As we live longer, more and more of us need assistance and care options. As the senior population has grown, so have elder care options.

Home Care. For those who need some assistance, but are not ready to give up their home and personal routine, home care services are available. Both non-medical and medical services are available; you may simply need some help with errands and chores, or you may want someone who can help with medications, post-hospital care, or rehabilitation routines. You can discuss you needs with an agency who supplies elder care staff, or try to locate possible candidates yourself via word of mouth or your local senior center. Levels of care and the hours needed in your home can be negotiated for a “trial run” while you see how it works out. Your needs may change with time, and you can always re-assess.

Retirement Communities. This is a generic term that covers a lot of ground. Usually the term is geared toward developments that have been specifically planned with seniors in mind. Clusters of homes, apartments, or condo with common amenities are designed and marketed to appeal to those who no longer work and have more leisure, or who have reached a certain age. (The latter are called “Age-Restricted Communities” and most specify that at least one member of a household be over 50 or 55, though minimum ages vary.) Residents maintain their own private (non-communal) residences, though they may use a group clubhouse, pool, lake, library, or golf course.

Assisted Living Facilities. For those who need more help with the activities of daily living (ADLs) such as showering, dressing, and eating, assisted living facilities (ALFs) are an option. These facilities usually offer a home-like setting, and staff offer assistance only as needed. ALFs also have nurses on duty; however, extensive one-on-one care is rarely offered. If needs increase, residents of ALFs may need to transition to long-term care facilities.

Nursing homes are usually the next level of care. Most nursing homes offer long-term units that offer round-the-clock care by trained nursing aides and nurses. There is often a higher staff-to-resident ratio here than in ALFs, meaning more individualized attention. Care in nursing homes is tailored to fit the individual resident’s needs; care can change as the resident’s needs change. While encouraging as much independence as possible, nursing aides usually assist elders with ADLs, and these facilities expect to offer more consistent medical attention.

Dementia Units. Some nursing homes offer special units for dementia care. As dementia progresses, more and more assistance is often needed with ADLs. Dementia care units offer nurses and trained aides who are available to patients 24 hours a day. For more severe cases of dementia, many specialized units offer safeguards to prevent confused residents from wandering out of the facility and becoming lost, hurt, or injured.

Graduated Care Facilities/Communities. To meet residents’ changing needs, larger facilities offer different levels of living options, such as apartments and condominiums for independent living (retirement units), ALFs, and then healthcare centers. The healthcare centers usually offer long-term, nursing, and dementia care.

Meals on Wheels (MOWs) are locally-run programs that deliver nutritious meals to the home-bound, including the elderly, the disabled, and other at-risk people. MOWs makes sure they receive nutrition, human contact, and the preventative medicine of good food on a regular basis. Daily deliveries also keep home-bound people safer. Volunteers, who stop by with food, can report to social workers if a home-bound person’s health has suddenly deteriorated, or if there is a plumbing leak or other household emergency that the home-bound person cannot handle.

The Need.  People who cannot go shopping or cook due to age, handicap, or chronic illness can become physically ill from lack of good nutrition, or even from simple hunger. Lack of nutrition can cause a person to end up in the hospital or in a nursing home. But often the home-bound are also lonely, and longing for human comfort, even if they are not physically ill.

Eligibility Requirements. Most Meals on Wheels programs require that a meal recipient meet several criteria. First, the person must be home-bound. Second, the person must be unable to cook or otherwise prepare meals. Third, the person must be without day-time help from another person. Finally, the person must be able to receive meals at delivery time. The people who meet these criteria are often the elderly or the disabled, but they might include home-bound critically ill people without relatives to help care for them.

The Food.  Each agency may supply food in a different manner, but Meals on Wheels often deliver hot meals each weekday. On Fridays, some MOWs provide an additional (cold) meal for use over the weekend. The meals are nutritious, providing ample protein and a healthy calorie intake, as well as vitamins and fiber. MOWs try to accommodate diabetic and other special dietary needs.

The Volunteers. MOW volunteers offer several hours one day a week or more. They drive a route, dropping off meals and spending a little time just checking to make sure the recipient is okay. It is a labor of love to bring food and cheer into the lives of those who most need both.

How to Get MOW Help. If you or someone you know needs regular meal service, contact the Meals on Wheels Association (MOWAA) for information on local programs. MOWAA is the umbrella organization for the different groups (most run by a social work agency or other service-oriented group) that have organized MOWs in their communities Often, it is up to able-bodied neighbors, friends, or family-members to bring people in need to the attention of the program. Social workers sometimes intervene on behalf of these people, as well.

MOW on the Internet. Find a local MOW group by entering your zip code on the “Find A Meal” page of the www.mowaa.org website. You can also contact www.eldercare.gov for information, or talk to a social worker in your area.