Planning for your care in the years ahead

    No one makes good decisions in times of crisis. Twenty percent of LGBT older adults report that they have no one to call for help at such times. Additionally, LGBT older adults do not have the “traditional, nuclear family” structure to turn to for support and care: 80 percent are single, 75 percent live alone and 90 percent have no children.

    Added to the lack of support structures for care when it is needed is the fact that LGBT older adults may need more care and assistance in order to age independently and successfully. Several studies indicate that LGBT older adults will need care and supports due to the onset of disabilities. One in five Americans has a disability; half of Americans over 65 have a disability. One estimate points to 62 percent of transgender older adults as having a disability.

    Knowing what kinds of services and supports are available, and how to access them, can help you remain independent, in your own home or community, rather than having to move to a nursing or other longterm-care facility. Here are some of the options for care that you should know are available if and when the need arises:

    Skilled Home Health Care: intermittent, skilled services provided in the home for the purpose of restoring and maintaining the patient’s maximum levels of function and health. This care covers a wide range of medical services and is provided by a licensed practitioner. These services are usually covered by Medicare, Medicaid and private health-insurance programs and must be ordered by a physician. These services are rendered instead of hospitalization or confinement in an extended-care facility or going outside of the home for the service.

    Outpatient and In-home Therapies:  Physical, occupational and speech therapies are often covered by Medicare or private health insurance when ordered by a physician. These services, which can be provided in the home or through outpatient visits, can help you to recover from the effects of an illness or injury. Medicare may also pay for counseling if you are experiencing social or emotional stress related to an illness, injury or disability.

    Non-Medical Home Care: These services can include light housekeeping, meal preparation, transportation to appointments, companion care, personal care, medication reminders and laundry. These services are generally fee for service, meaning that you pay for them out of your own pocket. Some longterm-care insurance programs or VA benefits may cover the cost.

    In-home support and home care can be provided through Area Agencies on Aging (AAAs). Every county in Pennsylvania is served by such an agency. To access in-home support services through an AAA, you must participate in an interview to determine if you are eligible based on your age, care needs and financial resources. A case manager will be able to tell you which services and how many care hours you are eligible to receive.

    The AAAs can help you access adult day centers and senior centers and can also help you connect with in-home support programs that include Meals on Wheels, nutritional support, mental-health counseling, home repairs, transportation assistance and protective services.

    (Note: Adult day centers provide a protective environment, personal care and recreational activities to persons who cannot remain safely at home or who are isolated at home alone. Senior centers provide a range of educational, health and wellness, recreational, nutritional and social activities to encourage older adults to remain active in the community.)

    The five Area Agencies on Aging in Southeastern Pennsylvania are:

    • Philadelphia Corporation for Aging (PCA), 215-925-7333, 

    • Bucks County Area Agency On Aging, 267-880-5700, 

    • Chester County Department of Aging Services, 610-344-6350, 

    • Delaware County Office Of Services for the Aging (COSA),  610-490-1300, 

    • Montgomery County Office of Aging and Adult Services, 610-278-3601, 

    • To find the AAA nearest you, call 800- 677-1116.

    The Alzheimer’s Association also has many free and fee-for-service programs for anyone who has dementia or Alzheimer’s disease. Call 800-272-3900 or visit them online at

    LIFE programs: If you need “nursing-home level of care” as determined by a physician, but want to stay in your own home, LIFE (Living Independence for the Elderly) programs provide comprehensive medical and supportive services to those who qualify. These services help people meet their health-care needs in the community instead of going to a nursing home or other institution. In other parts of the country, they are often called PACE (Program of All-inclusive Care for the Elderly) programs. They are Medicare and Medicaid programs. The LIFE program then becomes your insurance provider.

    There are many resources available to help you find the help and services you need. Unfortunately, there is no one source for all of the help that’s out there. There is a lot of work being done to get the word out to the community, and here are some people and places to contact:

    • City of Philadelphia Commission on Aging, 215-686-8450, 

    • Pennsylvania Department of Aging, 717-783-1550,  

    • CARIE (Center for the Rights and Interests of the Elderly), 215-545-5728, 

    • Congreso de Latinos Unidos, 215-763-8870, 

    • SeniorLAW Center, 215-988-1242, 

    • You can also contact your state senator or representative by visiting  

    Mindy Mozenter is director of community outreach and education for Home Instead Senior Care. She is a founding member of Center City Network Connections, an educational network of business people who touch the hands of seniors. Mozenter is also a volunteer for the Emergency Fund Coalition of the Philadelphia Corporation for Aging and a board member of Penn’s Village. For more information, call 215-925-4610.