Knowing Your Options for Services: Strategies for Life, Living Well with Vision Loss

Mary Beth Caruso, Certified Vision Rehabilitation Therapist
July 1, 2010

Last month’s column discussed ways, such as participating in training and implementing new methods and adaptations, to help a parent or other loved one to live independently at home.  Safety concerns due to the location, set-up or condition of the home; memory loss or fragile health; on top of the vision loss may prompt thoughts of increased support services or even moving. This can be overwhelming and very confusing! The first step is to become familiar with the variety of options. 

Community options for volunteer or paid support services while living at home can range from:

• transportation;
• to reading of mail;
• to homemaker services (such as cleaning, shopping and laundry);
• to home health care services (such as bathing and dressing);
• to visiting nursing services (for medical monitoring and management);
• to participation in senior center programs (social environment with some classes, recreational activities, trips and lunch programs)
• to adult day activity programs (structured social/recreational programming with higher staff ratios);
• to adult day health care programs (with higher intensity staffing for medical and personal care supports).

Residential options for settings with other older adults are numerous as well. New Lifestyles: The Source for Seniors (www.newlifestyles.com) describes:

• Retirement Homes as “independent living with amenities such as meals, transportation and activities.”  Other names for these may be Senior Housing or Over 55 Communities.  These may be private or public settings.
• Rest Homes as “licensed facilities to provide 24-hour supervision and supportive services for elderly or disabled individuals who do not routinely need nursing or medical care.”
• Continuing Care Retirement Communities “combine independent living, assisted living and nursing in a single setting. Normally requiring an entry fee, offering a living unit, meals, and health care, up to nursing care.” These can be located on a campus type setting, in one facility divided by floors or wings or these may be an established affiliation between an assisted living, nursing home and hospital.

MassALFA (Massachusetts Assisted Living Facilities Association - www.massalfa.org) describes:

• Assisted Living as “a special combination of housing and personalized supportive services in a home-like setting, designed to respond to the individual needs of those requiring help in activities of daily living (ADL), but who do not require the skilled medical care provided in a nursing home…a resident may bring in any services privately, such as hospice or a visiting nurse to provide assistance with skilled care. These private services would be at an extra cost to the resident.”
• Nursing Homes “provide 24-hour skilled nursing, rehabilitative services and extensive nursing assistance or intensive therapies for those who have on-going complex or unstable medical conditions.”

Now is the time to start talking about all of the options for the future.  I have heard of many individuals who have happily stayed in their own homes because they accessed community supports early on.  I have also heard of other individuals, who may have been able to stay in their home longer or in assisted living, but moved directly into a nursing home because they had not explored the myriad of options in advance of a crisis.  

Next month's column will present a quick survey, to inventory skills, interests and assistance needed, as well as general information for a person with vision loss to consider when exploring future living environments.

Perkins Outreach Services for Ages 55 and Older, Outreach@Perkins.org, 617-972-7643.

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