Maintaining Wellbeing During Senior Isolation

Pennsylvania offers Medicaid waiver programs under the Community HealthChoices (CHC) umbrella and the Pennsylvania Department of Aging (PDA) Waiver (often referred to as the PA Council on Aging Waiver). These programs help older adults and individuals with physical disabilities remain in their homes or community settings instead of entering nursing facilities. CHC and the PDA Waiver provide long-term services and supports (LTSS) based on assessed functional needs, emphasizing assistance with ADLs and IADLs. Covered services may include personal care assistance, adult day services, home-delivered meals, transportation, home modifications, assistive technology, and respite care for family caregivers. In addition, Pennsylvanias CHC Waiver offers Participant-Directed Services that allow participants to hire and manage their own caregivers, including family members. To qualify, applicants must be Medicaid-eligible, at least 60 years old (for PDA Waiver) or 21+ (for CHC), and require a nursing facility level of care as determined through a standardized functional assessment of ADLs/IADLs. In this article, we explain what Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) are and how needing help with these tasks is central to qualifying for Pennsylvanias Medicaid waivers like CHC and the PDA Waiver.What Are ADLs (Activities of Daily Living)?Activities of Daily Living (ADLs) are fundamental self-care tasks that a person must perform daily to maintain independence. Difficulty with ADLs often signals a need for supportive services. Core ADLs include: Mobility (Ambulating/Transferring): Safely walking, getting up from a chair, or transferring from a bed to a wheelchair. Dressing: Selecting and putting on appropriate clothing (including handling fasteners) without assistance. Eating: Feeding oneselfusing utensils to get food from a plate to the mouth and consuming it. Personal Hygiene: Bathing or showering and performing grooming activities like shaving, brushing teeth, and combing hair on ones own. Toileting (Continence): Independently using the toiletgetting to the toilet, transferring on and off, and cleaning oneself afterward. When someone can no longer perform several ADLs without help, it indicates that ongoing care or support is likely needed.What Are IADLs (Instrumental Activities of Daily Living)?Instrumental Activities of Daily Living (IADLs) are more complex tasks that allow a person to live independently in the community. While not necessarily performed daily, they are essential for managing ones household and life. Key IADLs include: Shopping for Essentials: The ability to shop for groceries, pick up prescriptions, or purchase clothing and other necessities. Meal Preparation: Planning and cooking mealsgathering ingredients and safely using kitchen appliances. Housekeeping: Keeping the home clean and livable tasks like cleaning, laundry, and taking out the trash. Money Management: Handling finances, such as paying bills on time, managing bank accounts, and budgeting. Transportation: Getting around or arranging transportationdriving oneself or using public transit or rides to run errands and attend appointments. Medication Management: Managing and taking medications properly remembering to take the correct medicines at scheduled times and refilling prescriptions. Communication: Using the phone or computer to communicatelooking up phone numbers, making calls, sending emails, and staying in touch with others. Trouble with IADLs is often one of the first signs that someone needs more support, even if basic ADLs are unaffected.Why ADLs and IADLs Matter for Medicaid Waiver EligibilityIn Pennsylvania, needing help with ADLs and IADLs is a central eligibility criterion for the CHC and PDA Waiver programs. These waivers serve individuals who would otherwise qualify for nursing facility care but prefer to remain in their own homes or community settings. Eligibility is determined through both financial and functional assessments. The functional assessment evaluates whether an individual requires hands-on assistance with ADLs and/or significant help with IADLs, thereby meeting a nursing facility level of care. Pennsylvania uses standardized toolsoften the Pennsylvania LongTerm Care Assessment System (PaLTAS) or the Minimum Data SetHome Care (MDSHC)to score independence in ADLs and IADLs.During the functional evaluation, an assessor reviews abilities such as transferring from bed to chair, walking safely, eating, toileting, meal preparation, housekeeping, medication management, and managing money. Cognitive issuessuch as memory problems due to dementiaare also considered since they impact daily functioning. If an individual cannot perform multiple ADLs without assistance or has significant deficits in IADLs, they are likely to meet the level-of-care requirement and become eligible for waiver services.Community HealthChoices (CHC) WaiverCommunity HealthChoices (CHC) is Pennsylvanias comprehensive HCBS waiver program for individuals aged 21 and older who require a nursing facility level of care. Administered by the Office of Long-Term Living (OLTL), CHC is a managed care program that combines physical health, long-term services and supports, and pharmacy benefits under a single plan (with behavioral health carved out). To qualify for CHC: Be age 21 or older. Meet Medicaid financial eligibility guidelines. Require a nursing facility level of care (confirmed through functional assessment). Live in a setting that meets HCBS requirements (e.g., home, apartment, assisted living). Be a Pennsylvania resident. Once enrolled, participants receive a comprehensive package of services tailored to their needs. Covered services may include personal assistance, home-delivered meals, adult day services, behavioral support, professional nursing, home modifications, assistive technology, transportation, and respite care. CHC also offers Participant-Directed Services, allowing participants to recruit, hire, train, and supervise their own caregiversoften family membersto assist with ADLs (bathing, dressing, toileting) and IADLs (meal preparation, medication reminders).PDA Waiver (Council on Aging Waiver)The Pennsylvania Department of Aging (PDA) Waiver, also called the Council on Aging Waiver, serves seniors aged 60 and over who require nursing facility level of care but choose to remain at home or in other community-based settings like domiciliary care homes. To qualify: Be age 60 or older. Meet Medicaid financial eligibility requirements. Be assessed as requiring nursing facility level of care (through the functional assessment). Live in a qualifying community setting. Covered services under the PDA Waiver may include personal care assistance, home-delivered meals, homemaker services, personal emergency response systems, respite care, adult day services, minor home modifications, and transportation. Like CHC, the PDA Waiver emphasizes managing ADL and IADL needs to keep participants safely in their homes.Participant-Directed ServicesBoth CHC and the PDA Waiver offer Participant-Directed Services, which empower participants to choose and manage their own caregivers, including family members, friends, or neighbors. Under this model, participants develop a service plan with guidance from a care coordinator, set schedules, and handle payroll tasks. This flexibility helps ensure that personal care and IADL support align with participants preferences and routines.Signs That Your Loved One May QualifyBelow are practical indicators that someone may be eligible for Pennsylvanias CHC or PDA Waiver due to difficulty with ADLs and IADLs: Trouble with Personal Care: Skipping showers, unkempt hair, or wearing dirty clothes may indicate difficulties with bathing and dressing (ADLs). Malnutrition or Weight Loss: An empty fridge or significant weight loss suggests issues with meal prep or feeding oneself (ADLs/IADLs). Mobility Decline and Falls: Struggling to walk without assistance, needing help to stand, or experiencing frequent falls signals reduced mobility (ADL: transferring/ambulating). Medication Errors and Memory Problems: Missing doses, mixing up pills, or forgetting appointments point to challenges with medication management and scheduling (IADLs). Household Neglect: Piles of mail, unpaid bills, or a cluttered home reflect trouble with housekeeping and money management (IADLs). A combination of needing help with several ADLslike bathing and toiletingand difficulties with IADLssuch as meal prep and housekeepingstrongly indicates a nursing facility level of care. Document these challenges for the functional assessment to demonstrate eligibility.Were Here to Help: Next Steps and Contact InformationNavigating Pennsylvanias Medicaid waiver programs can be complex, but you dont have to go it alone. At Passion to Care, we specialize in guiding Pennsylvania families through the CHC and PDA Waiver application processesfrom the initial functional assessment of ADLs and IADLs to completing paperwork and coordinating services once approved. If you notice your loved one struggling with daily tasks or if a professional has recommended nursing facility care, it may be time to explore CHC or the PDA Waiver. Our compassionate, family-first team ensures your loved ones needs are met with dignity and respect. Call us or contact us today to learn how to get started with Pennsylvanias Medicaid waivers for home and community-based services.

Through the pandemic, many changes were taking place. One of the most serious tasks was making sure everyone was staying healthy. When it came to visiting doctors or hospitals, people were not the happiest about it because there were chances that they could get sick. The virus was spreading, and no one was super about how they would get through. As a company, we were doing alright with the main focus of the work that we did was looking after the health of people. We had to make sure that they were safe and would work on providing their medication and looking after them in their homes, especially for people who were a bit older.One of the most significant challenges we were facing through the pandemic was staff shortages. People were getting sick across the board, and we had to source new people to assist with our requirements. Another challenge was that our staff had to be tested regularly because they were dealing with older people, and we would not risk getting our clients sick, which could be challenging to get through. If we had to predict the changes that would take place in the upcoming months, it would be that we would see a lot more people coming back into the workforce. We also predict that we would be able to hire a lot more.We had to make some changes to the way we were communicating which was challenging to adapt to immediately. There was a lot less face-to-face time with clients and staff, and we would work with them remotely for as much as we could. We had to work from the office space, for the most part, because of the nature of our work. While there were a few aspects that we could assist our clients with remotely, we would do most of our work in person. We were so used to it and following all the safety protocols that we did not find much of it challenging.There were certain safety norms that we had to follow when getting our work done. All workspaces were regularly wiped down and hand sanitizers and wipes were available throughout the office suite. We provided PPE kits for field staff and office staff if necessary. We made sure that we handled free Covid testing on location so that it would not be a task for our team to get through those tests. We did not want to take any chances that could cause our clients to get sick.While there were so many changes taking place, we did not want to burden our clients anymore, so we stuck to the same working hours. When working, we wanted to make sure they could come to us and find us at work during the same hours. We are using secure platforms to hold our clients information, and we make sure that their details are safe and dont get misplaced.We also work with our clients in person for the most part, and we make sure we follow all the rules and regulations to keep everyone safe. Additionally, if there are aspects that we can assist with remotely, we are more than happy to do that.We have meetings via video conferencing and use a series of apps that work for our clients. We are not too particular about the ones we use and find the most convenient ones that are easy to understand. Furthermore, we participate in virtual public events and business expos whenever we get the chance. It gives us the opportunity to showcase the work we do and meet a few more interesting clients.Through the pandemic, we learned that our staff remained dedicated and committed to providing care for our clients for the duration. We would not be where we are without their dedication and most of our clients know that and say the same.If you are looking for Caregivers and Registered Nurses in Denver, Pueblo, Caon City, La Junta, Colorado, connect with us at Argus Home Health. We provide a range of services that assist our clients and allow them to stay healthy through the pandemic. There are times that they cannot get to a hospital, and there are other minor requirements that might need registered nurses but are not a major hospital requirement, and we are more than happy to assist. We were doing this for a long time, and our clients are quite happy with the results. While all the assistance we provide might not be medical, there are other aspects of being in the house that we can assist with. If you want a better understanding of our services, please click here. If you are looking to connect with us or think that we can assist with a requirement that you have, please click here. 

In the new year, the country continues to respond to the COVID-19 pandemic. The United States Department of Health and Human Services(HHS) recently released guidance to nursing homes and long-term care facilities on practical steps they can take to help reduce the COVID-19 infection rates among residents and staff this winter.The HHS encouraged nursing homes and long-term care facilities to focus on achieving three goals meant to reduce the hospitalization and death rate among its residents, the population most vulnerable to severe complications from COVID-19 exposure. Nursing homes and long-term care facilities are being advised to focus on these three goals:Help residents and staff access updated COVID-19 vaccinesIncrease access to testing and awareness of treatment options Improve air quality in nursing homes and long-term care facilitiesThese practical steps can promote healthy living for older Americans and the professionals that care for them in these facilities, HHS says.Helping Residents and Staff Access Updated COVID Vaccines Since the initial nationwide push to get people vaccinated against COVID-19, the rate of nursing home residents getting boosters dropped to 42 percent, and the rate of nursing home staff that received updated COVID-19 vaccines dropped to 10 percent. The Centers for Medicaid and Medicare Services (CMS) reported that increased access to COVID-19 vaccines and education about the need for boosters and updated vaccines correlated to decreased infection rates. The HHS guidelines recommend that:Nursing homes and long-term care facilities offer updated COVID-19 vaccines throughout the winter Residential facilities partner with vaccine providers to create on-site vaccine clinicsCare facilities educate residents and staff about the need for annual flu shots and updated COVID-19 vaccinesIncreasing Access to Testing and Awareness of Treatment Options Prompt testing and effective treatment are necessary to reducing the spread of COVID-19. According to HHS, residential facilities should ensure each resident and staff member who shows symptoms gets tested. Nursing homes and long-term care providers should also explain to residents or staff their treatment options and other available resources. Among these resources are the following:Weekly tests kits are available, free from the federal government, to nursing homes and long-term care facilities Telehealth and virtual care options for COVID-19 evaluation and treatmentFree at-home test kits available for residents through their health insuranceImproving Air Quality in Nursing Homes and Long-Term Care Facilities Improving air quality is correlated with decreasing the transmission rate of COVID-19, influenza, and other respiratory diseases. Health care facilities are also being encouraged by the HHS to improve air quality in their facilities. Nursing homes and long-term care facilities can improve their air quality by:Using portable air cleaners in dining, recreation, and resident rooms and other areas where people congregateUsing ceiling fans where availableScheduling an inspection for the HVAC systemReplacing air filters in ventilation systemsUsing restroom fans or kitchen vents to remove contaminated airRepairing or replacing broken or damaged windows and doors to promote air ventilationIn acting on the above guidance, the HHS states, nursing homes and long-term care facilities can help decrease the rate of COVID-19 exposure and infection among the population of Americans most vulnerable to the effects of the disease.