Recent questions on the AgingCare website seemed to indicate that many caregivers see their responsibilities to their loved ones as an “either/or” situation.

Either you quit your job, cut back substantially, drive yourself to distraction trying to work and care for an aging relative, or  you throw in the towel, “give in” and start to look for institutional alternatives like assisted living or nursing home care.

There is another option available, though; a happy medium. It may work not for every situation, appropriate services may not exist in your area, and your loved one may balk at a change in caregiving personnel. But you owe it to yourself to investigate the wide variety of choices that exist within the community to assist caregivers with their responsibilities.

Call your Local Family Caregiver Support Program

This is a national program which is required to exist within each Area Agency on Aging in the country. There is no charge for their advice, and the service offerings can range from a packet in the mail to a continuing relationship with a supportive professional advisor.

Call your local aging services organization and ask for Information and Referral. Let the person know the kinds of questions you need to ask and they will direct you to the appropriate person. In general, they will know about the variety of program choices in your area. At the very least, you will reach a trained professional who is able to listen to your concerns and can point you in the right direction.

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Contact a Local Home Care Agency to Learn about Home and Community-Based Services

When providers, social workers and other concerned individuals speak about “home care” there are actually two distinct service models:

Private organizations (can be for profit) can be hired to come in and assist your loved one with cooking, shopping, bathing, dressing, toileting and other activities of daily living (ADLs) and instrumental activities of daily living (IADLs). They charge by the hour, usually with a minimum time commitment. “Skilled providers” may be part of a Visiting Nurse Association (VNA) or other medical organization and can also provide injections, wound care and other medical attention which can only be done by a licensed provider.

Publicly-supported nonprofit organizations or Aging Services Access Points (ASAPs) manage programs for elders with limited incomes who need assistance paying for home care. Don’t let the term “limited incomes” put you off. If the individual is married, only that individual’s income is counted. For women in families where the male was the major breadwinner, this means that she may very well qualify for a “300%” waiver (for incomes under approximately $2200/month.) There are strict asset requirements, though, and you should consult an attorney or accountant to learn what rules apply.

Public organizations often hire private organizations to provide the services your loved one needs. The amount of service depends on an assessment that is conducted by the social worker at the ASAP. Be sure to ask questions about how the amount of service required was determined and what kinds of changes in health and ability would necessitate additional services.

Ask about Adult Day Health Programs

If your loved one is able to get out of the house with assistance, but needs services during the day, an adult day care program can provide activities, supervision and meals in a protective environment. Adult day health (ADH) programs can provide medical assistance as well. Individuals who are eligible for Medicaid can also receive transportation services in addition to adult day services.

For individuals not eligible for Medicaid, there are daily fees and there may be requirements that you enroll the person for a specified number of days per week in order to receive transportation services. Inquire about sliding scale payments if your loved one doesn’t qualify for Medicaid, but does have a limited income.

Call the Veterans Administration

Some veterans and spouses of veterans qualify for programs which can assist with services for aged and disabled individuals. You should ask the VA advisor whether any aspect of your loved one’s service in the military is now looked at as the source of a service-connected disability. New research is showing that more veterans than originally screened are suffering from PTSD, effects of Agent Orange and other medical conditions that can be linked to their military service. This may qualify your loved one for additional benefits. Don’t be afraid to ask questions and consult with members of your loved one’s military unit with whom they may still be in touch.