For older adults needing in-home assistance not covered by Medicare or other insurance, there are a number of private companies and qualified individuals who can help for fees typically ranging from $15-25 per hour with a 4-hour minimum period.  However, it is strongly recommend to first hire a geriatric case manager for a few hours, who can visit the older person’s residence, assess the needs, and identify local sources of assistance.  In Atlanta, a member of our Eldercare group, Debbi Dooley, is a highly experienced geriatric case manager with Jewish Family & Career Services (ddooley@jfcs-atlanta.org ).  Another geriatric consultant used by members of our group to provide advice on residential dementia care options is Nancy Kriseman, author of the book The Mindful Caregiver: Finding Ease in the Caregiving Journey. (See a description of this book on the www.dlmcare.org Book page.)

For best results in finding care options, our group members stressed that it is important to work with a geriatric case manager (or equivalent) who does not receive commissions from particular residence facilities or home care providers.  One member noted that it is common for a company that advertises such services to get the equivalent commission for the cost of one month of services from the referral agency or up to 10% per month of the amount paid for the first 12 months.  Therefore there is a strong incentive for these companies or consultants to steer clients to places that give them a referral fee and to downplay or exclude better or more cost-effective options.

Caring.com, based in San Mateo, CA, was also recommended by a group member. Per their website, Caring.com “is the leading online destination for those seeking information and support as they care for aging parents, spouses, and other loved ones” https://www.caring.com.  Note that also per their website, Caring.com “makes money from paid advertisements, enhanced senior living and in-home care directory listings, senior living and home care referrals and emails from advertisers”.

The Atlanta-area Empowerline.com  https://www.empowerline.org/ (formerly called AgeWise Connection) is a good place to start looking for suitable residential options and in-home services in the Atlanta metro area for persons of all ages having activity limitations.  It is a federally-supported program administered by the Atlanta Regional Commission that provides free and certified phone counselors and helpful online resources 24/7 to connect metro residents with resources and services.  Similar programs are available across the country, which are funded by the U.S. Administration for Community Living (ACL) https://acl.gov/programs/aging-and-disability-networks/area-agencies-aging. 

It is a good idea to start thinking about potential residences before you need them. To learn about senior housing options—especially for those with limited financial resources, see Atlanta Senior Housing 101  https://www.empowerline.org/services/senior-housing-options/ Eldercare group members hope to visit local Atlanta sites for example, Wesley Woods Towers, Clairmont Oaks and Briarcliff Oaks (senior independent living), Arbor Terrace (assisted living residence), or Fountainview (dementia-specific nursing care residence).  

One of our group members, a retired social worker for Visiting Nurse Health Systems, said that the State-administered Georgia Community Care Services Program (CCSP)  was a good alternative to nursing home care for some frail older persons who have limited resources.  She said that CCSP has a “spousal empowerment” option that gives a caregiver-spouse control of most of the CCSP resources.  

The Georgia Community Care Services Program (CCSP) assists older and/or functionally impaired consumers in remaining in their homes and communities. The CCSP is a Medicaid waiver program that provides community-based social, health and support services to eligible consumers as an alternative to institutional placement in a nursing facility.  See the CCSP  brochure:  http://aging.dhr.georgia.gov/sites/aging.georgia.gov/files/imported/DHR-DAS/DHR-DAS_Publications/CCSP%20Consumer%20Brochure%2012.2011%5b1%5d.pdf

Additionally, the Non-Medicaid Home and Community Based Services program offered by the Georgia Division of Aging Services “include a range of solutions to help older Georgians live safely, healthily, and independently in their homes and communities. The Home and Community Based Services program is mandated through the Older Americans Act. It assists individuals age 60 and older and their caregivers. (Note that consumers may be eligible at 55 years old for some programs such as senior employment and kinship care.)”  The Division of Aging Services contracts “with 12 Area Agencies on Aging (AAA), to regionally manage the program and consumer case management.  For more information on these services,  contact your local AAA.”  https://aging.georgia.gov/home-community-based-services

An experienced group member stated that senior independent living residences will generally allow frail residents to have a limited amount of CCSP in-home Certified Nursing Assistant care, i.e., two hours in the morning and two hours in the evening, and that some independent living residences like Clairmont Oaks are very supportive in helping long-term residents avoid having to go to a nursing home—especially if they cannot afford assisted living.  This policy supports the principle of the “dignity of risk”, by allowing a person to take chances on living somewhat independently in preferred but less-than-ideal circumstances. 

Senior independent living residences sometimes have bonded in-home personal care workers who can provide low-cost services (e.g., bathing, dressing, cleaning) to residents who have a disability—for as little as a 30-minute minimum charge. Social workers at independent living and assisted living residences can often give good advice and helpful referrals if a relocation is required due to increased care needs.

Are there in-home care resources that you have used that you would recommend?