This becomes a more difficult question to answer as the traditional structure of the family changes. Nursing homes, or skilled nursing facilities, are available. However, unless the individual has certain physical deficits or skilled care needs, many insurers will not cover the cost of care. Nursing home care is incredibly expensive. When personal financial resources are exhausted, individuals may become eligible for medical assistance, a demoralizing process wherein the individual is required to become impoverished in order to receive financial support.
Many families feel a commitment to care for their aging loved ones.
Whether it is a response to the explicit pleas from the older person not to be placed in a nursing home, an unwillingness to pay for the exorbitant cost of care, or a sense of responsibility for their family member - the decision of how to care for an older person frequently falls on the shoulders of the family. The acute illness of the daughter changed the needs of the mother. The disruption that this creates for the patient and family might have been avoided if better systems of caring for older adults were in place in communities. The program is available to community-residing frail elders who are dually eligible for Medicare and Medicaid benefits or who have the financial ability to pay a premium equal to the Medicaid capitation rate. The program includes core services such as adult day care and multidisciplinary team case management.