Americans have always prided themselves on their independence and now more than ever, elderly Americans want to stay as independent as possible; even if they are in poor health or are managing conditions which mean that their lives are more restricted.
There are many ways in which technology can support this goal. Developments and innovations in home modifications also provide an extra level of safety and security, meaning that people who offer support, such as caregivers (whether professional or family and friends) can have added peace of mind that the person they are looking after will be monitored and can move around freely in their absence.
The technological advancements of recent years mean that a broader spectrum of aging seniors can reside at home and avoid unnecessary nursing home placement. These advancements include but are not limited to:
However, technology and home modifications can be expensive and many seniors on fixed incomes may not be able to afford these advancements. We’ll take each of these ideas and show you how they can be utilized within the home, so seniors can age in place as easily and confidently as possible. We’ll also discuss what Medicaid does and does not cover for every topic we highlight here. From the outset, it’s important to note that every state sets its own Medicaid rules, so you must research the regulations in the state in which you or your loved ones reside.
There really IS an app for everything these days, and seniors who want to age in place have not been forgotten about. A range of technological advances exist which cover a very broad spectrum of issues that older people may face.
Caregiver scheduling apps offer a wide reaching range of services, which means people who look after their loved ones can quickly and easily balance and manage their schedules, track daily and recurring tasks such as organizing and taking medications, and even help with managing healthcare appointments and monitoring symptoms of long term illnesses and conditions.
Apps such as Pillboxie, Easy Pill and MedCoach will assist seniors in planning and taking their own medication, if they are able to, and other apps like Symple and Pacifica can aid seniors and caregivers in monitoring their health symptoms. The latter is a useful app for self-care – for both the senior AND the caregiver, reminding everyone that taking time out to relax and be mindful is key in making sure day to day living is as stress-free as it can be.
While it is still possible to have ‘real’ panic buttons installed in a senior’s home that will put them in contact with the emergency services, there are now a wide variety of useful smartphone apps that can be installed that will allow older people to be able to press a button and contact their next of kin or other caregiver in the event of an emergency.
What will Medicaid cover for seniors who want to age in place? Each state has its own Medicaid programs and within these, there are sub-programs known as Home and Community Based Service Waivers. Each state has its own Waivers and the benefits vary. However, in general terms. Medicaid will pay for medical equipment when it is deemed ‘medically necessary’, when it is cost effective and seen to be durable. A definition of durable in this case is: “equipment that can withstand repeated use, is primarily used to serve a medical purpose, is appropriate for home use and is not useful to a person without an illness or injury.” Medicaid will only pay for basic levels of equipment. However, in terms of assistive technologies and tools, they fall under the canon of durable medical equipment so coverage may be available depending on the senior’s specific needs.
It’s worth noting that there can be a lot of crossover between technology and apps and assistive technology for seniors. Many assistive technologies are now paired with mobile apps.
One of the best forms of assistive technology for seniors comes in the form of PERS (Personal Emergency Response Services). PERS, also referred to as Medical Alerts, is a system to help seniors stay safe at home. In most cases, they are comprised of three simple components:
PERS is a simple service to operate. When a senior needs help in an emergency they simply press the button they are wearing. A signal is sent to the emergency response center via the console connected to the phone. The senior has no need to pick up their phone, as the call center operator can speak to them through the console and send for further help, whether this be the emergency services or getting a carer / caregiver to come out.
Will Medicaid cover forms of Assistive Technology for seniors? In brief, Medicaid will cover the cost of PERS / Medical Alerts and other assistive technologies, but each state may have a different description of what they consider assistive technology to be.
If your state Medicaid program does not offer adequate or any cover for this form of assistive technology, it can be worth looking into Consumer Directed Services to help. Consumer Directed Services means that Medicaid will provide the senior with funding to be used for their care but will not necessarily dictate what kind of care it can be used for. In theory, this means that a senior could use the funding to purchase PERS or other medical alert systems without Medicaid having to approve it.
If the senior, or their caregiver is in control of their own budget they can then opt for a high spec system which will suit their needs better; and in the long term, this can be viewed as something which may reduce the need for further Medicaid services down the line. To illustrate further, someone may invest in PERS that has a medication management system with it. This may cost extra per month but could cost less than having to request Medicaid cover for home care.
One of the biggest considerations when a senior is aiming to age in place is how a home can be modified to better suit their changing needs and any medical conditions that they may have been diagnosed with. There are a wide variety of options for equipment that can be installed to make life easier and moving around the home stress-free. These ideas and suggestions require professional input in terms of fitting and maintenance so it’s worth finding reputable tradespeople to help out.
Professionally installed grab bars placed in various spots throughout the home can really help a senior who is experiencing problems with their balance or general movement. It is also worth considering fitting these on the outside walls of homes and near the front and back doors.
Seniors who must use a wheelchair may need to consider having all the doorways of their home modified to make them wider. Additionally, wheelchair ramps should be fitted to the front and back entrances, which will make entering and exiting a home a much more comfortable experience. Technological advancements mean that in the future it may even be possible to harness 3D printing advances to create portable wheelchair ramps that can be adapted to suit different areas of the home. Furthermore, this also means that getting out and about and using public spaces will be much easier, too.
Bathing and showering can present many challenges for seniors who would like to age in place – getting in and out of both often presents risks that need to be assessed and dealt with. Investing in a walk in tub or shower that has a chair or a stool to sit on can mean that bathing and washing is made much easier. For any senior that has experienced issues with weight gain or must use a wheelchair full time, considering a bariatric walk in tub is a good option. They provide greater support for a broader range of body shapes and sizes, and can often support the weight of a wheelchair, too.
Finally, stairlifts can be a huge boon to anyone who has difficulty walking up and down stairs in the home, unaided, or is wheelchair bound. As well as looking into indoor ones, there are outdoor stairlifts that can be bought and fitted for seniors who like to enjoy their garden and outdoor time but find moving around difficult or cannot navigate balconies or steps.
What can Medicaid cover for home modifications? Most states offer some assistance for home modifications either through their regular Medicaid program or through their Home and Community Based Services (HCBS) Waivers. Generally, states will cover home modifications (both the cost of materials and labor) when the modification is determined to be medically necessary or when the modification reduces the individual’s reliance on others, and therefore reduces what Medicaid would have otherwise spent on home care.
Elderly individuals living at home may also want or need to get out and about. Medical appointments, shopping for essentials or visiting friends require transportation, but many seniors are not able to safely drive themselves.
The good news is, there are a range of options to help the elderly get around and they are not necessarily dependent on having a smartphone. For seniors that do have a smartphone, apps like Uber and Lyft mean that booking a ride is as easy as installing an app and pressing a few buttons. These apps give real peace of mind to anyone wanting to book a journey to and from a destination, with tracking to make it easier to check when the vehicle will arrive and depart.
However, for those seniors that do not possess a smartphone it is still possible to use these apps. A service called GoGoGrandparent is available for those seniors who would like to book a ride with Uber or Lyft – but would like to do so over the telephone or online. Furthermore, caregivers and loved ones can do the booking on the individual’s behalf and can be kept in the loop regarding their journey, thereby adding a layer of security.
What will Medicaid cover in terms of transport? Medicaid will cover the cost of emergency medical transport. An emergency is when care needs are immediate such as in situations like a heart attack or being injured in a fall. However, if a senior simply needs help with a ride to a specific medical appointment, Medicaid won’t consider this to be an emergency, but may still be provide coverage. Those eligible for Medicaid are able to get coverage for a ride to and from a doctor’s office, a hospital or any other Medicaid-approved care outlet. This is termed as non-emergency medical transportation. Every state has different rules about the types of rides that are allowed and when, so make sure to always double check. If you are enrolled in Medicaid, customer service staff can give out facts and details about any ride benefits for which a senior is eligible. A ride may be by a taxi, car, van or even on paratransit. The ride must be set up in advance and the driver will only be able to take their client to and from their appointment – the ride must not be used for any other purpose.
Another important element of aging in place is making sure a senior has important face to face contact with other people as regularly as possible. Human interaction and connection are a vital part of helping seniors feel like they're a part of something, engaged, happier and healthier. While contact with family and other loved ones goes without saying, having the chance to meet with others of their own generation is paramount too, and this is where adult day care can help.
What will Medicaid offer in terms of Adult Day Care? Medicaid will pay for adult’s day care in all states. However, not for everyone. The rules are very similar to in-home care in that it is covered under limited enrollment waivers and is also often covered under the State Plan. However, a waiver does not equal entitlement, which means that seniors may be wait listed. Furthermore, State Plans don’t cover adult day care uniformly, and therefore it is important to check the rules that apply to the state in which the senior is living to determine to what benefits they will be entitled. In some states, Medicaid may even cover transportation to and from an adult day care center from one’s home.
Technology and home modifications mean it is perfectly possible for seniors to live independent lives for longer and avoid unnecessary nursing home placement. Medicaid - though at times very confusing - does provide significant benefits to help the elderly remain living at home. Knowing how to qualify for Medicaid and navigate the maze of benefits is essential in order to get financial assistance and remain in one’s home.