Private Home Care vs. Community Care What’s the Difference

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.

Why Senior Move Management Makes Life Transitions Easier by A Call to Order Professional OrganizersSupporting Seniors with Care, Compassion, and ClarityLife ChangesWe Help Carry the Emotional WeightEvery home holds a lifetime of memoriesbirthdays celebrated in the kitchen, quiet mornings on the porch, the smell of favorite meals cooked with love. So when its time to move, especially for a senior, its never just about boxes and furnitureits about letting go, starting again, and doing so with dignity.At A Call to Order Professional Organizer, we understand the deep emotional layers of senior relocations. Whether you're moving a parent into assisted living or helping a loved one downsize, the process can feel overwhelmingfor everyone involved. That's where Senior Move Management becomes not just helpful, but essential.Senior move managers aren't just organizers. We're listeners, planners, advocates, and compassionate companions in what is often one of life's most emotional transitions. And for families navigating this journey, having that steady, understanding hand can make all the difference.How Senior Move Management Brings Peace to the ProcessBecause no one should feel rushed, lost, or alone during a move.Relocating later in life often comes with a swirl of emotionsgrief, uncertainty, fear of change. Add to that the physical strain and countless decisions that come with moving, and its easy to see how overwhelming it becomes. But with professional senior move support, what once felt unmanageable becomes a guided, step-by-step process grounded in care.Heres how we help make life transitions easier:1. A Clear Plan Reduces OverwhelmInstead of facing an entire house full of decades-worth of belongings, we break the process down into manageable steps. From sorting and downsizing to coordinating moving logistics and setting up the new home, everything is planned and paced for comfort and clarity.2. Emotional Support Is Just as Important as the Task ListOur team doesnt just focus on what needs to go wherewe focus on how it feels. We understand that parting with familiar items and leaving a long-time home can be heart-wrenching. We honor those feelings, allow space for them, and help families navigate them with kindness.3. We Make the New Space Feel Like HomeIts not just about moving thingsits about creating a safe, welcoming, and familiar environment in the new home. We recreate setups where possible, hang favorite artwork, place treasured items in view, and make sure the first day in the new space feels comforting and reassuring.Tips for Families Navigating a Senior MoveCompassion is the most important box to pack.Whether you're local or coordinating from afar, here are a few gentle ways to support a senior loved one through a move:1. Start Early and Go SlowGive the process time. Beginning conversations early allows room for thoughtful decision-making and minimizes last-minute stress. Rushing can lead to regret. Early planning is one of the most powerful tools for reducing anxiety.2. Honor Their StoryWhen sorting through belongings, listen to the stories behind the items. You might be surprised how healing it can be to reminisce. Ask questions like, Tell me about this photo or Who gave you this? Sometimes, being heard is just as important as being helped.3. Bring in a Neutral, Professional PartnerAs much as family means well, emotions can run high. A Senior Move Manager acts as a neutral guide, keeping the process organized and respectful while reducing tension between family members. We help keep the focus on what mattersa peaceful, positive transition.4. Focus on Whats Being GainedInstead of focusing only on whats being left behind, talk about whats ahead: a simpler space, closer community, more safety, or better access to care. Reframing the move as a new chapter helps ease the emotional weight.A Move with MeaningAt A Call to Order Professional Organizer, we know that a move is never just a move. Its a moment of transformation, one that deserves tenderness, understanding, and a team who truly cares.Thats why Senior Move Management is more than a serviceits a lifeline. We take on the physical burden, yes, but more importantly, we walk beside seniors and their families with warmth and respect, ensuring that no one ever has to face change alone.If you or a loved one is approaching a move and feeling overwhelmed, please know this: help is here, and it comes with a heart. Call us at 719-231-5425 or visit www.acalltoorderco.com to schedule a free consultation.Because making life transitions easierthats what were here for.FOLLOW US and stay inspired as you simplify and transition with love: LinkedIn: https://www.linkedin.com/in/acalltoorderco/ Facebook: https://www.facebook.com/ACalltoOrder Instagram: https://www.instagram.com/acalltoorderco/

As we age, our bodies and minds go through a variety of changes, many of which can increase the likelihood of falling. For older adults, falls are not just a minor mishap; they can lead to serious injuries, loss of independence, and a lower quality of life. Understanding why seniors are more vulnerable to falls is the first step in creating safer environments and developing effective prevention strategies.The Aging Body and Increased Fall RiskSeveral age-related factors contribute to an increased risk of falls among seniors. These include physical, sensory, and cognitive changes that often occur gradually but can have a significant impact.1. Decreased Muscle Strength and FlexibilityWith age, muscles naturally weaken, and joints may become stiffer. This can reduce balance, coordination, and reaction time, making it harder to prevent a fall when tripping or slipping.2. Poor Balance and Gait ChangesChanges in the way a person walksoften due to arthritis, neurological conditions, or previous injuriescan lead to an unsteady gait. Seniors may shuffle their feet, walk slower, or have trouble lifting their legs, all of which increase fall risk.3. Vision DeclineVision plays a critical role in balance and spatial awareness. Conditions like glaucoma, cataracts, or macular degeneration make it difficult to judge distances, see steps clearly, or identify hazards in dim lighting.4. Hearing LossHearing is connected to balance. Inner ear problems or age-related hearing loss can lead to vertigo or dizziness, making it harder for seniors to stay upright.5. Chronic Health ConditionsMany seniors live with chronic diseases such as: Diabetes (which can cause nerve damage and numbness in the feet) Heart disease (leading to dizziness or fatigue) Parkinsons disease or Alzheimers (affecting movement, memory, and decision-making) These conditions can impair coordination and increase confusion, both of which heighten fall risk.6. Medication Side EffectsOlder adults often take multiple medications, which can interact and cause side effects such as dizziness, low blood pressure, drowsiness, or blurred visionall potential contributors to falls.7. Cognitive ImpairmentSeniors with dementia or other cognitive disorders may have poor judgment, forget to use walkers or canes, or become disoriented, all of which increase their chances of falling.8. Low Physical Activity LevelsWhen seniors become less active, muscles weaken and balance deteriorates. A sedentary lifestyle can quickly lead to frailty, making even routine movements more hazardous. What Can Be Done?Awareness is the first step. By understanding why seniors are more prone to falls, families, caregivers, and seniors themselves can take proactive steps such as: Regular balance and strength exercises Home safety modifications Routine vision and hearing checks Medication reviews with a doctor Use of mobility aids as needed   Falling doesnt have to be a normal part of aging. By recognizing the reasons behind increased fall risk in seniors, we can create supportive environments that promote confidence, mobility, and independence. With the right strategies in place, seniors can continue living full, active, and safe.