FAQS: Frequently Asked Caregiving Questions Answered

Index of Categories: Scroll down and choose a question category from the list below:

Help for family members caring for older adults 
Includes FAQs on the the Area Agency on Aging, Finding Information, Home Modifications, Programs, Respite, Caregiver Stress, and Veterans.
Drug Assistance and Medical Information 
Includes FAQs on Assistive Devices, Depression, Illnesses, and Medications
General Questions 
Includes FAQs on Geriatric Case Managers, Adult Day Care, Hospice, Home Health Care, Skilled Nursing Care, Non-Medical Companion Care, Long Term Care, and Medicare & Social Security benefits.
Impact of Caregiving on Employers 
Taking Care of Legal Issues 
Includes FAQs on Advance Directives, DNRs, Living Wills, Power Of Attorney, Trusts, and Wills.
Paying for Care 
Includes FAQs on Informal Caregiving, and Medicare/Medicaid.
Assisted Living, Nursing Homes, and other options and Paying for it 
Includes FAQs on Assisted Living, Home Equity, and Home Health.
Long Distance Caregiving (when you live in another community) 
Includes FAQs on Finding Information, and Finding Resources.

Help for family members caring for older adults

Tip: Click on a question for the answer.

Area Agencies on Aging: What is the Area Agency on Aging?
What is 2-1-1?
Area Agency on Aging: How do I find my local Area Agency on Aging?
What is a Family Caregiver anyway?
Finding Information: Where are places I can get information and education to help me as a caregiver?
Programs: Do you have to be a family member to receive help the Family Caregiver programs? 
Programs: Do I have to be poor or low income to get help through the Area Agencies on Aging? 
Veterans: How do I find help as a Veteran?
Respite: How can I get some relief as a caregiver?
Respite: How can I get away from my caregiver responsibilities? 
Respite: What is respite?
Respite: Do I have to be poor to get help with respite? 
Respite: How can I get respite? 
Benefits: How can I receive help when I don’t have any money?
Home Modifications: What kind of furniture is suitable for the older adult , and what are some complaints that the older adult may face with furniture?
Home Modifications: Does the VA offer grants for the repair of homes?
Caregiver stress: What about caregiver stress, how can I cope?

Help for Family Members Caring for Older Adults Answers:

What is the Area Agency on Aging?
A network of 670 Area Agencies nationwide dedicated to addressing the needs of older people and their caregivers. Go tho the following link to find the AAA nearest you: http://www.aoa.gov/eldfam/how_to_find/agencies/agencies.asp.

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What is 2-1-1?
2-1-1 is the national abbreviated dialing code for free access to health and human services information and referral (I&R). 2-1-1 is an easy-to-remember and universally recognizable number that makes a critical connection between individuals and families in need and the appropriate community-based organizations and government agencies. 2-1-1 makes it possible for people in need to navigate the complex and ever-growing maze of human services’ agencies and programs. By making services easier to access, 2-1-1 encourages prevention and fosters self-sufficiency.

Click below to go to the 2-1-1 home page:
http://www.211.org/

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How do I find my local Area Agency on Aging?
Go to the following page and find the initials for state in which you live, click on it, and then choose the county or region in which you live:

Area Agencies on Aging Listed By State

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What is a Family Caregiver anyway?
A caregiver is anyone who helps an older person with household chores, errands, personal care, or finances.  You are a caregiver if you do any of these things. You are a family caregiver if you help someone who cannot or is limited from doing any of these things for themselves.

  • Drive an older family member to and from medical appointments.
  • Communicate with health care professionals.
  • Contact community service organizations such as the Area Agency on Aging, Meals on Wheels, or the Alzheimer’s Association.
  • Help arrange for home health care or hospice services.
  • Assist someone to pay bills.
  • Help someone clean their home or arrange for housecleaning.
  • Do home repairs or arrange for someone else to do so.
  • Do yard work or hire someone else to do so.
Click here to go to module 1 of this online education resource for more information.

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Where are places I can get information and education to help me as a caregiver?
You can find information on this site, which includes nine caregiver education modules (click here for the module list), and multiple pages of information and resource links (click here for the links category page).

You can also contact your local Area Agency on Aging for more information and educational resources. Go to the following page to locate the nearest Area Agency on Aging: http://www.aoa.gov/eldfam/How_To_Find/Agencies/Agencies.asp.

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Do you have to be a family member to receive help the Family Caregiver programs?
No

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Do I have to be poor or low income to get help through the Area Agencies on Aging?
No, persons of any income level are eligible for services.

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How can I get some relief as a caregiver?
Through a respite program. Click here for more information and our list of available programs.

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How can I get away from my caregiver responsibilities?
Through a caregiver respite program. Click here for more information and our list of available programs.

Respite is when someone stays with the care receiver and relieves the caregiver to run errands, conduct business, shop, or to take care of the caregiver themselves.

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What is respite?
Respite is a program designed to provide respite relief for family caregivers to give them well deserved time off for other family or personal interests. Caregivers may be of any age or income, do not have to be immediate family members, and are not required to live in the same household with the older person.

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Do I have to be poor to get help with respite?;
No, persons of any income level are eligible for respite care programs.

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How can I get respite?
Click here for more information and our list of available caregiver respite programs.

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How do I find help as a Veteran?
Click here to go to our Veteran’s Benefits links page.

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How can I receive help when I don’t have any money?
Services from the Area Agencies on aging are almost always free of charge and is not based on the income of the older adult or the family member. Most government services and medication discounts are based on income.

Medicaid is a state and federal cooperative venture to provide medical coverage to eligible needy persons. Go to the health and human services web site for your state and do a search for Medicaid. In Texas, go to
Texas Medicaid Program at http://www.hhsc.state.tx.us/Medicaid/index.html

Also, regardless of where you live in the US, go to Benefits Check Up: http://www.benefitscheckup.org. This is an online service designed to help seniors, their families and caregivers find the right benefits programs to meet their needs.

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What kind of furniture is suitable for the older adult , and what are some complaints that the older adult may face with furniture?
The furniture needs to be higher up–couches are often low and very difficult for an older person to get out of. It is also good if the cushions are fairly firm so they don’t just sink into the couch. Chairs should have arms for the person to push up on.

You may want to consider purchasing the following book, wich includes general information on furniture for elders on pages 93 through104: The Comfort Of Home

Also, click here to go to our Assistive Devices Information and Resources page.

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Does the VA offer grants for the repair of homes?
Yes. They offer purchase, construction, home improvement, manufactured homes, interest rate reduction, and second homes.

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What about caregiver stress, how can I cope?
See the following pages for help to cope with caregiving stress:

Links For The Caregiver 
Caregiver Resources and Information Links

Information on other sites:
www.caregiverstress.com 

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Drug Assistance and Medical Information

Tip: Click on a question for the answer.

Medications: How do I find help paying for medicines?
Depression: How do I know if my family member is depressed and what can I do about it?
Illnesses: Where can I find some quick information on a specific illness such as Alzheimer’s, Stroke, Etc.?
Assistive Devices: What is an assistive device? How can I find them?
Finding Medical Care Specialists: How do I find a physician specializing in geriatrics or working with older adults?

Drug Assistance and Medical Information Answers

How do I find help paying for medicines?
Click here to go to our page of prescription drug assistance links.

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How do I know if my family member is depressed and what can I do about it?
“Behavior and Emotions of Aging” ~ Module 2 (on this site) to read about the signs of, and treatment for depression.

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Where can I find some quick information on a specific illness such as Alzheimer’s, Stroke, Etc.?
Or click here to go to our general medical information and chronic illness links page.

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What is an assistive device? How can I find them?

An assistive device is a tool to help a person do something more easily. Assistive devices are used for many types of activities of daily living (ADLs). ADLs include:

bathing
dressing
eating
grooming
using the toilet
walking
moving in and out of bed or chairs.

Click here for our assistive devices resources links page.

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How do I find a physician specializing in geriatrics or working with older adults?
Go to one of the following links:
http://www.abim.org/dp/apps/physdir1.htm 
Enter your care receiver’s city & state, then check “Geriatric Medicine” & click “Begin Search.”
https://www.abfp.org/diplomate/find.aspx 

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Tip: Click on a question for the answer.

Help: What is adult day care?
Home Health: What is home health care?
Long Term Care: What does long term care mean?
Geriatric Case Managers: What is geriatric case or care management?
Non-Medical Companion Care: What is non-medical companion care?
Hospice: What is hospice?
Skilled Nursing: What is skilled nursing care?
Social Security: Where can a find information about receiving Social Security benefits while living in a foreign country?
Medicare: What is the Medicare Eligibility Tool?
Your question isn’t listed? Click here to submit it.

General Questions

What is Home Health care?
Home health care services cover a broad range of services including: basic care (such as bathing, dressing, etc), and nursing care in the home. In order to be covered by health insurance, most services must be ordered by a physician and must be medically necessary to maintain or improve the health condition. Home health care services are usually provided on a visit basis rather than an hourly basis.

Generally, home health services are initiated when a loved one is no longer able to care for him or herself due to failing health or recent changes to their health. Often a physician, nurse, hospital discharge planner or case manager suggests obtaining professional help at home to assist with health care needs.

Go to the following links for more Information:
www.vnatexas.org

What is adult day care?

Adult day care centers are classified as either “social” or “medical.” Both offer a secure setting for seniors who have physical or mental impairments, meal service, and activities. In addition, “medical” adult day care centers offer:

Meal service.
Medication administration.
Activities.
Nursing supervision.
Since adult day care centers are expensive to run, they are rarely found outside of urban areas.

Go to the following link for more Information:
www.nadsa.org/ 

 

What does long term care mean?
Long-term care includes a range of services to help people with the tasks of everyday life, such as taking a shower or dressing. Care is provided in a number of different ways and settings, from home health care to assisted living centers and nursing homes. It also includes adult day care. Providers range from homemakers to registered nurses and physical therapists.

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What is geriatric case or care management?
Geriatric Care or Case Managers (GCM’s) are social workers, nurses or counselors who specialize in assisting elders and their families to formulate, implement, and monitor long-term care arrangements. Care managers perform one or more of the following activities:

Conduct assessments to identify problems, develop care plans including eligibility and need for care services.
Screen, arrange and monitor in-home health or companion services.
Act as a liaison between elders and family members living at a distance, monitoring their situation and identifying problems.
Transition the elder to a new living situation including a retirement community, assisted living or a skilled nursing facility.
Provide crisis intervention on a 24 hour basis.
Review financial, legal, or medical issues and refer specialists to assist in developing long term financial or estate plans.
Provide independent advocacy to the elder and their family concerning health care products and services.
Offer counseling, support and psychotherapy as may be required · Provide or refer money management services.
Act as or refer conservators of the person or estate.
Provide expertise on quality and availability of resources within the community

Click here for our Geriatric Care or Case Managers links page.

What is the Medicare Eligibility Tool?
Medicare Eligibility and Enrollment information can now be found in the new Medicare Eligibility Tool. This tool includes information on:

Medicare Premiums and Cost,
Initial Enrollment Package,
Special Enrollment Period,
Your Medicare Card, and
Address Change.

Please visit the Medicare Eligibility Tool for detailed information on your Medicare eligibility and enrollment.

What is non-medical companion care?
Non-medical companion caregivers with daily living activities, such as bathing, dressing, going to the toilet, exercising and walking, feeding, meal preparation, taking medications, shopping, and light housekeeping. They also assist with intermittent activities, such as doing errands and making appointments.

More Information:
www.aarp.org/legalsolutions/selfhelp/homecare.html

What is hospice?
Hospice provides compassionate care to people at the end of their lives. Care is devoted to respecting the wishes of the patient and their family. Hospice is based on a holistic approach that provides a wide range of services, including support. The focus of hospice is caring, not curing. Care is provided in hospitals, nursing homes, the patient’s home or hospice facilities. Usually, a physician refers a patient to hospice care within the last six months of life.
What is skilled nursing care?
Although they have traditionally been called “long-term” care centers, skilled nursing facilities today just as frequently provide transitional care. Transitional care is just what it says—interim medical and nursing treatment designed to help people transition back to everyday life following an illness or injury. Most often, that means post-acute care following a hospital visit.
Where can a find information about receiving Social Security benefits while living in a foreign country?
Go to the following page on the Social Security site:
http://www.ssa.gov/foreign/foreign.htm

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Impact of caregiving on employers

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How are employers affected by family caregiving?
What is the cost of caregiving on business?
How much does family caregiving cost society?
Your question isn’t listed? Click here to submit it.

Impact of caregiving on employers

How are employers affected by family caregiving?
Click here to open the Metlife Study of Employer Costs for Working Caregivers.
Note: The above link is to a PDF file, and will open in a new window. You must have the Free Adobe Acrobat Reader software installed on your computer in order to view or print the page.
Click here to download Adobe acrobat Reader.

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What is the cost of caregiving on business?
The estimated cost is between $11.4 and $29 billion per year.
Click below for more information:
AARP Research | Caregiving and Long-Term Care. [link opens in a new window]

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How much does family caregiving cost society?
Costs of care for elders with and without dementia have also been studied, with estimates made of the value of the informal care provided. Several years ago, Massachusetts Elder Health Project (MEHP) data were used to estimate costs of care for community-residing disabled elders (Harrow et al., 1995). The cost of informal caregiving hours was calculated using a market value approach. The costs of formal services were calculated using actual hourly rates for each type of service used.

The total economic costs of community care (both informal care and formal services) were estimated at $9,552/year (in 1991 dollars). About 80% of these costs were for informal care, representing no expenditure of real dollars by individuals or by the government.

As might be expected, cost estimates for informal care of elders with Alzheimer’s Disease are substantially higher, estimated by others in 1991-1992 to be between $43,600 (Max et al., 1995; Rice et al., 1993) and $38,900 (Weinberger et al., 1993). Similarly, from 80-90% of these costs were for informal care. Click here for our caregiver statistical information links page.

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Taking Care of Legal IssuesTip: Click on a question for the answer.

Advance Directives: What is an advance directive?
Wills: How do I prepare a will? 
Power Of Attorney: Where can I find a Power of Attorney for Health Care? 
Living Wills: What is a living will and how can I do one? 
DNR: What is a DNR & how can I get the form in Texas?
Trusts: What is a trust?

Taking Care of Legal Issues Answers

What is an advance directive?
An advance directive is a legal document, such as a living will or a power of attorney for health care. As long as one is well enough, he/she makes medical decisions for his/her self. If one is unable to make or communicate medical decisions, the advance directive legally transfers medical decision-making authority from you to the person designated to make decisions and states end-of-life health care wishes.

Go to the following link for more Information:
www.uslivingwillregistry.com/forms.shtm

How do I prepare a will?
To find downloadable wills and information
WillsAdvanceDirectives

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Where can I find a Power of Attorney for Health Care?
Our downloadable Power of Attorney Forms Health Care Forms are located here.

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What is a living will and how can I do one?
Module 7, Legal & Financial Planning for information on living wills.
Our downloadable Power of Attorney Forms Health Care Forms are located here.

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What is a DNR & how can I get the form in Texas?
DNR is an Do Not Resuscitate type of advance directive that comes into effect when someone is terminally ill (generally means less than six months to live). It describes the kind of treatment the person authorizes in certain situations. For more information go to: Module 7

Do Not Resuscitate (DNR) Form – state of Texas
More information about Do Not Resuscitate Orders (DNR)

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What is a trust?
A trust is a legal relationship whereby one individual (the settlor) transfers his assets (the trust fund) to another individual or company (the trustee) who holds and manages these assets for the benefit of others (the beneficiaries) named by the settlor.

 A trust can be established in a person’s lifetime or on their death under the terms of a will.
The trustee is bound by the terms of the trust deed and governed by the trust laws of the jurisdiction ruling the trust. His responsibilities include providing professional administration and prudent management of the trust assets.
Trusts are confidential, tax efficient and highly flexible financial planning instruments.

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Paying for Care

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Medicare: What does Medicare pay for?
Medicare/Medicaid: What is the difference between Medicare and Medicaid?
Informal Caregiving: What is the policy on getting paid for informal caregiving? Is there any state or local help available?
Your question isn’t listed? Click here to submit it.
Paying for Care Answers:
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What does Medicare pay for?
Medicare hospital insurance (Part A) helps pay for:
inpatient hospital care;
skilled nursing facility care;
home health care; and
hospice care.Medicare medical insurance (Part B) helps pay for:
doctors’ services;
outpatient hospital services;
home health visits;
diagnostic X-ray, laboratory and other tests;
necessary ambulance services; and
other medical services and supplies.
What is the difference between Medicare and Medicaid?
Medicare:
Medicare is a federal insurance program. Medical bills are paid from trust funds which those covered have paid into. It serves people over 65 primarily, whatever their income; and serves younger disabled people and dialysis patients. Patients pay part of costs through deductibles for hospital and other costs. Small monthly premiums are required for non-hospital coverage. It is basically the same everywhere in the United States and is run by the Centers for Medicare & Medicaid Services, an agency of the federal government.Medicaid:
Medicaid is a federal-state assistance program. Medical bills are paid from federal, state and local tax funds. It serves low-income people of every age. Patients usually pay no part of costs for covered medical expenses. A small co-payment is sometimes required. It varies from state to state and is run by state and local governments within federal guidelines.
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What is the policy on getting paid for informal caregiving? Is there any state or local help available?
Funds may be available through your local Area Agency on Aging through their respite programs for caregivers. Each AAA is different but your local AAA may be able to assist you. Call your local Area Agency on Aging or do a site search for the links to Area Agencies on Aging and look for your local AAA. Then call that local number or send an Email through their website. Back to question categories.
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Assisted Living, Nursing Homes, and other options and Paying for it
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Assisted Living: What is Assisted Living?
Home Health: What is home health?
Home Health: How do I pay for home health?
Home Equity: My Mom will soon go into a nursing home, she owns a two family house, and we were told if we rented her apartment, this would help defer the cost of the nursing home, because she would receive Mass Health benifits. She has no liquid assets, just the equity in her home. I have power of attorney, in order to rent out her apartment, it would need remodeling, probably de-leading, plumbing etc. Can I take out a equity loan on her home before she applies for Mass Health to pay for these renovations, and would there be any legal ramifications?Would the state be able to attach onto that money that we used for renovations?
Ombudsman: Ombudsman, what is it?
Your question isn’t listed? Click here to submit it.
Assisted Living, Nursing Homes, and other options and Paying for it Answers
What is Assisted Living?
An assisted living facility or residence combines housing, supportive services, personalized assistance and healthcare designed to meet the individual’s needs on a daily basis.

These needs may include:
Bathing
Dressing
Balancing a checkbook
Medication reminders
Housework, etc.

In many assisted living facilities, 24-hour supportive services are available to meet the planned and unplanned needs of the residents.
Residents in assisted living facilities may have their own rooms, suites or apartments, or they may share their quarters with their spouses or roommates. Unlike independent living facilities, congregate living facilities, shared living arrangements or home health care programs, assisted living facilities provide some level of ongoing supervision of residents and assume responsibility for their well-being. Click here for our assisted living information and resources links page.

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What is home health?
Home health care services cover a broad range of services including: basic care (such as bathing, dressing, etc), and nursing care in the home. In order to be covered by health insurance, most services must be ordered by a physician and must be medically necessary to maintain or improve the health condition. Home health care services are usually provided on a visit basis rather than an hourly basis.

Generally, home health services are initiated when a loved one is no longer able to care for him or herself due to failing health or recent changes to their health. Often a physician, nurse, hospital discharge planner or case manager suggests obtaining professional help at home to assist with health care needs.
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How do I pay for home health?
There are many different types of home health services available across the United States. These services can be paid for using a variety of sources. Medicare is the primary payer for home health care in America.Other payers for home health care include:
Medicaid
HMOs or managed care plans
Private insurance
Long-term care insurance
Private payment by individualsClick here for our benefits information and resources links page.
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My Mom will soon go into a nursing home, she owns a two family house, and we were told if we rented her apartment, this would help defer the cost of the nursing home, because she would receive Mass Health benifits. She has no liquid assets, just the equity in her home. I have power of attorney, in order to rent out her apartment, it would need remodeling, probably de-leading, plumbing etc. Can I take out a equity loan on her home before she applies for Mass Health to pay for these renovations, and would there be any legal ramifications? Would the state be able to attach onto that money that we used for renovations?
Go to familycaregiversonline.cdmail.biz/aaa_by_state.html for a link to your local* Area Agency on Aging (AAA), then go to their site and look for their phone number, call or or send an Email through their webiste. The AAA provides benefits counseling free of charge, and should be able to answer your questions and/or direct you to other sources of assistance.

* the area in which your elder lives.

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Ombudsman, what is it?
Residents in nursing facilities are among the most frail and vulnerable Texans. At times, they need help to improve their quality of life and care. An ombudsman can provide assistance so all facility residents receive respectful and competent care.

The nursing home industry expanded rapidly after Medicare and Medicaid began in1965. When federal and state regulations could not keep up, problems began to surface. Consumer advocacy and protection emerged as a major need. Congress amended the Older Americans Act in 1978 to establish the long-term care ombudsman program to serve vulnerable residents in long-term care facilities.

Ombudsman services are available in every state and territory of the U.S. In Texas, the Office of the Long-Term Care Ombudsman operates in the Texas Department on Aging.
Texas Ombudsman Program Philosophy. Persons who are unable to care for themselves are entitled to dependable and consistent care that includes:
A safe and healthy environment;
Satisfaction of nutritional needs;
Medical services, including physical, mental and psychosocial rehabilitation; and
An environment that promotes and maintains the individual’s dignity, self-determination, communication and protection of individual rights.

Overview
The Texas Ombudsman Program advocates for quality of life and care for residents in nursing facilities and assisted living facilities. Federal and state authority mandates ombudsmen to identify, investigate and resolve complaints made by or on behalf of residents and to provide services to help in protecting health, safety, welfare and rights. Information and assistance in choosing the most appropriate living residence is also a valuable service. They often help establish and operate resident and family councils. Individuals receive ombudsman services Texas’ aging network.Certified ombudsmen – staff and specially trained volunteers – serve residents, their families and friends. To promote quality care, the program works with professionals, advocacy and membership organizations that are interested in long-term care and elder rights issues and coordinates with regulatory agencies.
Go to http://www.nursing-home-abuse.com/Regional Ombudsmen.htm to find the ombudsman in your area of Texas. Back to question categories.

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Long Distance Caregiving (when you live in another community)

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Finding Resources: How can I find help when my relative lives in another community? (Local AAA Caregiver assistance)
Finding Resources: What resources are available to me on the internet?
Finding Information: What education and information is available to me as a long distance caregiver? 
Your question isn’t listed? Click here to submit it.
Long Distance Caregiving (when you live in another community) Answers:
A How can I find help when my relative lives in another community? (Local AAA Caregiver assistance)
For long distance assessment tool developed by the AARP go to: http://familycaregiversonline.com/docs/LongDistanceAssessment.pdf
For a resource for locating numerous services, and information go to Elder Care Locator http://www.eldercare.gov/.
To find local resources, go to http://www.familycareamerica.com/ Information and tools that can make long distance caregiving easier.
Enter this site by entering the ZIP code of the area that most interests you and clicking GO.
This will help localize resource listings to that community.
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What resources are available to me on the internet?
This online education and resource tool including a site search where you enter key words or phrases to find information and contact information. If you know the organization or specific information that you need, such as Medicare or the name of a specific illness, go to http://familycaregiversonline.com/family_caregiver_links.htmll and scroll through the alphabetic categories.
What education and information is available to me as a long distance caregiver?

For long distance assessment tool developed by the AARP go to: http://familycaregiversonline.com/docs/LongDistanceAssessment.pdf

For a resource for locating numerous services, and information go to Elder Care Locator http://www.eldercare.gov/

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