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    44001 Garfield Road
    Clinton Township, MI
    48038
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The Right Connection - Dementia Services

Dementia Services

Click on each title below to see detailed information.

A first step is to have the person suspected of having dementia checked out by a qualified physician. The doctor can determine what, if anything, is actually wrong and recommend treatment. If the doctor’s diagnosis is dementia, further legal steps to provide that person with adequate legal protections are necessary. 

It is important to have the doctor specify in detail, as clearly as possible, exactly what the person is capable of doing from a decision-making standpoint when the diagnosis is made. For example, can the person identify and understand the extent of the property s/he owns and who his/her heirs are? Is s/he capable of understanding the nature of a transaction sufficient to enter into a contract? Can s/he identify those who s/he trusts enough to manage his affairs in order to authorize them to do so? 

If the answer to any of the above questions is “yes” then consult an elder and estate planning attorney in order to put that person’s legal affairs in order with documents such as Powers of Attorney for financial and medical affairs, wills, trusts, and any other documents which apply to his particular circumstances. By doing this, you can keep that person’s life private and reduce legal fees and court costs.  

If the answer to the any of those questions is “no” it may be necessary to go into probate court and petition for a Guardianship and Conservatorship in order to take over management of that person’s personal and financial affairs. This is an expensive, public process that requires ongoing court supervision. This scenario will often occur once a person with dementia progresses to later stages and no longer has the capacity to enter into legal documents that would eliminate the need for a guardianship or conservatorship.  This is another reason for consulting a physician and an elder and estate planning attorney as early as possible. It is strongly recommended to have legal documents in place that provide others with authority to act on one’s behalf well before dementia or any other incapacitating condition occurs.

Referrals to physicians trained to recognize dementia in a given geographic area is available from the Alzheimer's Association, (800) 272-3900.  TTY: (877) 204-6924

Pamphlets, fact sheets, videos, books, etc. on dementia are available from:

Alzheimer's Association, Southfield
Website: www.alz.org/gmc

(800) 272-3900

A Friend's House, Clinton Township
Website: www.ccsem.org

(586) 412-8494

Goldenberry Adult Day Caring Center, Clinton Township

Website: http://mca.macombgov.org/MCA-Seniors-DayServices

 (586) 469-5579
St. John Senior Link (888) 751-5465
   
Support groups for caregivers of persons with Alzheimer’s Disease are available free throughout Macomb County at various times and locations.  Support group meeting days and times are subject to change.  For current information, check the Support Group Chapter or call the Alzheimer’s Association, (800) 272-3900.  TTY: (877) 204-6924.

Support groups for persons with early stage Alzheimer’s Disease is available at SarahCare Adult Day Services, 13425 Nineteen Mile Road, Suite 500, Sterling Heights, MI 48313 on the second Wednesday of the month from 6:00 -7:00 P.M. A pre-assessment is required, call (800) 272-3900,  TTY: (877) 204-6924.

Support groups for persons with Alzheimer's disease and their caregivers:


Second Monday of the month starting at 7:00 P.M.                               

Brookdale of Utica
45969 North Pointe Boulevard
Utica, MI 48315

  (586) 997-0955
Second Wednesday of the
month from 10:00 A.M. -
11:00 A.M.

Sterling Heights Senior Center
40200 Utica Road
Sterling Heights, MI 48313
Register at the Senior Center of
online at https://registration.sterling-heights.net/CourseActivities.aspx?id=1002
Second Wednesday of the
month from 6:00 - 7:00 P.M.
(The Early Stage support group for those with Alzheimer’s disease and their Caregivers meet separately.)

SarahCare Adult Day Center - Lakeside
13425 19 Mile Rd.
Sterling Hgts, MI 48313
(586) 731-2273
Second Thursday of the
month from 3:30 - 5:00 P.M.
(Caregiver Support group.)


SarahCare Adult Day Center - Lakeside
13425 19 Mile Rd.,
Sterling Hgts, MI 48313
(Respite Care available)

(586) 731-2273
(Call in advance for respite care)

 

Third Tuesday of the month
at 2:00 P.M.

Village of East Harbor
33875 Kiely Drive
Chesterfield, MI 48047
(586) 725-6030

 

Third Wednesday of the month from 10:00 - 11:30 A.M.


Arden Courts Alzheimer’s Assisted Living
11095 E. 14 Mile Rd.
Sterling Heights, MI 48312
(586) 795-0998
Third Tuesday of the month at 2:00 P.M.


 

Memory Café at the Graubner Library
65281 Van Dyke
Washington, MI 48095
(The Memory Café is a place where anyone with or concerned about memory loss, along with their family, friends or care partner come together to remain
socially active. The café is open to those in all stages of dementia.)

Pre-registration required. For
more information or to register,
call the Alzheimer’s Association
24/7 Helpline at (800) 272-3900.

Pamphlets, fact sheets, videos, books, etc. on dementia are available from:

Alzheimer's Association, Southfield
Website: www.alz.org/gmc
(800) 272-3900
TTY: (877) 204-6924

A Friend’s House, St. Clair Shores, MI
Website: www.ccsem.org

(586) 412-8494

A Friend’s House, Warren
Website: www.ccsem.org

(586) 759-8700

Macomb Co. Adult Day Care Center, Clinton Township
http://mca.macombgov.org/MCA-Seniors-DayServices

(586) 469-5579

St. John Senior Link (888

(888) 751-5465

Counseling for older adults experiencing family, social, or emotional problems is available from:     

Alzheimer's Association, Southfield: (800) 272-3900 (24 hour for Caregivers), TTY: (877) 204-6924

In a mental health emergency, call the Macomb County Crisis Center, (586) 307-9100 or (855) 996-2264 (Toll free). The client will be directed to either services through the Community Mental Health network or to the nearest Emergency Room. 

At the hospital, staff will assess the immediate need and obtain authorization for the appropriate level of care. Treatment may be provided in an inpatient unit or in an alternative community setting, according to best practice guidelines, Macomb County Community Mental Health or hospital policy, and the situation. 

For other emergency situations, or after regular business hours, contact the Macomb County Crisis Center, (586) 307-9100. (TDD: Tap the space bar after dialing the number.)

Mental Health Assessment Services are available for persons through Macomb County Community Mental Health - outpatient sites. Services include: assessment of the problem, insurance, and referrals to an appropriate agency, based on needed level of care, type of insurance and location of service.  Macomb County Community Mental Health receives referrals through its Access Center.  

 CMH Access Center

(586) 948-0222

8:30AM-5:00PM M-F

Agencies are asked to contact the CMH Access Center to discuss service responsibilities prior to referring the consumer. Provider line to the Access Center: (586) 948-0206.

A program of services (personal care, homemaking, respite, adult daycare, transportation, home-delivered meals, counseling, medical equipment and supplies) for eligible Medicaid recipients (18 years or older with a disability, and who medically qualify for nursing home admission (e.g., personal care, respite, medical supplies and equipment) to assist frail adults to remain living independently. (This service may have a waiting list).  For more information about the MI-Choice program, call:     

Easter Seals/Macomb Oakland Regional Center
Will help with application, eligibility, and in-home assessment 
(586) 263-8700
Area Agency on Aging 1-B
Will help with application, eligibility, and in-home assessment
(800) 852-7795

Free to low-cost medical services including treatment for acute illnesses (colds, ear infections, bronchitis, rashes, cuts); women's health (gynecological physicals, family planning, sexually-transmitted-diseases); treatment for chronic illnesses (high blood pressure, diabetes); employment and school physicals: referrals to other services.  Service is available for persons and families of all ages, economically disadvantaged, persons with no medical insurance.  Available from:

Medical Outreach Clinic (MOC)

A 40-foot vehicle from McLaren Hospital Macomb transports medical staff and equipment to various locations in the County. It operates most Tuesdays and Thursdays.

A schedule of the van’s locations is posted at:  https://www.mclaren.org/main/macomb-medical-outreach-clinic or call (586) 493-3640 (answering machine).

Free preventive and primary medical care is available for individuals without any medical insurance at all. To prove eligibility, bring latest income documentation, a picture ID and a Social Security card to one of the locations.  

Services include an initial consultation, necessary medications, and follow-up care by appointment. 

If a patient's needs cannot be met by the van, they are referred to one of the hospital's resident clinics (orthopedics, surgery, and OB/GYN) or another physician affiliated withMcLaren Hospital.

(586) 493-3640
Neighbors Caring for Neighbors Clinic at Samaritan House
15420 19 Mile
Clinton Twp., MI 45038
Clinic Hours: The clinics are open on varying dates and times, depending on community need, staffing availability and a number of other options. Appointments are preferred.  Walk-ins are accepted for urgent problems only. (586) 263-3400

Trinity Community Care Clinic
47511 Van Dyke
Shelby Twp., MI 48317

Trinity Community Care provides free medical care to those who cannot afford it.

Open on the third Sunday of the month from 12:00P.M - 4:00 P.M.  Call for an appointment.

(586) 649-3014
(LM for call back)

Assistance with locating programs which help with prescription drug costs is available from a number of community resources.  For a referral to these programs or eligibility criteria, contact:  

Office of Senior Services, (586) 469-5228      
Area Agency on Aging (800) 852-7795
TTY: (877) 204-6924

A search engine designed to help patients, caregivers and health care providers learn more about the resources available through the various biopharmaceutical industry programs. MAT is not its own patient assistance program, but rather a search engine for many of the patient assistance resources that the biopharmaceutical industry offers. https://medicineassistancetool.org/ 

Recipients of Medicare from Social Security can enroll in Medicare Part D (prescription drug benefit). Low income persons below 150% of poverty can receive “extra help” from Social Security, (800) 772-1213, at a reduced or no premium.  For advice about which provider to choose, call the Area Agency on Aging - Medicare/Medicaid Assistance Program, (800) 803-7174 or the Department of Senior Services (586) 469-5228 or Social Security (800) MEDICARE (800) 633-4227, or see www.medicare.gov

Prescriptions mailed to your home for persons in Macomb County age 18 and older who do not have prescription drug coverage and earn $21,780 or less per year (individual) or earn $29,420 or less per year for a couple (add $300 per dependent) - and not currently enrolled in Medicaid.  Prescriptions are mailed to your home.  There is an $8.30 co-pay per prescription.  Call for an application and information.  Available from World Medical Relief, (313) 866-5333.  E-mail:  info@worldmedicalrelief.org/local-programs.  Website:  http://www.worldmedicalrelief.org/

Prescriptions for veterans with a service-connected disability (if unsure of eligibility, contact the Health Benefits Department) is available from Veterans Administration Benefits through the Detroit VA Medical Center, (800) 511-8056.

A ninety (90) day supply of 125 medicines for $20, $30 or $40.  Often prescription drugs not available in other programs are included here.  Available from Rx Outreach, (800) 769-3880.  Website:  http://www.rxoutreach.com

Free medical care and medications to low-income, uninsured persons is available from the Medical Outreach Clinic. Website: https://www.mclaren.org/main/macomb-medical-outreach-clinic 

A free online directory of organizations that loan home medical equipment for free or at low-cost is available from the Great Lakes Loan Closet, www.LoanClosets.org

Free loan of medical equipment such as walkers, wheelchairs, crutches, three-pronged canes, tub seats, etc. to senior citizens aged 60 and older is available from Office of Senior Services, (586) 469-5228.

Loan closets of medical equipment (wheelchairs, canes, crutches) are sometimes available at fire departments, city offices, and fraternal orders.  Contact those organizations in your community.   Also referrals  to loan closets and durable medical equipment suppliers are available from the Area Agency on Aging 1-B, (800) 852-7795.

A free online directory of organizations that loan home medical equipment for  free or at low-cost. Available at www.LoanClosets.org

Mass transit for citizens by SMART bus services. Exact fare tickets and monthly (unlimited rides) cards may be purchased through SMART or at participating banks and select outlets.  Aides on duty with persons with dementia ride FREE (must be ADA Certified).  For more information call Suburban Mobility Authority for Regional Transportation (SMART), (866) 962-5515.  Website:  www.smartbus.org

Transportation for income-eligible residents to essential locations such as hospitals, doctor's offices, DHS, etc.  Rides must be scheduled in advance. Available from Macomb Community Action Centers:

Central Community Action Center

Mt. Clemens

(586) 469-6964

North Community Action Center

New Haven

(586) 749-5146

South Community Action Center

Warren

(586) 759-9150

Information and referrals to transportation resources in SE Michigan is available from the Area Agency on Aging 1-B, (800) 852-7795.

Enrollment of persons who wander in a national search database to provide quick and easy reporting and identification to local police departments of persons who have wandered away.  For more information about the "Safe Return" program, call the Alzheimer's Association,  (800) 272-3900 or “MedicAlert Safe Return” (888) 572-8566.  Website:  www.medicalert.org

An emergency response system for persons who may fall or need emergency assistance in their home involving the installation of a system to the telephone. The client wears a neck pendant or wrist band with a button that can be pushed.  When the button is depressed, a network operator speaks to the client over a loud speaker attached to the telephone. If there is no response, their contact person is immediately notified.  An emergency response system is available to all persons from (prices subject to change):

American Red Cross Lifeline (800) 959-6989

$29.99 (landline) - $41.95 (wireless) Call for all options.

Guardian Medical Monitoring

(888) 349-2400 Call for pricing

Life Station Medical Alert

(866) 516-3441

$25.95/month if paid annually, $27.95 if paid quarterly and $29.95 if paid monthly.

Adult day care and activity services for Macomb County residents aged 55 and older with physical, mental/emotional impairments or social isolation are available from the following Macomb County centers:

A Friend's House - St. Clair Shores: (586) 412-8494, ext. 4014

Eligibility:
- Adults with dementia or cognitive disorders or injuries who require constant supervision
- Adults in need of environmental supervision in home by family or caregiver
- Must be able to move from a wheelchair with one person assisting
- Must be free from infectious disease

Services offered: Nursing services, medication administration, toileting assistance, incontinence care,  personal care (bathing), lunch, morning and afternoon snacks, exercise, group discussions, crafts, recreational activities, cooking activities, inter-generational activities, pet therapy, occupational therapy, consultation services, home safety and independent functioning assessments, field trips, monthly caregiver and Alzheimer’s support groups, social work services, individual and family counseling. Offer caregivers resources and education and referrals to other services.  Wheelchair Accessible Transportation is available within a 15-mile radius of the facility.

Cost: Services provided based on ability to pay.

Hours:  Monday - Friday, 8:00 A.M. - 6:00 P.M.  Periodic Saturday services also available.

Goldenberry Adult Day Caring Center, Clinton Township: (586) 469-5580

Eligibility: Persons 60 years of age or older with:

  • a diagnosis of dementia or related illness
  • persons affected by social isolation and are in need of a safe environment and structured activities

Services offered:  Morning and afternoon snacks, full lunch, activities, and exercise. Lift-equipped transportation is available within a 15-mile radius. Personal care (bathing) is available on site for an extra fee.

Funding assistance may also be available through Veteran’s Administration and Area Agency on Aging 1-B for those who qualify.


Hours: M-F 7:30 A.M. to 5:30 P.M.

Tours available without an appointement

Free 4-our trial visit available with 48 hour notice

 

FOR A LIST OF ADULT CARE CENTERS IN COMMUNITIES SURROUNDING MACOMB COUNTY, CALL THE OFFICE OF SENIOR SERVICES, (586) 469-5228, THE ALZHEIMER’S ASSOCIATION AT (248) 272-3900 OR THE AREA AGENCY ON AGING 1-B, (800) 852-7795.

A program of services (personal care, homemaking, respite, adult day care, transportation, home-delivered meals, counseling, medical equipment and supplies) for eligible Medicaid recipients (18 years and older with a disability, and who medically qualify for nursing home admission, e.g., personal care, respite, medical supplies and equipment) to assist frail adults to remain living independently. (This service may have a waiting list.) For more information about the MI-Choice Program, call:    

Macomb Oakland Regional Center   

(800) 236-3202

Area Agency on Aging 1-B

(800) 852-7795
TTY: (877) 204-6924

Immediate short-term homemaking and personal care assistance for persons 60 years or older following a hospitalization. Available from the Area Agency on Aging, 1-B (800) 852-7795 and ask to speak to the Community Living Program.  

Assistance with all activities of family living for elderly or disabled adults who are eligible for Medicaid.  Available from the Department of Health and Human Services Home Help program:

Department of Health and Human Services, Mt. Clemens
 
serving Chesterfield, Clinton Twp., Harrison Township, Mt. Clemens, New Baltimore, St. Clair Shores

(586) 469-7233

Department of Health and Human Services,  Sterling Hgts.
serving Armada, Chesterfield (not 48051), Lenox, Macomb, Memphis, New Haven, Ray, Richmond,
Rochester (48306), Romeo, Shelby, Sterling Heights, Utica and Washington

(586) 254-8006

Department of Health and Human Services, Warren
serving Capetown Housing Unit - SANG Base, Center Line, Eastpointe, Fraser, Warren, Harrison Twp.,
Roseville, and St. Clair Shores

(586) 573-2352

Homemaking services are available from:

Macomb County Interfaith Volunteer Caregivers

(586) 757-5551

Area Agency on Aging 1-B

(800) 852-7795
TTY: (877) 204-6924

Alzheimer’s Association

(800) 272-3900

Legal Hotline for Older Michiganians: (800) 347-5297

Michigan Law for  Everyone by Sherry A. Wells, J.D. is a book which provides information on landlord-tenant, contracts, real estate, divorce, juvenile law, guardianships, insurance, accidents, unemployment, small claims courts, wills and probate, business law, workers compensation, how to find an attorney, attorney fees, examples of laws and legal forms. Available at bookstores.

Free or minimal cost legal advice by telephone provides legal advice except for traffic violations or misdemeanors. Available from Legal Aid and Defender Association in Wayne County, with an office in Macomb County.  Toll-free number:  (877) 964-4700.

Referral to area legal resources including elder law attorneys is available from the Alzheimer’s Association, (800) 272-3900.

Referrals to attorneys who practice elder law is available from Macomb County Bar Association (586) 468-8300.           

Referrals for legal assistance for older adults is available from the Area Agency on Aging 1-B, (800) 852-7795.

Small group instruction or one-time presentation on basic nutrition, food buying and preparation skills, meal planning and budgeting - EFNEP  is for limited-resource adults who are responsible for planning, shopping and preparing food for children in their household, individuals and families who are expecting a child or adults who care for children on a regular basis (grandparents). Available from the MSU Extension - Expanded Food Nutrition Educational Program (EFNEP), (469) 469-5816.             

Emergency Food is available through various food pantries in Macomb County.  The criteria to access the Macomb Food Program requires only that a person be a Macomb County resident and have an emergency need for food.  The person in need of emergency food must call United Way information/referral 2-1-1 or (800) 552-1183.

Congregate Meal sites are available around Macomb County, for more information call the Office of Senior Services, (586) 469-5228.            

Home-delivered meals are available for seniors unable to leave their home.  For more information call the Office of Senior Services, (586) 469-5228.

Immediate short-term homemaking and personal care assistance for persons 60 years or older following a hospitalization. Available from the Area Agency on Aging, 1-B, (800) 852-7795 and ask to speak to the Community Living Program. 

Relief breaks for full-time family caregivers of elderly or disabled adults, excluding personal care, from volunteers matched with families throughout Macomb County is available from Macomb County Interfaith Volunteer Caregivers,  (586) 757-5551.  Office hours Monday - Thursday 9:00 AM - 4:00 PM.  Office is closed on Fridays, Weekends, and Holidays.

Twenty four (24) hour caregiver in a licensed foster care home twice a year for up to two weeks per reservation is available for persons who caring for someone age 60 or older.  Available from the Area Agency on Aging 1-B Out-of-home Respite (OHR) Program, (800) 852-7795.

A database to find and compare Medicare-certified nursing homes based on a
location, compare the quality of care, and their staffing:
https://www.medicare.gov/care-compare/?redir=&providerType=NursingHome 

Information on nursing homes, including formal complaints, is available from Alzheimer’s Association, (800) 273-3900.

Information and lists of nursing facilities and private and licensed assisted living facilities in SE Michigan are available from the Area Agency on Aging 1-B, (800) 852-7795.

If a family wishes to proceed to a formal complaint, formal complaints of abuse or neglect in nursing homes, homes for the aged, hospitals, home help agencies and hospices are reported to the Bureau of Health Care Services (BHCS). Call the toll free Complaint Hotline at (800) 882-6006.

Investigation of complaints of abuse and/or neglect of elderly persons is available from the Department of Human Services - Adult Protective Services Division:  

Regular business hours

Department of Health and Human Services - Adult Protective Services Centralized Intake:  (855) 444-3911 (Toll free Number, available 24/7)

Emergency Situation

Call your local police department.

Hospice services are available from: 

Great Lakes Caring - Clinton Township (586) 468-8580
Heart to Heart Hospice (586) 255-5520
Henry Ford Hospice and Palliative Care - Macomb Team (586) 276-9555

Hospice of Michigan

(586) 263-8854

McLaren Visiting Nurse and Hospice (586) 323-6290

Reverence Home Care and Hospice

(800) 248-2298

  • CHECKLIST TO EVALUATE IF MOM AND DAD CAN STILL LIVE AT HOME

As people age, they can develop difficulties performing everyday activities. This checklist can help families determine what resources might be appropriate now and help prepare for the future. For further help, consult a physician, geriatric-care manager, county social service department or other professionals. For each task below, check the one description that best fits the situation of the person you are concerned about. Add the numbers to get a score, then find the recommendation for that score on the next page.

Maintains Home/Lawn

  • Without assistance (1)
  • With some assistance (2)
  • Needs total assistance (3)
  • Lives in apartment or other maintained housing (1)

Does Housekeeping/Laundry

  • Without help (1)
  • With some help or reminding (2)
  • Needs total assistance (3)
  • Hires outside agency (1)

Recognizes Strangers

  • Able to recognize strangers and seek help (1
  • Unable to recognize strangers or seek help (3)

Handling Emergencies

  • Independently able to get emergency help (1)
  • Needs guidance and instruction (2)
  • Unable to get emergency help (3)

Driving

  • Drives or is able to use public transportation (1)
  • Doesn’t drive or needs help with transportation (2)
  • Needs special van for transport (3)

Social Activities

  • Independently arranges and attends social activities (1)
  • Needs help making social arrangements and getting transportation (2)
  • Unable to participate in social activities without direct help (3)

Managing Finances

  • Independently manages finances (1)
  • Needs some help (reminding, writing out checks, reviewing mail) (2)
  • Unable to manage finances (3)

Getting Groceries

  • Able to get or arrange for groceries (1)
  • Needs help (2)
  • Unable to get groceries (3)

Preparing Meals

  • Prepares meals without assistance (1)
  • Needs help (2)
  • Unable to prepare meals (3)

Eating

  • Feeds self without help (1)
  • Needs supervision or reminders (2)
  • Unable to feed self (3)

Recognizing Surroundings

  • Always alert and oriented to date, time, and place (1)
  • Intermittently confused about time and place (2)
  • Consistently confused about time and place (3)

Keeping Appointments

  • Able to set and keep appointments (1)
  • Needs reminding (2)
  • Needs help to set appointments (3)

Following Directions

  • Able to understand and follow directions (1)
  • Needs to check directions several times before understanding (2)
  • Unable to follow directions even with supervision (3)

Wandering

  • Does not wander (1)
  • Wanders or has gotten lost (3)

Personal Care

  • Independently manages hygiene, brushing teeth, nail care, shaving, hair care (1)
  • Needs reminders to maintain grooming and appearance (2)
  • Needs help to complete grooming (3)

Dressing

  • Gets dressed independently (1)
  • Needs reminders to choose clothing and dress (2)
  • Needs help to dress (3)

Bathing

  • Independently bathes or showers (1)
  • Needs standby help or supervision (2)
  • Needs help to bathe (3)

Continence

  • Continent of bowel and bladder, or uses incontinence products independently (1)
  • Needs reminding to use toilet, or help using incontinence products (2)
  • Unable to use toilet independently (3)

Gait

  • Walks or moves independently (with or without cane, walker or wheelchair) with no falling (1)
  • Has unsteady gait and has fallen in past 6 months (2)
  • Needs help to walk or maneuver wheelchair (3)

Transferring

  • Independently transfers to bed, chair or toilet (1)
  • Needs help to transfer (3)

Medical/Rehabilitation Therapy

  • No need for medical or rehabilitative therapy (1)
  • Has medical needs or therapies and manages them independently (1)
  • Needs intermittent help managing medical needs (2)
  • Needs medical monitoring (3)

Medications

  • Needs no help identifying and taking medications (1)
  • Needs help or reminders to take medications (2)
  • Unable to manage medications (3)
                  

Scoring the Evaluation - What kind of help is needed?

            

SCORE 21-30            

People with this score function independently.  There may be no need for services now, but start exploring options.  Make sure that legal and financial plans are in place. Consider which level of care family members would be able or willing to give, as needs change.

Tips:

  • Talk as a family with your older relative about medical, financial and legal arrangements and personal preferences.  Encourage them to fill out a health-care directive (living will) and to write a will, or to review existing documents.
  • Help older adults do as much as possible for themselves, and recognize your own limitations. That can help them remain more vigorous and alert and help you avoid caregiver burnout.
  • Find out about community resources. Keep a file of articles and advertisements for services. Tour senior housing and assisted-living apartments in the area.
  • Complete a home-safety evaluation to minimize the risk of falls and to improve safety.
  • Review this assessment regularly to track changes.

SCORE 31-50            

People with this score may be unable to complete some important daily activities without help. Consider several options:

  • Community-based services include a broad spectrum of help.  Evaluate whether some of them are practical and affordable. Some seniors qualify for economic assistance through a county social service office. For safety, it may be more difficult for people with memory loss to continue to live at home.
  • As needs increase, cost of services may exceed similar services in residential care homes or assisted-living apartments.
  • Adult day care provides structured activities and meals. Some offer health services and transportation. Most can be attended full or part-time.
  • Companion programs provide in-home visitors who can help with shopping, meals, housekeeping and companionship. They do not provide medical care and usually do not give personal care such as bathing or dressing. Twenty-four-hour care can run upwards of $175 a day.
  • Home health care provides medical care in the home. Services may be provided by a nurse, occupational, speech or physical therapist, or home aide.
  • Assisted-living apartments provide some supervision, 24-hour security and on-site staff. Residents can buy care as needed.  Many units have kitchenettes, but residents may choose to eat in a common dining room.
  • Residential care/memory-loss homes are similar to assisted living, and are designed for people with Alzheimer’s or other memory-impairing illnesses.

SCORE 51-66            

People with this score are unable to care for themselves and have health problems. Some may need rehabilitation and may be able to return home.

  • Nursing homes provide complete personal and medical care for people who are unable to manage independently. That can include short-term rehabilitative services as well as long-term care for  very frail people.
  • Residential care/memory-loss homes are designed for people with Alzheimer’s or other memory-loss conditions. They can work well for people who need supervision but do not need intensive medical care.
  • 24-hour home health services are available to very frail people who prefer to remain at home and receive 24-hour care from a home health agency. This will cost much more than nursing-home care.  Hospice services include medical and social programs for terminally ill people and their families.
Daily Living Alternatives 1 2 3 4
Alertness Consistently alert, oriented, making logical decisions *      
Mild confusion daily. Forgetfulness * * * *
Moderately confused, fearful, poor judgment   * * *
Severely confused, little recognition of family, poor short term memory, agitated at times.       *
Ambulation Totally independent * * * *
Independent with use of walker, cane, or wheelchair, Transfer independently * * * *
Assistance in transfer, ambulation is limited or poor     * *
Unable to transfer, bed bound       *
Meals Self preparation *      
Needs meal preparation   * * *
Needs meals prepared & assistance/encouragement to eat   * * *
Assistance with feeding/special dietary needs       *
Tube feeding       *
Grooming Self thing, grooming, dressing *      
Standby supervision with bathing, grooming and dressing   * * *
Partial or total care of daily grooming       *
Bowel & Bladder Totally independent * * * *
Occasional incontinency, self managed   * * *
Frequent incontinency requiring assistance       *
Totally incontinent       *
Physical & Stress Self administration daily * * *  
Daily reminders to take medications   * *  
Daily supervision & administration       *
Active in groups, clubs, or hobbies *      
Needs planned activity for stimulation & exercise * *   *
Needs daily physical therapy for strengthening       *
Social Worker and Psychologist available       *
Medical & Staff Weekly or monthly blood pressure check or health screening * *    
Transportation provided to medical appointments *      
Doctor available/on call 24 hours a day       *
Onsite attendants   * *  
Physical, occupational, speech therapies on site       *
24 hour licensed nursing care       *
1 = Congregate Care Community, Full Service Retirement Community, or Independent Apartment Living 
2 = Assisted Living Apartment
3 = Home for the Aged, Adult Foster Care Home
4 = Nursing Home/Rehab Facility, Long-term Care Facility or Extended Care Facility
1 2 3 4

N.B., Other options is to have the senior live at home but use Adult Day Care for daytime caregiving needs, the PACE program or the MI Choice program. (See the Senior Citizens Chapter)