Support Systems to Age in Place

Home Maintenance, Transportation & Chore Services

Many seniors who want to remain in their homes find it difficult because of a lack of transportation or because of the necessity of maintaining the home and the yard and being unable to do so.

There are numerous community and private services that provide such things as home repair, deep cleaning, remodeling, maintaining the yard, shoveling snow, transportation, and so on. Sometimes Medicaid or the local community area agency on aging will provide these services for financially needy individuals for free. For people with means there may be a charge.

By working your life resource planning team you will be protected from fraud or other failure to perform that is often frequent with these kinds of companies. The team will do background checks, training, and supervision of these providers.

Assistive Technology

Assistive technology is a broad term and may mean different things to different people but for our purposes we will define it as the following:

1. Devices or systems to help people who have no skilled medical needs manage their disabilities
2. Devices or systems that support disabilities with people who are receiving Medicare home care (durable home medical equipment)
3. Personal items or devices that make life easier for people with disabilities
4. Living environments that accommodate disability
5. Consultants, books and other advice
6. Home modification

Devices to Help with Disability and No Skilled Needs

These are systems or devices that are not covered by Medicare. This may include certain home modifications, stair lifts, elevators, computer training, sensory augmentation devices, aides to mobility or for mobility convenience such as grab bars, bath lifts, chair and toilet lifts. Others include medical alert systems, exercise equipment and whirlpools or special bathing equipment.

Devices that Medicare Considers Durable Medical Equipment

As a general rule Medicare will reimburse 80% of the cost for rental or purchase of devices or systems that support disabilities due to a medical problem. Medicare has a certain list of these items that it will approve. Following is a partial list of devices that Medicare will cover and that support disability in the home:

• Oxygen equipment
• Canes, walkers and crutches
• Wheelchairs and scooters (scooters require a large co-pay)
• Other mobility or medical-related home care devices (Medicare maintains a large list of these devices that may or may not be covered.)

Personal Items or Devices That Make Life Easier

These are items to make life in the home easier for those who are disabled. This might include therapy systems, joint and limb supports, dining aids, bath, hygiene and toileting aids, reachers, button hooks, fasteners, shoehorns, holders, turners and so on. The list also includes special clothing items.

Living Environments that Accommodate Disability

There are a number of companies or organizations that will restructure the living environment at home to make it possible for people to live at home. This might include special training, augmentation devices, transportation, in-home services, environmental control devices, exercise, recreation programs, etc.

Consultants, Books and Other Advice

There are numerous books available from bookstores and from online sources that give advice to caregivers in all areas of disability support. These sources often go beyond the issue of devices and equipment and deal with such things as meal preparation, menus, activities, music, and other social issues important to the disabled. Private and government consulting is also available. Check online or dial 211 or call the local area agency on aging for more help.

Home Modification

Many people with disabilities want to remain in their home as long as possible. Such things as narrow doorways that cannot accommodate wheelchairs, more than one living level, and inconvenient layout of the home may prevent a person from living there. In addition, disabled people often require rails, special bathroom facilities, and special dining accommodations as well. There are three options to modifying the home:

• Research can be done and materials procured to make the home more livable, and a family friend, or relative can pitch in and do the remodel.
• A contractor can be employed to do the necessary modifications.
• An attempt can be made to find a local company that specializes in full-package movement modification for the disabled. These providers may be readily available in larger population areas.

Your life resource planning team will work with companies that provide reliable service in this area of need.

Medical Alert Systems, Tracking and Prevention Devices

This area of assistance focuses more on the use of devices that warn of problems with homebound people who are often without caregivers for certain periods of the day. This may include:

• 24-hour vital sign monitoring
• video surveillance
• emergency signaling systems (medical alert) or
• GPS locator devices for wandering care recipients.