A familiar setting for older adults, and respite for those who care for them

The Castle Center provides adults with dementia in need of assistance care during the day. Open five days a week, the center offers participants meals, medication monitoring, personal care assistance with the help of nurses and volunteers, socialization and activities like arts and crafts. The Center also offers time off for caregivers — like family members — who often care for people with dementia 24/7.

PACE — Program for All-Inclusive Care for the Elderly — provides free, necessary care to seniors, as well as resources like medicines and other accommodations. PACE also provides a health clinic, urgent care center, home services and offers respite to caregivers in need of a break. Nationwide, there are 273 PACE programs in 32 states. Michigan alone has seven, with two more to be added within the next year or so.

Worker-owned home-care cooperatives are emerging as an alternative to the for-profit agencies that dominate America's direct-care sector. In these cooperatives, professional caregivers earn an average of $2 more per hour than the industry standard, share in business decision-making, and stay on the job at nearly double the rate of workers at traditional agencies. Patients also stay with co-op agencies twice as long, suggesting higher satisfaction and quality of care.

Program of All-Inclusive Care for the Elderly (PACE) centers provide government-funded medical care and social services to those aged 55 and above who qualify for nursing home care but can still live independently with some assistance. There are currently more than 160 PACE centers in 32 states. PACE centers are also gaining momentum as a nursing home alternative, as several states have begun passing legislation and making policy changes to allow Medicaid to cover PACE care.

The Ohio District 5 Area Agency on Aging hires state-tested nursing assistants (STNA) to act as community care specialists and provide in-home care to seniors. This care provides respite for unpaid family caregivers and allows seniors to continue living independently in their homes. In 2023 alone, the program served 130 residents, providing 2,371 hours of in-home care.

The James L. West Center for Dementia Care’s Senior Day Program offers engaging activities like dance, music therapy and cooking classes, and a sense of community for people with dementia, while giving family caregivers a break. The Center currently cares for about 13 people each day, though it has the capacity for up to 20 people and is slated to expand to help more people.

Medi-Cal is a Medicaid program for low-income residents regardless of their immigration status. As of October 2022, more than 300,000 older immigrant adults without legal residency enrolled in Medi-Cal, which was more than the state’s original projection. To continue expanding Medi-Cal’s reach, community health workers and educators are visiting senior centers, churches, markets and community events to encounter people who may not be aware of their eligibility in the program.

Companies like Sanofi are beginning to partner with organizations like Bright Horizons to offer eldercare benefits to employees, like in-home adult care services. The benefit allows Bright Horizons to dispatch care workers to a person’s home and the company administering the benefit subsidizes the majority of the cost. Providing eldercare benefits reduces the burden on employees, allowing them to be more present at work. Since the pandemic, Sanofi has seen a 20% increase in the number of employees registering for the eldercare benefit program.

REACH (“Reaching Everyone with Accessible Community Health”) provides preventive and curative healthcare through a community-based health insurance initiative that offers different packages of care. Community members pay a monthly fee for the insurance, which gives them access to treatment for all ailments including prescription medicines. About 11,000 people are served locally by 22 community health workers but are referred to health clinics and hospitals for more serious issues. Partnerships with pharmaceutical companies and the nonprofit arm of a local clinic helps make treatment costs affordable.

The Money Follows the Person is a federal program that increases access to Medicaid funds for home and community care services for people transitioning out of institutional care. The program has helped more than 101,000 people move out of long-term care facilities into community or home living. The program has also helped people save money by cutting taxpayers’ Medicaid and Medicare bills by about 23% for each person who was moved out of a nursing home or other institution. Based on the program’s success, the current administration is reviewing plans to extend or make Money Follows the