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Hospice agencies provide coordinated care for individuals who have been diagnosed with a terminal medical condition and who want their care focused on comfort, rather than life prolonging treatments. Hospice care is usually provided at home, but also can be provided in Independent Living Communities, Personal Care Homes, Assisted Living Residences, and Nursing Homes. Medicare and many other insurance plans provide hospice benefits.

Personal Care Homes provide meals, 24 hour supervision, and help with activities of Daily Living (ADLs). Some Personal Care Homes have secure units for people with dementia, who may beat risk for wandering out of the facility. Check Keystone Elder Law’s website under “Resources” for additional information about Personal Care Homes. Most CCRCs and some nursing homes have personal care units. They can be identified by checking the “services” for each facility listed in those sections of this directory.

These agencies can bill most insurance companies for the cost of their services. The service must be ordered by a physician and be of an intermittent skilled nature. The types of services provided are skilled nursing, physical, occupational, and speech therapies, social work, and in some cases, home health aides. These services are usually short-term in duration.

Home Care Agencies provide companion and home health aide assistance. Some agencies also provide private duty LPNs and RNs. These services can be provided at home, in Independent Living Communities, Personal Care Homes, Assisted Living Residences, Skilled Nursing Facilities, and hospitals. These services are not normally covered by insurance with the exception of some Long Term Care Insurance coverage. Some agencies employ the caregivers they send out; other agencies use independent contractors to provide care. It is always wise to check the following:

  • Is the caregiver bonded?
  • If the caregiver is hurt while providing care, is he or she covered by Workers’ Compensation? If not, how would that person’s medical expenses and loss of income be covered?
  • Has the caregiver undergone a background check?
  • Who is responsible to report caregiver wages to the IRS?

Skilled Nursing Facilities (SNF), commonly known as “nursing homes,” provide nursing and rehabilitative services for people who are incapacitated and need assistance at various times throughout a 24 hour day. Keystone Elder Law’s website has information on selecting nursing care in the section labeled as “Resources.” In addition to the skilled nursing facilities listed below, all the CCRCs listed in this directory provide skilled nursing care.

The LIFE program also provides skilled nursing care, but does
this by combining services in the LIFE Center with services in the patient’s home.

CCRCs offer multiple levels of care: Independent Living cottages and/or apartments that may or may not include meal plans; Personal Care and/or Assisted Living; and Skilled Nursing care. People who move to a CCRC usually move in at the independent or personal care level, moving to higher levels of care if their health and functional abilities decline. These facilities usually have significant entrance fees and typically are affordable for only ten percent of the population. A distinguishing feature of CCRCs is that they will care for the resident for the rest of the resident’s life, even if the resident runs out of money.

Personal Care Homes provide meals, 24 hour supervision, and help with activities of Daily Living (ADLs). Some Personal Care Homes have secure units for people with dementia, who may be at risk for wandering out of the facility. Check Keystone Elder Law’s website under “Resources” for additional information about Personal Care Homes. Most CCRCs and some nursing homes have personal care units. They can be identified by checking the “services” for each facility listed in those sections of this directory.

Adult Day Programs normally operate during daytime hours Monday through Friday. They provide a meal at noon, socialization, and activities for adults who require supervision or assistance during the day. They help working families to be able to keep an elder family member from being placed in a care facility, and they provide respite care for caregivers at home. Some programs have financial assistance available through their local Aging Office.

This service is for people who are homebound and can no longer prepare their own cooked meals. Meals are usually delivered during the middle of the day. Some areas have Meals-on-Wheels programs which pre-date the establishment of Aging Offices. Where Meals-on-Wheels is not available, the local Aging Office can usually arrange for home delivered meals or for help with meal preparation.

There are a number of subsidized apartment buildings for senior adults and disabled individuals. Some of these are managed by county and city housing authorities, and some of them are managed by private groups which have a contract with the federal government, usually Housing and Urban Development (HUD). A complete listing for any county can be obtained by contacting both the appropriate Housing Authority and the Aging Office for that county.

These offices help people with applications for and questions about Social Security (SS), Social Security Disability (SSDI), Supplemental Security Income (SSI), Supplemental Security Income Disability (SSIDI), and Medicare.

Information for all offices: www.ssa.gov

Veterans Affairs Offices are not part of the Veterans Administration (VA), but they assist veterans with information about VA benefits. They also help veterans to apply for these VA benefits. If your assets exceed the amount allowed by the VA, contact Keystone Elder Law to learn about options you may choose to qualify for benefits. The AARP Bulletin of October 1, 2010 explains that is usually unwise to purchase an annuity as a means to qualify for a VA enhanced pension because doing so places a disproportionate percentage of one’s assets in a situation of probable penalty if nursing care becomes needed unexpectedly. Keystone Elder Law P.C. can explain this and offer other options.

LIFE is a managed care program providing a comprehensive all inclusive package of services to enhance the ability of seniors to live in their homes and communities with dignity and independence. LIFE includes many elements of the traditional health care system, providing access to the full range of preventive, primary, acute, and long-term care services, and is coordinated by an interdisciplinary team. Services are provided primarily in the LIFE Center supplemented by in-home and referral services according to a participants needs. Nationally, this program is known as the Program of All-inclusive Care for the Elderly, but to avoid confusion with another program PA has
renamed the federal program as LIFE.

The following links have a variety of information on issues, resources, and services for senior citizens and caregivers.

The services in an Independent Living Community vary. Some provide an apartment setting. Others include housekeeping and linen service, and some include from one to three meals per day. None of them provide help with activities of daily living such as bathing or dressing. However, residents of these facilities who need this assistance may be able to remain in Independent
Living Communities by obtaining this help from a home care agency. Most CCRCs and some Personal Care Homes provide Independent Living. They can be found by checking “Services” for each facility found in those sections of the directory.

Transportation for seniors is offered by counties in different ways. In some counties, transportation is handled by the Aging Office. In other counties a separate, county transportation department has been established. Some counties contract with established transportation companies to provide services to seniors. Transportation services are designed to help people to get to shopping areas and to appointments at doctors’ offices, government agencies, and social service organizations.

These centers provide a variety of social, recreational, and educational activities for older adults. Some centers are part of the Congregate Meal Program which provides a hot noon meal at the center. Some centers have their own transportation service.

Community Organizations and Agencies are groups that provide information, referrals, support services, counseling, and research toward a specific cause such as cancer, diabetes, Alzheimer’s, heart health and more. These agencies can assist you in knowing where to start when you or a loved one is facing any of these causes. There are a number of organizations in the area. Contact one or multiple for guidance on your situation.

As our objective is to provide a comprehensive list of services and organizations for older persons in the area, we do discover organizations as we search. This is a newer category that we created to feature grocery shopping assistance companies in the area. These companies assist with shopping for food and other items at local supermarkets which we know can sometimes be difficult for older individuals.

As we strive to give the most comprehensive list of services in the area, we continually discover new services and organizations. We have had the pleasure of meeting and working with organizations dedicated to assisting older persons with making transitions. Whether you need assistance clearing out a room in your home, or with moving into a loved one’s home, or facility, the organizations listed in this category are here to help.

For medical emergencies, call 911.

The Capital Region is fortunate to have a number of good hospitals. There are three basic types of hospitals in the Capital Region: Acute Care, Rehabilitation, and Long-term Acute Care Hospitals. Acute Care Hospitals provide medical and surgical services and all of the acute care hospitals in the Capital Region have Emergency Departments.

If there is a medical emergency or if someone is in imminent physical danger, call 911.

Elder Law focuses on the legal issues commonly faced by older individuals. This includes basic documents (will, financial power of attorney, living will, and healthcare power of attorney), estate planning to preserve assets, plan for care, how to qualify for public benefits such as Medicaid or Veterans benefits and, in the future, minimize probate costs and inheritance tax after passing. In a perfect world, all laws and regulations would work together and complement each other’s processes. Unfortunately, as we all know, our laws and regulations often do not work together creating a tangled system that can be difficult to navigate and reach the best scenario for your situation. Elder Law attorneys understand these complexities and knows how to work through them to help you achieve your goals.