Care Management

In-Home Assessment

You are not like anyone else, and neither are your needs for care. When you call Seniors•At•Home, we will provide you with a personalized intake interview  to ensure that we understand your needs. Our intake specialist will listen to your concerns and work with you, your loved one, family, and medical providers to evaluate your options.

Seniors•At•Home services are flexible, and we are available to provide ongoing care management, as well as short-term senior care consultations, to help you address issues of aging and long-term planning, either in your home or at our offices.

At your convenience, a Seniors•At•Home geriatric care manager will visit your home to review those aspects of your residence and lifestyle that affect  your ability to live a safe, healthy, independent life. Together we will examine your:

• Physical and emotional health
• Social activities
• Home safety and maintenance needs
• Needs for transportation, housekeeping, meal preparation, running errands, bathing, dressing, etc.
• Financial resources and need for assistance managing finances

Plan of Care

Once the in-home assessment is completed, your care manager will work with you to prepare a personalized plan of care. This care management plan, which we will review together:

• Outlines specific areas of concern we have identified
• Recommends actions that will address these concerns
• Establishes a timeframe for implementing the plan of care

Implementing the Plan

Seniors•At•Home helps to fulfill your care management plan by utilizing our comprehensive range of services, as well as other community resources. In addition to the activities listed above, we can:

• Provide counseling
• Address issues of isolation, lack of social support, senility or the onset of dementia
• Complete applications for financial assistance and government programs
• Determine eligibility and complete applications for transportation assistance
• Provide money management assistance
• Evaluate housing needs and assist with housing choices, including move coordination
• Recommend home care options
• Provide volunteer visitors
• Coordinate services with family, physicians, and other community services or health care providers

Monitoring and Follow-Up

Seniors•At•Home provides regular progress calls to update the family, caregivers, and/or medical providers. Once the care management plan has been put into place, many families find it reassuring that  our professional staff continues to provide oversight and basic "check-in" with the senior on a regular basis. The status of the senior, as well as any problems or new concerns, are conveyed quickly to the person(s) responsible for care.

A typical ongoing monitoring plan may consist of one home visit per month and three monthly phone calls to the family or caregiver. However, your Seniors•At•Home care manager will work with you to provide as much or as little monitoring and follow-up as necessary to ensure your confidence and satisfaction.