This is the twenty-eighth in a series of articles intended to demystify retirement living options.

Suppose that you or elderly relatives find the logistics of daily living to be a bit overwhelming.

Imagine needing help with any or all of the following, or similar activities: setting up a pillbox with medicines to take at different times of day for the coming week; shopping for groceries; preparing meals; keeping track of and disposing of food that is expiring or spoiled; walking the dog; doing dishes; changing the sheets, caring for houseplants; remembering to pay bills; going on outings to concerts, church services, or other events; remembering and getting to doctors’ appointments, and keeping track of follow-ups afterwards; dealing with a feeding tube; and/or bathing and dressing.

Often, people either don’t have family members available, or prefer to address their needs without calling on family, and so turn to service agencies for help.

How many different agencies would it take to get all of the above needs addressed? Five or ten? The good news is that the answer is probably one or two.

Many agencies can help with nonmedical services such as shopping, cleaning, and transportation. Several options are even available for handling services that fall between those activities and care that requires highly trained professionals such as registered nurses.

Marsha Douglas, the Area Supervisor for Abrio Care in Prescott, AZ, explained that the agency has staff trained to handle what it terms “para-medical” services, such as helping with colostomy bags, urinary catheters, and feeding tubes; checking oxygen saturation levels and blood pressure; and setting up pill boxes for the coming week.

Some agencies can help with the transition from one level or location of care to another. For example, when people come home after a hospital stay, they are often unclear about what medicines they are supposed to continue taking and what follow-ups need to occur, and their health can suffer as a result.

Douglas noted that Abrio Care offers a service called Discharge Express that includes activities such as transporting people home after hospitalization, picking up new medicines, checking their home for safety, preparing a meal, tucking them into bed, and returning the next day to ensure that they are doing well.

Mary Mackenzie, Administrator and Director of Nursing for Granite Mountain Home Care and Hospice in Prescott, noted that when patients transition from its home health services (skilled medical care) to non-medical services provided by its Granite Mountain Private Duty arm, it coordinates care to ensure that the transition is a safe and smooth one for its clients.

Abrio and Granite Mountain are among the agencies that can handle virtually all of the non-medical tasks and activities listed at the beginning of this article, as well as many not listed.

The non-medical home care agency Home Instead lists many activities that its caregivers are prepared to handle, including some that you might not expect: assisting with entertaining, reminiscing about the past, writing letters, and discussing current events.

Non-medical agencies may provide services a few hours a week, or in eight-hour shifts, or around the clock seven days a week.

They typically try hard to create a good fit between clients and caregivers based on the client’s specific needs.

Douglas of Abrio noted, “Studies show that 85 percent of people want to stay at home,” rather than move into an assisted living or skilled nursing facility, and Abrio works hard to help them safely continue to meet this goal.

Agencies that help people with activities of daily living such as bathing, dressing, using the toilet, and so forth may be paid for by a variety of sources such as the Veterans Administration, Arizona Medicaid (ALTCS), Arizona Department of Developmental Disabilities, the Area Agency on Aging of the Northern Arizona Council of Governments, long-term care insurance, and out of pocket.

Mackenzie of Granite Mountain noted that people are often covered by Medicare for home health services (skilled care) and after 2-4 months they may transition to non-medical care that may be covered by Medicaid (ALTCS).

Typical charges for people paying privately are roughly $18-19/hour.

The next column will discuss how agencies screen and supervise people who work with vulnerable adults.

-- Next -- 109. How Do Agencies That Provide In-Home Nonmedical Services Screen and Supervise Employees?