When you know what support is needed, and who among family and friends can provide help, you and your loved one can begin developing the care plan. Most often, care for an older adult begins in the person’s own home; he or she remains in a comfortable, familiar environment, and retains a measure of independence. This is what is often referred to as "aging in place."

Sometimes a supporting relative or friend will have unique qualifications. For example, if your sister Susie is a freelance writer working from home, she may be the best person to deal with unscheduled emergencies. If Aunt Sally, the nurse, is comfortable talking with the medical community, she might agree to be the medical liaison.

Your plan, of course, depends not only on the needs of your loved one, but also on your specific situation. Options are limited when a friend or relative doesn’t live nearby. For example, if your friend Ellie (who lives 100 miles away) can no longer drive or handle her own housekeeping activities, you have few choices. In such situations, you may be able to assist by asking a friend of Ellie’s to buy the groceries. Perhaps you can arrange for Ellie to employ a house cleaner or other service to do housekeeping tasks.

Home care includes a multitude of medical and personal services provided in your loved one’s own home. Home assistance is available through some hospitals, home care agencies, and public health departments.

Arranging a home and community-based care program requires investigation and organization. The Eldercare Locator Service - 1-800-677-1116 - can connect you with the local Area Agency on Aging, which can provide information on most aspects of home care, including how to find competent caregivers. You may also want to ask for referrals from friends and relatives, physicians, and hospital discharge planners. You will probably have to coordinate services from more than one source.

Finding Community Resources
For additional assistance in locating community resources, check with a local senior center, local volunteer programs, or local and national disease associations such as the Alzheimer’s Association. (See For More Information.) The table below lists types of services available in many communities.

• Supportive services (handyman, chore, personal care, telephone reassurance, friendly visitors)
• Adult day services that provide respite care (i.e., to give family and friends time off)
• Transportation services
• Meals (congregate and home delivered) and nutrition screening and counseling
• Preventive health services
• Home health care
• Hospice care (e.g., local hospitals)
• Nursing and therapies
  

Most of these services are not free, although some may be covered by insurance and/or Medicare. If you are a caregiver, help may be available to you under the National Family Caregiver Program. This program, which is part of the Older Americans Act, provides the following services:

• Information about available services
• Assistance in gaining access to services
• Counseling
• Support groups
• Caregiver training
• Respite care
• Supplemental services
  

Help is available for finding the most appropriate resources through information and referral services like the Eldercare Locator service. Still, finding and coordinating services can be a challenging task. One possible option is to employ the services of a Geriatric Care Manager (GCM). A GCM is often a nurse or social worker who can help assess needs and arrange services for older people. The GCM can make an initial assessment of care needs and suggest options for meeting those needs, including referrals to local resources. This may be especially helpful if your loved one is at home and you are uncertain what he or she needs, or what services are available. You may find a GCM through a local senior center, Area Agency on Aging, an elder care attorney, or a gerontologist. Be sure to check references. Verify that paid caregivers have the appropriate licenses or certifications. Determine the cost for the GCM’s services and find out how they are billed.

Adult Day Centers
These programs are an adjunct to home care. They offer social and health services in a group setting to individuals who are frail, physically challenged, or cognitively impaired. They provide a safe, protective setting during daytime hours. Services may include medical care, rehabilitation therapies, nutrition therapy, and health monitoring. Adult day services are often a cost-effective option. The centers offer a respite to family and other caregivers, helping them avoid burnout and, perhaps, helping loved ones avoid admission to a residential care facility. See For More Information for sources to help locate adult day-care centers in your community.

If your loved one is receiving care through a home care agency or another community resource such as an adult day center, keep the name and phone number of a supervisor available in case you have questions. Also, make certain the supervisor or nurse who will be overseeing your loved one’s care has your phone number should there be an emergency or should any questions arise.