HOME AND COMMUNITY-BASED SERVICES

Back to ACoA Annual Report


Rick and Laura Wilson of Anchorage. Rick has dementia. Laura is involved with Alzheimer's Resource of Alaska in
many ways. (Photo by Clark Misler.)

Eighty percent of all caregiving for dependent seniors, disabled adults, and adults with Alzheimer's disease and related disorders (ADRD) falls on the shoulders of family members and friends. Home care generally saves money when compared to institutional care. However, this incredibly demanding service exacts a social, financial, emotional, and physical toll on caregivers. Home and Community Based (HCB) services offer relief to families who find themselves in the role of caregiver for disabled seniors 60 years of age or older and persons of any age with ADRD. By utilizing HCB services, some family caregivers are able to continue working outside the home. These services also help to alleviate the emotional and financial strain of continuous caregiving. In addition to providing relief to family caregivers, Home and Community Based services allow Alaskan seniors the opportunity to age in place by providing support services for seniors who live alone.

As seniors become more dependent due to chronic health conditions, frailty, or dementia, Home and Community Based services provide essential support to enable those individuals to remain living at home. By blending federal, state, and local funds with Alaska Mental Health Trust funds, as well as client and third-party payments, the Commission provides an optimum of client intensive services for dependent seniors and for adults with Alzheimer's disease and related disorders. Those services include:

Funds for HCB programs are distributed every two (Family Caregiver Program) or three (Adult Day, Care Coordination, Respite, ADRD Education) years through a competitive RFP process. New agencies and programs providing services to previously underserved areas are given priority by receiving extra points on their proposal.

Care Coordination: Care coordination connects clients with support services to enable them to remain living at home or in the community of choice. Through assessments of clients' abilities, health, support structure, and need for assistance, care coordinators develop a network of services, both formal and informal, unique to the specific individual. Care coordinators design plans of care acceptable to the client and family, and assist the client in obtaining the specified services. While receiving care coordination services, the client's situation is periodically reevaluated to assure that the plan of care meets the individual's changing needs in order to remain at home. While grant funded care coordination is limited in Alaska, there has been considerable growth in private care coordination services due to funding from the Medicaid Waiver program.

Adult Day Services: Adult day services, funded by ACoA and located in eleven communities in Alaska, provide structured, therapeutic activity programs for at least five hours per day, three days a week. Some programs also provide extended hours on weekdays and occasional Saturday service. Adult day program participants undergo assessments to determine their social, physical, emotional, and cognitive strengths and needs, in order to develop an individualized plan of activities that will best meet their needs while attending the program. For maximum benefit, most clients attend an adult day program on a regular basis. Adult day services often help stabilize individuals after a health crisis and provide assistance in daily living activities that help to maintain the individual at home and in the community. For persons with ADRD, adult day programs provide an environment that help individuals maintain functioning even while the disease progresses. In addition to providing direct care to the program participants, adult day programs provide respite, education, and support to caregivers.

Respite Care: Respite services provide substitute care for disabled adults to provide intermittent or temporary relief to a primary caregiver, usually a family member. Respite services funded by the Alaska Commission on Aging target persons of any age with Alzheimer's disease or related dementia and persons 60 years of age and older, with physical disabilities or mental health issues, who are at risk of institutional placement. Both the primary caregiver and the care recipient are considered clients of the program and benefit from the services. Services may be provided on either a planned or emergency basis in a variety of settings such as the family caregiver's home, the respite worker's home, a licensed adult foster home, residential care facility, hospital or nursing facility.

Respite service programs in Alaska provide support, relief, and education to families and other caregivers, as well as promote the optimum level of independence and functioning of disabled seniors or persons with Alzheimer's Disease or related disorders.

Workforce shortages and limited funding to recruit, train, and maintain respite workers create obstacles to providing respite services in both rural and urban areas throughout the state.

ADRD Education, Outreach and Family Support: The ADRD Education and Support grant provides funding for services statewide which help identify people with Alzheimer's disease or related disorders (ADRD), educate caregivers and service providers about ADRD, and provide a variety of family support services, such as individual consultations and support groups. Through these funds, the current grantee supports a toll-free phone number that provides recorded messages about caregiving techniques and operates offices in Fairbanks, Anchorage, the MatSu valley, and Juneau that offer local educational workshops and family support groups.

National Family Caregiver Support Program: Nationwide, it is estimated that one of every four persons is providing (or has recently provided) care for a relative or friend age 50 or older. This care may involve running errands, cleaning the home, preparing meals, taking the person to the doctor, helping with bathing or dressing or providing round-the-clock care and supervision. Caregivers often make it possible for disabled adults to remain in their home setting rather than moving into a long-term care facility. Although providing care to a family member can be a positive and rewarding experience, family caregiving can be stressful.

Alaska has recognized the importance of family care and has offered services to benefit caregivers for a number of years. However, until recently there was no comprehensive program for family caregivers. The National Family Caregiver Support Act, part of the reauthorized Older Americans Act, has changed this. This act authorized a variety of services implemented through partnerships between state, tribal, and local governments, both public and private organizations and community service providers to develop programs whose sole purpose is to provide relief from the emotional, physical, and financial stress experienced by family caregivers. Family caregiver programs in Alaska focus their services on the needs of the caregivers in their area and include:

Under the Title III-e of the reauthorized Older American's Act, family caregivers of adults 60 and older and grandparents and relative caregivers of children not more than 18 years of age are eligible to receive support services offered by Alaska's family caregiver programs. This statute requires states to give priority to:

SENIOR RESIDENTIAL SERVICES

Kotzebue and Tanana Residential Facilities were established by legislatively mandated funding. The funds are granted through the Commission on Aging to these two rural senior assisted living residences.

The residents, who are primarily Alaska Natives from rural communities in Alaska, are provided all meals and assistance with their housekeeping. Each resident has a semi-private room and receives 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 45 residents in FY02.

Next Section: Senior Community Service Employment Program
Back to ACoA Annual Report