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Long Term Care Services

What is Long-Term Care?

"Long-term care" describes a range of options and resources for older persons and persons with disabilities who need assistance for the rest of their lives. Long-term care options include informal care by family and friends in a person’s own home and formal care by an agency or paid employee. Options also include care in an adult daycare facility, a retirement community, a residential care facility, an assisted living facility, an adult foster home, or a nursing home setting.

OPTIONS FOR LONG-TERM CARE

  1. STAY AT HOME
    Home may be a single family home, an apartment, or a mobile (manufactured) home in a mobile home park. These settings are considered "independent" living because residents must make their own arrangements if they need assistance.

    In apartment complexes or retirement communities designed for "independent, active" elders, some services are often provided to enhance safety and convenience.

    There are several options for seniors who live independently but need some assistance.

  2. Bring Services to the Home
    Arrange for home-delivered meals, cooking, housekeeping help, transportation, personal care such as bathing assistance, and other services that can be brought directly to the home.
    • Modify the Home
      There are two kinds of home modification--safety improvements and accessibility improvements. Safety improvements prevent accidents such as burns or falls. Safety improvements include removing obstacles and safety hazards, and turning down the water temperature. Accessibility improvements make it easier to move about the house and function independently. Examples include grab bars in the shower or bath, raised toilet seats, ramps and widened doorways.
    • Provide Special Equipment
      Adaptive devices are another way to enhance independence. In addition to hearing aids and glasses, these may include canes, walkers, wheelchairs, a mechanical chair that lifts you to a standing position, a personal safety alarm, or a personal identification bracelet.
    • Hire a Caregiver
      Hire a live-in, full-time or part-time caregiver for assistance.
    • Receive Assistance from Family, Friends or Neighbors
      Get a helping hand from nearby neighbors, friends or family. For low income, older adults who are Medicaid eligible, Clackamas County may be able to pay a neighbor, friend or relative for certain types of help. Call CCSSD, (503) 655-8640 for details.
  3. ADULT DAY CARE
    Adult day care is an option for seniors who already have a place to live and assistance some of the time. These elders have caregivers who may be working or need breaks during the day. Adult day care centers provide a place for the seniors and their caregivers to have a break (sometimes called a "respite") from each other.

    Adult day care centers provide meals and stimulating, interactive experiences for older adults. The day care centers vary in the care they offer. Some sites can meet only light care services. Some are able to accommodate individuals who are confused and forgetful.

    In the local area, there are a growing number of day care options. There are several facilities that specialize in adult day care. In addition, some senior centers offer limited day care programs. Nursing homes and adult foster homes may allow families to use their facility as a "drop-in" center. These facilities may be able to provide bathing assistance too. Contact local care and senior centers for information on their programs.

  4. UNLICENSED, SUPPORTED HOUSING
    Supported housing settings, sometimes called congregate care communities, are apartment buildings or clusters of cottages where residents receive help with basic services such as meals, laundry, housekeeping, and transportation. Usually, these basic services are included in the rent. Some facilities offer additional services for extra fees. Supported settings may also advertise as retirement communities but offer more than retirement communities for "independent" seniors.
  5. LICENSED, SUPPORTED HOUSING
    All of the following types of care facilities are licensed; adult foster care homes are licensed by the county, while residential care, assisted living, nursing homes and specialty facilities are regulated by the state. All of these types of care settings provide many services to their residents. Generally, the number of residents, staffing levels, size of the facility and personal space available to the resident are the key factors that differentiate them. The services offered even within a particular type of facility may also vary quite a bit.
    • Residential Care
      Residential care facilities serve seniors and adults with disabilities needing light to moderate assistance. Meals, snacks, housekeeping, laundry, bathing assistance, help with medications and many other services are generally provided by the facility. Bedrooms and bathrooms may be shared or private. Staff is on-site 24 hours a day. Residential care facilities have six or more residents.
    • Adult Foster Care
      Adult foster care homes can serve seniors and adults with disabilities at all levels of need. Residents share a single family home with a live-in caregiver, the caregiver’s family and at most four other residents. Bedrooms and baths may be shared or private. All meals, snacks, housekeeping, laundry and help with personal care and medications are provided. Some homes also provide nursing care. There are more than 150 adult foster homes in Clackamas County.
    • Assisted Living
      Each resident has a private apartment with a fully accessible bathroom, and assistance with meals, housekeeping, personal care and medications is provided. There is staff on duty 24 hours a day. Short term or light nursing care is also offered on-site. Often, the facilities are designed and staffed to help individuals who are too confused to function more independently and safely.
    • Nursing Facilities
      Nursing facilities serve people with serious illnesses and those recovering from acute medical crises who need continuous nursing care or monitoring. Nursing staff is available 24 hour a day. Today, many nursing home stays are temporary. Nursing home care is the most costly type of long-term care.
    • Specialty Facilities
      Some facilities may specialize in serving people with a particular illness, disease or disability. Facilities may provide expert care in Alzheimer’s Disease, mental illness, AIDS, brain injuries or other specific conditions.
  6. CAMPUS OF CARE HOUSING
    Some complexes feature several kinds of supported housing grouped together in one community. Residents may move from one section or building to another as their care needs change. For example, one complex may offer independent living, an unlicensed supported housing option, and a licensed option such as residential or nursing facility care.

    Campus of care communities may offer their services on a month to month rental basis. In certain communities, known as continuing care or lifetime communities, residents pay a large entry or buy-in fee initially as well as monthly fees for services. In return for the large investment, residents receive a guarantee of care usually for the rest of their life. Look for a sign declaring the continuing care community is accredited and read the contract carefully before committing yourself to live in such a community.

Financial Assistance to Pay for Long-Term Care

For information, call your local DHS-SPD office. DHS-SPD Oregon City Office 971-673-7600, DHS-SPD Milwaukie Office 971-673-6600, DHS-SPD Canby 503-263-6700, or DHS-SPD Estacada 503-630-4605. They will be able to assit you with programs such as:

  • Oregon Health Plan (OHP) which provides medical, dental and mental health services.
  • Food Stamps which help with grocery expenses.
  • Medicaid which provides assistance to pay for care in the home or in a facility such as an adult foster home or nursing home. Medicaid also provides comprehensive medical benefits including prescription drug coverage.
  • Qualified Medicare Beneficiary (QMB) and Special Medicare Beneficiary (SLMB) which provide assistance with Medicare premiums, deductibles and co-insurance.

For information regarding Oregon Project Independence (OPI) which provides in-home services such as housekeeping, bath assistance and respite care on a sliding fee scale.  

For information call CCSS, (503) 655-8640

Specialized Information and Referral

Specialized Information and Referral provides telephone or in-office assessments to identify the needs of persons aged 60 years and older or persons 18 years and older who have disabilities. Needs could include: long-term care, financial assistance, in-home support, counseling, and more. Following the assessment, staff members provide information and referral to meet these needs. Information and Referral is also available to the general community on other issues concerning seniors and persons with disabilities.

For information call CCSS, (503) 655-8640.

Preadmission Screening

Preadmission Screening provides an assessment, information on placement options, and referrals for persons who are considering or at risk of nursing home placement. Screenings are usually conducted at the person's residence or in the hospital. Screening includes compiling medical history information and assessing current health status, medical nursing needs and ability to carry out activities of daily living. There is no fee for the service.

For information call DHS-SPD Oregon City Office 971-673-7600 and ask for the Screener.

Long-Term Case Management and Risk Intervention

Case Management services are provided to Medicaid and OPI clients. Case managers are specialists in working with the elderly and/or adults with disabilities. They understand how to identify people's needs, to discuss options, and link people to resources. They also advocate with other service providers to be sure each individual's needs are met as appropriate.

Risk Intervention Case Management works with persons, aged 60 years and older, who are at risk of losing their ability to live independently in the community. People do not have to meet income criteria. A Case Manager works to evaluate needs, discuss options, and provide advocacy for access to financial, and community resources. Referrals to the Risk Intervention Case Manager may come from persons in the community.

For information, call DHS-SPD Milwaukie Office 971-673-6600.