Alberta Stinson wants to stay home. For a woman who is 73 and blind since birth, living on her own seems an impossible expectation. Thanks to the Hamilton County Elderly Services Program (ESP), Stinson is one of almost 8,000 Cincinnatians who were able to do just that in 2006 -- live independently in their own homes.
In addition to coordinating help from Cincinnati Association for the Blind, Stinson's caseworker has worked with her to secure help with yard work by a local volunteer group and a "senior companion" to help with transportation and other needs. That means this woman, who learned to read Braille at 27 and earned her GED at 49, can stay in her home of 30 years.
Managed by the Council on Aging (www.help4 seniors.org), ESP provides assistance to anyone over the age of 65 who lives in Hamilton County.
"The program's designed to keep people at home and to live independently so that they don't need to go into a long-term care facility," says Richard Kidd, long-term care manager for the program. "A wealthy individual could have the same types of help needs as a low-income individual has. We meet the needs of all income levels -- we have low income individuals to high income individuals, and there's a sliding fee schedule for those who do have the means to pay."
Paying the bills
Housekeeping, transportation to a doctor's office, meal delivery and home repairs are just some of the myriad services offered. These are the things most people might expect the elderly to need, especially if they don't have any children or their family lives in another state
But there are also many everyday tasks that require more time and effort.
"(A) 'homemaker' goes in and does very basic housecleaning services because some of these individuals are disabled and aren't able to clean their house," Kidd explains. "In order to stay in your home, it has to be maintained as a clean, healthy place to live. Typically, they would go in once a week.
"If you had a client who had very poor eyesight or had limited capabilities in figuring out how to pay bills, we would send in an individual that would help them do those types of things."
What about simply having a break? Giving a full-time caregiver a rest -- or respite -- is as important to the person receiving care as any other service, according to Kidd. The family or friends who help an elderly person remain in her home also need support, he says.
"A lot of these clients are getting care from their spouse -- that's unpaid care -- but periodically the caregiver needs to get out of the house to do shopping or just to get a break," Kidd explains. "So we'll send in a respite aid and enable that person to leave the house."
Determining what services an elderly person will require in order to live at home begins with an evaluation or "intake." That assessment of need results in an individualized care plan.
Depending on the circumstances, that can mean a caseworker will identify and coordinate specific services such as home medical equipment or enrollment in an adult day care. The client might just request an assessment so that he can hire a personal assistant qualified to help with the identified needs.
Cheaper than Medicaid
ESP doesn't require people to use their services; it merely offers the option. In the case of Ed and Mary Stupak, those services make it possible for the couple to remain together in their home.
Ed Stupak was one of the program participants who asked to testify at one of the two public hearings required to get the levy on the Nov. 6 ballot. His wife goes to an adult day-care program twice a week, and a homemaker comes in to assist with tasks. Kidd says that summarizes what the Elderly Services Program is all about.
"This gentleman stated that it was because of this program that he was able to keep his wife at home and that they could spend their remaining years together," Kidd says. "He virtually had everybody in tears. That is indicative of what we do. It's hard to put those kinds of things into words."
What is easy to explain is the cost of services. For approximately $335 a month ESP is able to provide individualized care programs that allow people to remain in their homes, compared to a Medicaid nursing home at $4,883 a month or $2,700 for an assisted living arrangement. The overhead for managing all of that for 7,994 clients last year came out to 4.4 percent of the program's entire $18.9 million budget.
In an attempt to gain a better understanding of where the program is and how it needs to grow and change to meet the impending challenge of aging baby-boomers, the Hamilton County Commissioners asked for an independent review by the Scripps Gerontology Center of Miami University. Praised as a "model program," ESP is asking voters to pass a 1.29 mill levy that will renew existing funding and include a 0.13-mill increase for five years.
The existing levy raised $19.3 million in 2006 and will raised about $21 million annually through 2013. For what amounts to less than 10 cents a day -- a $100,000 homeowner would pay $26.51 a year -- the program can continue to provide services and get ready for the next generation that will need assistance.
A former nursing home manager for 20 years, Kidd says having a choice is the best option.
"Nursing homes are a needed service, but it's great when people can stay at home, too," he says.
So far there is no known organized opposition to the levy, including from the Coalition Opposed to Additional Spending and Taxes.
"COAST does not have a position," says Chris Finney, spokesman for the organization. © Alberta Stinson (right) with her Council on Aging care manager, Anne Balsley.