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Home and Community Based Care in Virginia

Virginia Growing Older

Demographic projections show that Virginia’s population is becoming older and more diverse. According to the Virginia Department for Aging and Rehabilitative Services (DARS), of the more than 8.6 million residents in Virginia, nearly 1.9 million are ages 60 or older. By 2030, the population over age 60 is expected to grow to 2.2 million—close to one in every four Virginians or almost 25 percent of the population.

As the ratio of older people to working-age people grows, there will be increasing demands on this younger age group to care for their aging parents as well as provide for their own children.

Family members, friends, and neighbors now provide most of the long-term care for older Virginians who still live at home. Family members also provide care for older adults with disabilities.

Starting Early 

Dignity and quality of life are paramount concerns to seniors and family caregivers as the population ages and the pool of potential caregivers among family members, friends, and neighbors dwindle. All too many caregivers carry the burden alone until they reach the breaking point when they turn to institutional placement as the only alternative for their loved one.

Early involvement with home and community-based services can provide respite for a family caregiver and peace of mind for older adults. These community resurces may also allow an older individual to remain safely in his or her own home for an extended period, even if an assisted living facility or nursing home ultimately becomes the appropriate placement.

Services in Virginia

An array of home and community-based services are provided in every community across Virginia.

  • Emergency response services such as Lifeline allow a senior to call for help at the push of a button 24 hours a day. Falls are a major concern for older adults and, with an emergency response service, a senior does not face the prospect of spending hours, or even days, alone on the floor and in pain.
  • In-home care is also available and may range from companion care (which provides company, light housekeeping, meal preparation, and laundry) to personal care (which includes bathing assistance.) Skilled nursing care is also available in the home and may be paid for by Medicare or Medicaid under very rigid guidelines.
  • Adult day care services are available in many urban and suburban areas of Virginia, with limited availability in rural areas where transportation is more problematic. Caregivers often assume responsibility for a frail senior with cognitive and/or physical limitations that make it unsafe to leave them home alone. Adult day care enables the caregiver to continue to work or to receive respite from the rigors of caregiving. 
    Adult day care is a community-based, comprehensive program that provides a variety of health, social, recreational, and related support services in a protective setting. Adult day care facilities routinely operate from early morning to late afternoon Monday through Friday. However, seniors may utilize the service for shorter time periods if this is desirable or funds are limited.
  • Meals-on-wheels provides nutrition and regular contact to homebound elders who have no family support during the day. This program is heavily dependent on volunteer support to accomplish meal delivery.
  • Home modifications are another key to remaining safely at home for many seniors. Wheelchair ramps, wider doorways, lower counters and grab bars in bath areas can spell the difference in living independently in one's own home or requiring assisted living or nursing home care. In many areas, non-profit organizations, local government agencies and civic organizations provide assistance with home modifications.
  • Check-in services for seniors are available in some areas. A daily telephone call is provided to establish contact and assess wellbeing. A variety of agencies and organizations provide this service, including a growing number of sheriff's departments.

Services are also available to train and educate caregivers on a variety of topics, provide support groups, and counseling on a variety of topics including medical insurance, nutrition, and mental health.  

Finding Services

So, how do you locate and access the services that are available in your community? Your first call for information and assistance should be to your local Area Agency on Aging. There are twenty-five Area Agencies on Aging serving Virginia and Agency names are as diverse as Mountain Empire Older Citizens, Inc. in Big Stone Gap; Jefferson Area Board for Aging in Charlottesville; Fairfax Area Agency on Aging in Fairfax; and Peninsula Agency on Aging in Newport News.

These twenty-five Area Agencies on Aging (AAAs) were established under the Federal Older Americans Act in the early 1970's. The AAAs exist to serve the 60 and over population and family caregivers. AAA staff can also assist seniors and family caregivers by providing a comprehensive, objective assessment to help determine if the senior can continue to safely live at home. If you are not familiar with the Area Agency on Aging serving your area, you may locate them by calling the Office for Aging Services, Division for Community Living at 1-800-552-3402.

It is likely you or your family member will face one of life's most difficult decisions: 'Can I continue to live safely at home?' Remember when that time comes you are not alone and you do not have to wait until you have reached the breaking point.

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