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Home and Community Based Care services include:

• Adult Day Services
• In-home Respite Care
• Care Coordination
• Alzheimer’s Education and Caregiver Support – statewide

"The Fun and Fitness Kids," led by Laraine Hass, entertain residents at the Friendship Center in Homer. (Photo by Friendship Center Staff.)

Adult Day Services (ADS)

The Alaska Commission on Aging awards grants that help meet the costs of operating 12 Adult Day Programs located in 11 communities: Anchorage (two centers) Bethel, Chugiak, Fairbanks, Homer, Juneau, Kenai, Ketchikan, Kodiak, Nome, and Palmer.

Adult Day Services provide therapeutic and support services at a central location to functionally or cognitively impaired older Alaskans. Services may include exercise programs, reminiscing and memory activities, social and cultural gatherings, as well as assistance with health and personal care. All ACoA grant funded programs provide services five days per week for a minimum of five hours per day. Clients attend ADS programs on a planned basis that is determined by the individual’s needs and abilities. After a comprehensive assessment, the staff, client, and caregivers develop a mutually agreed upon plan of care to meet the physical, social, emotional, and cognitive needs of the client. Everyone then reviews the plan of care at least every six months and makes revisions as needed. The need for ADS services often exceeds available staffing and space. Caregivers receive respite, information, and support services in addition to the direct services provided to the clients attending the programs.

Who is served: Typically, adults attending adult day programs have had a major health crisis. Often this has made it difficult to independently accomplish daily living tasks such as bathing, dressing, eating, and toileting and/or be left alone safely without assistance. Other individuals have experienced a gradual deterioration of their mental abilities due to progressive diseases such as Alzheimer’s disease. ADS programs help people who experience such limitations remain in their communities. For adult children caring for an elderly parent, having an ADS program available may be the critical factor that enables the adult child to continue to work outside the home or to continue caring for the elderly parent. The programs are also a consistent source of stimulation and therapeutic activity for the participants.

During FY00 a total of 466 individuals received 238,923 hours of adult day services in programs receiving funding from the ACoA and other funding sources. Of these individuals:

• 66% had Alzheimer's Disease and Related Disorders (ADRD)
• 27% were ethnic minorities
• 62% had incomes below the federal poverty level
• 41% lived in rural areas

Respite Care Services are defined as planned care, assistance, and activities provided by a trained paraprofessional caregiver to a dependent adult in the client’s home for a scheduled period of time. Occasionally, the period of time may be extended to 24-hour care in either the client’s home or in another residence or facility. Respite care provides the full-time caregiver a crucial break from the relentless demands of caregiving. Respite also allows the dependent adult to benefit from a change of pace from their regular care provider.

Who is served: The ACoA provides grants to support respite services in the following areas through four agencies:

Respite Care Client Profile

In FY00, ACoA grantees provided 108,303 hours of respite services to approximately 404 clients in approximately 75 communities throughout Alaska. Grantee quarterly programmatic reports on 296 client profiles indicate:

• 64% had ADRD
• 37% were ethnic minorities
• 59% lived in rural areas
• 61% had incomes below the federal poverty level

Care coordination involves an in-depth assessment of a person’s needs and resources that leads to linking the client to a full range of appropriate services, utilizing all formal and informal resources, and monitoring the care provided over an extended period of time.

Who is served: A care coordinator interviews the client, the client’s family, caregivers, and medical and social care providers to assess the client’s complex medical/social situation. Based on the assessment, a tailor-made plan of care that includes referrals for services is designed around the individual’s strengths, needs, and desires. The plan is implemented when the client, the client’s family, and caregivers accept it. The care plan is reevaluated at least once per year and more often if needed. A revised plan of care is then designed to meet the client’s changing needs.

As reported by ACoA grantees, 1,229 individuals received care coordination services in FY00 through funding from the ACoA, Medicaid Waiver program, and other sources. Quarterly programmatic reports on 1,089 client profiles indicate:

• 27% had ADRD
• 43% were ethnic minorities
• 47% lived in rural areas
• 73% had incomes below the federal poverty level

In FY00, through a statewide grant from the Commission, the Alaska Chapter of the Alzheimer’s Association (AAAC) provided the following:

• 5057 information and referral assistance calls to individuals seeking phone numbers, local contacts, and other brief information
• 236 individual and/or family consultations to individuals seeking extensive information and requests of a broad or indefinite nature
• 109 support group meetings for caregivers of Alaskans with Alzheimer’s Disease and Related Disorders (ADRD) in 12 communities
• 90 consultations to 70 service providers often involving an evaluation of a client situation and provision of information to paid service providers. AAAC staff gather information on the particular client, the nature of the problem, disease stage, approaches that have been tried, and supports available. Based on this information, AAAC staff provides suggestions for intervention.
• 73 public awareness activities Examples include newspaper articles, public service announcements, newsletters, and public speaking engagements.
• Advocacy for people with ADRD and their caregivers. This may include assisting the family in obtaining services, or working with other service providers to address specific needs of the client that may fall outside the realm of "regular" service delivery.
• Education relating to Alzheimer’s disease or related disorders for caregivers and people with ADRD, and professional training for providers of services. Example topics include current medications and research, disease progression, recreational activities, environmental modifications, services, and communication techniques.
• Quarterly newsletter to statewide mailing list
• Caregiver information system available through an 800 telephone number
• A multi-media lending library that contains ADRD resource information and a speaker’s bureau for community presentations

Residents of Homer Friendship Center picnic on the Kenai River. (Photo by Friendship Center Staff.)

Kotzebue and Tanana Residential Facility grants were established by the Alaska Legislature many years ago. The Commission awards these grants to two regional senior assisted living residences.

Who is served: The residents, who are primarily Alaska Native elders from regional villages, are receiving all meals as well as assistance with their housekeeping and activities of daily living. Each resident has a semi-private room and uses services such as medication monitoring, skilled nursing care, assistance in transferring from wheel chair to bed, dressing, eating and bathing. These two programs served a total of 48 residents in FY00. At the end of the fiscal year, another three seniors were on waiting lists to receive residential services.

Next Section: Senior Community Service Employment Program
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