Massachusetts Senior Care Association

Adult day health programs, also known as adult day care centers, provide supervision, recreation, health and personal care services during the day to older people so that family caregivers can work or attend to other responsibilities. All adult day health programs must meet minimum standards set by the Massachusetts Medicaid program, also known as MassHealth. Adult day health programs are provided either on a private pay basis or through Medicaid.

Adult foster care programs match elders who are no longer able to live alone with families willing to provide room and board and personal care. Families are paid a stipend by MassHealth for elders who are Medicaid-eligible. Some adult foster care funding is also available to pay for assisted living services for people who are clinically and financially eligible through the state’s Group Adult Foster Care Program.

Congregate housing facilities provide a living arrangement in which elders have a private bedroom and share common space with others. Support services are usually available to help elders maintain their independence. Most congregate housing sites are sponsored by local municipal housing authorities or nonprofit organizations. Public congregate housing is partially subsidized by the state or federal government.

Home-based services help individuals live independently at home and are provided by home health agencies, visiting nurse associations and state-funded home care corporations (called Aging Services Access Points or ASAPs). They include:

• Homemaker Services to maintain household functioning by providing help with:
  • Home management, including shopping, meal preparation and light housekeeping.
  • Personal care, including bathing, dressing, grooming and toileting.

• Home Health Services to manage health and medical conditions that can be treated at home. These services are provided by:
  • Home health aides, who provide basic health care services such as personal care, recording temperatures and checking pulses, changing simple bandages, and assisting with self-administered medications.
  • Licensed nurses and therapists, who provide skilled nursing care and therapeutic services.

Home health agencies are certified by the federal Centers for Medicare and Medicaid Services (CMS) through the Massachusetts Department of Public Health to provide basic health care and physician-authorized services. Certification is required to have services covered by Medicare and Medicaid; certification also demonstrates that the agency meets minimum standards for quality.

Hospice care serves patients with a life threatening illness and a life expectancy of six months or less. Hospice care may be provided in the home, nursing facility or hospital, and the hospice team works cooperatively with the patient, family, physician and other caregivers to provide specialized care that is focused on comfort, not cure. The hospice team includes the patient’s physician, hospice medical director, registered nurses, home health aides, licensed social worker, bereavement counselor, pastoral counselor, rehabilitation therapists and volunteers.

Medicare, Medicaid, health maintenance organizations and other private insurance plans cover reimbursement for hospice services. All commercial insurers are required to provide a hospice benefit in Massachusetts.

Resources on hospice care in Massachusetts include The Hospice and Palliative Care Federation of Massachusetts and the Massachusetts Commission on End of Life Care.

Residential Care Facilities (RCFs), also known as Rest Homes, provide housing, meals, 24-hour supervision, administration of medications and personal care to individuals who do not routinely require nursing or medical care. Payment options for RCF care include private pay and government assistance through the Supplemental Security Income Program and the Emergency Assistance to Elderly, Disabled and Children Program.

Respite Care is short-term care provided at home, in a nursing facility or in an assisted living residence to give families caring for elders at home some time off from their caregiving responsibilities. Respite care is primarily private pay.

You may want to think about senior housing if you want to live on your own, but don't want to have all the chores that go along with having a home. It's also a great option for people who want to live in a community with other seniors.

Depending on the community you choose, you can rent an apartment either at the market rate or if your income level applies, a lower rate. They are often specially designed with things like railings in bathrooms or power outlets higher up on the wall. They may also offer a 24-hour emergency call service if residents need help right away. Some places may also offer different kinds of services to the people who live there like meals, transportation, social activities and other programs.