Suchergebnisse

Low-income older adults have historically received institutionally based care when they were unable to care for themselves and there was a lack of sufficient formal and informal support to allow them to remain in their own homes. In 1981, revision of federal Medicaid legislation permitted states to provide home-and community-based services (HCBS) for older adults at risk of nursing facility placement in an attempt to prevent unnecessary placement and to offer choice. However, Medic-aid-HCBS applicants may have to wait up to 45 days or longer for approval of their financial application. During those 45 days, the applicant may enter a nursing facility because Medicaid-HCBS was not available soon enough to prevent placement. This article presents research on an instrument to help case managers initiate community-based in-home services for the lowest-income Medicaid applicants within 3 to 5 days of initial assessment.

The decision to move into assisted living (AL) can be viewed as a life-changing process for older adults and their families; and each may possess differing views of this process. This qualitative study examined the AL decision-making process as described by twenty-two older adult and family member dyads. Participants described emotional and logistical components related to the AL moving decision. Further, fifteen of twenty-two dyads expressed conflicting or differing views of the AL moving decision. Our discussion examines the need for future studies to explore the impact of family and older adult disagreements on the older adult's AL adjustment; the necessity for community-based agencies and AL settings to provide social services over the duration of the decision-making process; and the importance of employing social workers skilled in family practice in the AL setting.