About Adult Day Services


Adult day services have been around for about 30 years. A
survey completed in 2001 put the number of adult day care centers at 3,493
nationwide. The survey by Partners In Caregiving also indicated that at least
twice as many centers are needed as are currently available. The National Adult
Day Services Association estimates current numbers of adult day care providers
at around 4,000.

Adult day services offer an ideal alternative to caregivers by providing a
daytime care environment outside of the home. Here is a program where a loved
one could be nurtured, stimulated and provided medical care and at the same time
provide a welcome relief for the caregiver.

It is baffling that such a valuable service goes largely underused by the
public. Six hours a day of adult day services is only about 20% of the cost of
bringing someone into the home to provide services for the same number of hours.
And having a loved one in a protected and stimulating environment can afford
necessary rest to overloaded caregivers. Most adult day services will also offer
a van service to pick up and drop off loved ones at the house. In addition, most
services that have nurses and social workers on staff can provide necessary aid
to those care recipients in need of medical and emotional attention.

Adult day centers have had a difficult time surviving because of public
apathy. In many areas the services would be used but they are simply not
available to families. Medicare will pay for for medical model adult day care
services in lieu of home health services. Hopefully, this will greatly expand
the availability of this valuable service



About Senior Centers

The first Senior Center in the country opened in 1943 in the
Bronx, New York and was called the William Hodson Community Center . By 1961
about 218 senior centers had opened all across the country. The first Senior
centers were operated by cities or nonprofit or religious organizations. Funding
came from government, community donations and fees from people using the
facilities. In the early days some federal funding came from Title XX of the
Social Security act but funding for Title XX has been decreasing and much of
that money today is being used for other programs.

In 1972, the Older Americans Act was amended to provide
funding for senior centers as this was considered to be an important piece of
the aging network. Today, there are estimated to be about 15,000 senior centers
across the country serving about 10 million older Americans annually. About
6,000 of these centers receive part or all of their funding through the Older
Americans Act.

Senior centers act as a focal point for older Americans to receive many aging
services. They are a vital part of the aging network. For Area Agencies on
Aging, the senior center has become a place where many AAA services can be
provided, where outreach and targeting can occur and where feedback can be
received from the elderly. The most common services offered at a senior center

  • Health and wellness programs
  • Arts and humanities activities
  • Intergenerational programs
  • Employment assistance
  • Community action opportunities and social networking opportunities
  • Transportation services
  • Volunteer opportunities
  • Educational opportunities Information and referral
  • Financial assistance
  • Senior rights counseling and legal services
  • Meal and nutrition programs
  • Leisure travel programs

Larger senior centers in major cities may offer additional specific services
because they serve a large and diverse group of patrons. Here are some examples:

  • Education classes, perhaps through a local college
  • Foot care
  • Health clinics
  • Haircuts
  • Daily exercise
  • Telephone friends
  • Support groups for Alzheimer's caregivers
  • Support for Parkinson's disease
  • Low vision and diabetes services
  • Weekly health speakers
  • Grocery shopping
  • Many and varied classes for personal growth and learning
  • Special events and fundraisers such as auctions, raffles, sales, bazaars,
    rummage sales, bingo, special meals and parties, fashion shows and facility

Most elderly people are aware of senior centers in their neighborhoods but
for those who are not familiar with the program, senior centers are listed under
that title in the Yellow Pages.


About Aging Services (Area Agencies
on Aging)

Older Americans Act of 1965

The Older
Americans Act establishes an effective interrelationship between the federal
government, State aging units and local service coordinators called Area
Agencies on Aging. All three centers of service, the Federal, the state and the
local engage in detailed future planning in order to accomplish their jobs.
Input at the local level is received from diversified advisory boards
representing stakeholders in the elder community. Community meetings and
feedback from patrons of senior centers are also used in the planning process.
Over the past 40 years, a great deal of thought and energy and research has gone
into devising a delivery system that is both efficient and cost effective. In
fact, the 29,000 service providers nationwide providing care under the act are
the largest single network of long-term care providers in the country.

Local agencies on aging represent geographic areas in a state that can be
serviced effectively by that local unit. Area agencies on aging normally
contract with local for profit or nonprofit or public providers to deliver
benefits. An agency may be allowed to provide directly, supportive services,
nutrition services, or in-home services if it can prove a case for providing
these services more effectively. An agency may also provide directly, case
management services and information and assistance services depending on the
methods used for such services in that state. Agencies may also use employees
from cooperating or sponsoring counties or cities to staff and administer
programs such as senior centers. Much of the work performed comes from dedicated
volunteers who are both individuals and employer sponsored teams. This entire
aging network system seems to work very well in accomplishing the goals of the
Older Americans Act.


The Administration on Aging
The Administration on Aging
is established by the Older Americans Act as a separate agency under the
Department of Health and Human Services. HHS has the largest single budget in
the executive branch and includes the centers for Medicare and Medicaid services
(CMS) , the FDA, Centers for Disease Control (CDC), the National Institutes of
Health (NIH) and a number of other smaller agencies. The AoA is a small agency
with only about 130 employees and compared to its huge sister agency, the CMS,
its budget is very tiny. The work of the agency is carried out by a staff in
Washington , DC and through 10 regional offices that serve the states,
territories, the district of Columbia and about 250 tribal organizations
throughout the country. The president appoints an Assistant Secretary of the
Administration on Aging to manage its affairs.

The Administration on Aging has guided the development of the national aging
services network that today consists of 56 State units on aging, 655 area
agencies on aging, almost 250 Tribal organizations, 29,000 community-based
provider organizations, over 500,000 volunteers, and a wide variety of national
non-profit organizations. This nationwide infrastructure currently provides a
wide array of home and community-based services to over 8 million elderly
individuals each year, which is 17 percent of all people aged 60 and older,
including 3 million individuals who require intensive services and meet the
functional requirements for nursing home care. It also provides direct services
to over 600,000 informal caregivers each year, who are struggling to keep their
loved ones at home. The national aging network is the largest long-term care
provider network in the country.

The AOA works closely with other agencies in the Department of Health and
Human Services to help formulate and administer programs for the elderly. In
fact over two thirds of state Medicaid programs for home care (home and
community-based waivers) are administered by area agencies on aging.
Investigative and demonstration grants and surveys are often jointly pursued by
a number of agencies in the department.


Area Agencies on Aging -- Purpose and Description
agencies on aging are the designated managers for state service and planning
areas. A service and planning area is a geographic area of the state with more
than 100,000 people and containing a significant number of elderly over the age
of 60 that can be effectively served by the area agency under the Older
Americans Act. The following can be designated as an area agency on aging to
manage a service and planning area:

  • An already established entity that is meeting the requirements of the state.
  • A city, a county, a council of government or a regional planning commission
    in the service and planning area where the elected official in charge has
    designated an agency or office in its government organization to act as an area
    agency on aging.
  • A public or nonprofit private agency in a planning and service area which
    can meet the requirements from the state as an area agency on aging.

Any of these organizations must be able to meet the statutory requirements
and state requirements and operate as an area agency on aging.

In many states, area agencies on aging operate as an office of a county and
county employees are used to run the organization. In large urban areas cities
may manage an area. In areas that are sparsely populated, area agencies may
operate under a regional planning commission or a council of government with
multi-county employees or with a nonprofit company providing the management. A
number of states have chosen to divide their states into multi-county regions or
service areas. Where none of these natural subdivisions fit, a large rural area
may be defined as a service and planning area and receive a suitable name to
identify it. Where county or city governments are unwilling or unable to provide
management, a number of states have chosen to contract with nonprofit
organizations to run those particular area agencies in their states. Of the 655
AAAs across the country, approximately 67 percent are public agencies such as
cities, counties, councils of government or regional planning commissions and 33
percent are private, non-profit organizations.

Area agencies do not always call themselves an "area agency on aging" and may
use other names to identify themselves. Many nonprofits that receive their
operating funds from state aging units typically use their nonprofit name
instead of identifying themselves as an area agency on aging. Large county and
large city AAA's often disguise themselves under government designated aging
departments. States divided into multi-county regions may identify themselves as
region one or planning area 2 and so forth. These many name conventions can be
confusing to the public since using another name may not alert seniors or their
families to the services they would expect under the Older Americans Act,
national aging network. On the other hand, many nonprofit agencies that except
money under the older Americans act and operate service areas are required to
offer the same services as government-sponsored agencies. Here are some examples
of some of the names.

  • Northwest Alabama Council of Local Governments
  • Southern Alabama Regional Council on Aging
  • South Alabama Regional Planning Commission
  • Middle Alabama Area Agency on Aging Central
  • Alabama Aging Consortium
  • Division of Aging and Community Services/Aging and Adult Administration -
    Regions 1 to 8
  • Central Coast Commission for Senior Citizens
  • San Francisco Department of Aging and Adult Services
  • Los Angeles City Department of Aging
  • Los Angeles County Aging and Adult Services
  • Denver Regional Council of Governments Aging Services Division
  • South-Central Colorado Seniors, Inc.
  • Senior Resources
  • Senior Resource Alliance
  • Alliance for Aging
  • Southern Crescent Region
  • Metro Atlanta Region Commission
  • Heart of Georgia Region
  • Chicago Department on Aging
  • Northwest Indiana Community
  • Action Corp.
  • REAL Services, Inc.
  • Aging and In-Home Services of Northeast Indiana, Inc.
  • Senior Spectrum
  • (and the list goes on and on)

The older Americans act funding is not the only source of money for area
agencies on aging. Agencies may also manage other government programs such as
Medicaid waivers for home care, social service block grants, transportation
programs and other state home care service programs. Currently about two thirds
of all Medicaid home and community waivers are managed by area agencies on
aging. Many agencies may have 10 or more different government funding sources
for programs under their management. Nonprofit organizations acting as area
agencies on aging may also be receiving community donations as well. And on the
other hand many nonprofits who are not area agencies may be accepting funding
under the older Americans act to furnish programs such as community meals or
homes served meals.


About Seniors Relocation and Real
Estate Services


As people age, they often become overly attached to their
homes and even though there may be compelling reasons to find other living
arrangements, these folks will go to extreme lengths to remain in their homes.

Notwithstanding the affection for their dwellings, there is
oftentimes undeniable pressure for seniors to move out and into a different
living arrangement. Consider the following:

  • The challenge of maintaining a yard and providing upkeep has become too
  • There is a need for long term care that can't be handled in the home.
  • The older person needs supervision that can't be provided in the home.
  • The neighborhood has deteriorated and safety is a concern.
  • There is a desire to be near children or grandchildren (70% of those 65+
    live within 1 hour of a child).
  • The home cannot accommodate disability needs.
  • There is a need to avoid climbing stairs.
  • Assets are tied up in the home and cash is needed through selling the
  • Driving is no longer possible and available local transportation is not
  • There is a desire for a warmer climate, a yearning for new vistas or a need
    for challenging new experiences.

Typically, the thought of giving up their residence, finding
new accommodations, downsizing personal possessions and executing the move can
seem overwhelming to many older people.

Perhaps another obstacle for many seniors, contemplating a
move, is the lack of support or help from family members. In fact, some seniors
have no children. For others, the children are living far away or are extremely
busy with their jobs or their own families. And in some cases -- because people
are living so long -- the children are elderly as well and find it difficult to
help with the move.

This overwhelming pressure and stress relating to moving can
often result in gridlock -- a failure to make any decision at all.

Because many elderly people face such a daunting task with
moving, a growing number of seniors relocation specialists are stepping forward
to provide assistance. These individuals or companies provide or arrange for the
following services:

  • advice and counseling,
  • help with finding new accommodations,
  • downsizing possessions through personal, caring assistance with discarding,
    donating or arranging estate sales,
  • selling the existing property,
  • organizing, arranging and scheduling the move,
  • unpacking at the new location and removing boxes and other debris,
  • setting up and arranging furniture.

And it isn't just the elderly person, contemplating a move,
who is hiring these specialists. Active senior communities, independent living
facilities, nursing homes and assisted living often retain a relocation
specialist to provide advice and arrange services to help seniors with a move.
Family members of seniors have also found it more convenient to hire a
specialist to help their loved ones with relocation.

So who are these companies or individuals who provide seniors
relocation and real estate services?

Seniors Real Estate Specialists
A Seniors Real
Estate Specialist (SRES) is a real estate agent who specializes in helping the
elderly transition to a new location. The specialist has been trained to
recognize the special needs of seniors and understand the various living
arrangements available to older people. Most of these specialists concentrate on
selling the property and do not directly provide relocation services but they
will arrange for companies or individuals or advisors who can provide these
other services.

Senior Move Managers
A Senior Move Manager
is a member of the National Association of Senior Move Managers. These people
often have a background in social work or case management and have experience
working with the elderly. As such, they understand the needs and desires of
seniors. Senior Move Managers can provide or arrange for any needed service such
as counseling and advice, selling property, downsizing or relocating their

Moving Companies
Many independent moving companies
recognize the special needs of seniors and they will provide moving services,
storage and other specialized programs for this unique group of customers. These
companies will often work together with senior advisors and relocation

Specialists with Developers or Senior Communities

Active senior community developers, senior residences and care
facilities have recognized that providing relocation services will help their
clients or residents transition more quickly into the new living arrangements.
This not only relieves the stress on the seniors but also results in less cost
to the providers who might be holding open properties or rooms for a long period
of time -- while receiving no income -- due to the difficulty of selling the old
residence and relocating.

Professional Organizers

Professional organizers -- many of whom are members of the National
Association of Professional Organizers -- have found a unique niche in helping
people reduce clutter in their homes or provide a more efficient office or
living environment. Because of extensive experience in reducing personal
possessions, a professional organizer can be particularly useful in helping to
downsize in anticipation of a move.


Professional or Geriatric Care Managers
managers help the elderly and their families deal with the issues of long term
care. Most care managers also help people, needing long term care, to find
appropriate living arrangements. A natural outgrowth of finding new
accommodations has resulted in many care managers specializing in relocation
services as part of what they do.


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