine out of ten hospices are very good. That said, Hospice Compare does let you know about hospice agencies you can contact in your community.  And, the Hospice Foundation of America offers a list of questions you should ask of hospice agencies before choosing one.

    Note: The hospice benefit includes some benefits for family caregivers, including respite care and bereavement services. Respite care will allow a family caregiver to take a break from caring for a loved one who is terminally ill.  And, after a loved one passes, a hospice may cover grief and loss counseling for family caregivers, support groups and memorial services. Counseling coverage for the family member can last up to a year after a loved one’s death.

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  • Respite care: Medicare may pay for you to take a break when caring for a loved one

    Respite care: Medicare may pay for you to take a break when caring for a loved one

    It can be very stressful as well as physically demanding to take care of anyone, particularly someone you love. In some cases, Medicare will cover the cost of a loved one’s care so that caregivers can take a break. To qualify for Medicare respite care, the person you are caring for must:

    1. Have a life-threatening illness
    2. Be enrolled in the Medicare hospice program.  (Here are three things to consider about hospice care)

    If your loved one qualifies, Medicare will pay for him or her to stay in a Medicare-certified skilled nursing facility or a Medicare-approved hospital for up to five days at a time. For more information, visit MedicareInteractive.org.  

    If your loved one does not have a life-threatening illness or is not enrolled in the Medicare hospice program, there still may be community services available to allow you to take a rest from caregiving. Contact your local area agency on aging to learn about community resources, including adult day services. Visit www.eldercare.gov for the agency nearest you and click Get Help to learn about free and low-cost services available to older adults.