First Choice: Home

It is not surprising that most elders would like to remain in their community—in their homes—for as long as possible. Home is a place of comfort. Familiar surroundings foster well being and a positive outlook. As a part of the community, an elder maintains dignity, independence, and freedom.

Receiving help while remaining in the community should be the first option that elders can access. Effective home care usually delivers the greatest benefit to elders, the disabled, and their respective caregivers. Thankfully, the “community first” approach is being supported by many branches of government. In his “New Freedom Initiative,” President Bush has promised to increase community access to disabled residents and strongly support the Olmstead decision. Issued by the Supreme Court in 1999, the Olmstead decision instructed states to provide the least restrictive care for disabled Americans. At the state level, Governor Romney, via the Executive Office of Elder Affairs, has issued the “Community First” policy that is intended to ensure that elders can remain in the community for as long as possible. The Massachusetts Home Care Association, of which MVES is a charter member, has pushed the legislature to enact laws that guarantee elders have equal access to community-based care and nursing facility care—whichever best meets their needs and lifestyle choices.

With these governmental initiatives and the support of the public and legislators, MVES has continued to offer more services that help elders stay in the community. The State Home Care Program offers an increased amount of services that clients may receive. The cost-effective “Community Choices Program” provides increased state funding for home care services in order to delay or prevent nursing facility placement. Through the program, clients receive more direct care in their home, enabling them to stay in the community at a lower cost than if they were in a nursing facility. Expanding on the idea of choices, a new array of consumer-directed care programs, including the Personal Care Attendant program, is now available to elders and caregivers. Additionally, MVES and the state have recognized that family caregivers have tremendous responsibility. As a result, caregiver respite, training, and support programs have been broadened.

Despite all of the governmental initiatives and the efforts of elder advocates, we still have much to accomplish. We need to continue to ensure that elders can first access care in the setting of their choice. We need to listen to the elder population and caregivers and respect their overwhelming desire to remain at home in the community. And, to remain in the community, elders and their caregivers must have a comprehensive group of services and resources available to them—as a first choice.