Short Term Options
Home Health (HH): Consider initiating Home Health Nursing for medication management and a home safety assessment, Physical Therapy for conditioning if clinically appropriate, and Social Work services to help identify more resources.
Pill Packing: Request patient’s pharmacy to pack pills for home delivery.
Center for Volunteer Caregiving: This agency has free phone-based services to help seniors deal with social isolation. One service is a short, daily call (<5 minutes) to check in on seniors and ensure safety, remind about meds, etc. The second service is a more social call (about 20-30 minutes) a couple times a week to address loneliness and provide emotional support. Post-Covid, they may also provide some in home services.
Personal Care Services (PCS): Medicaid allows for in-home aides for up to 81 hours a month (about 2-3 hours per day) to help with ADL’s, IADL’s, light housework, and, in some cases, help with medication adherence. Must complete pages 1-2 of the form below and fax to Liberty Healthcare (fax # on the form). Liberty performs an evaluation and determines how many hours the patient is eligible for. https://files.nc.gov/ncdma/DMA-3051.pdf
Advance Care Planning (ACP): Start ACP conversations early. The form does need to be notarized. Most local banks will notarize for no fee for existing customers.
Long Term Options
Program of All-Inclusive Care for the Elderly (PACE): Allows patients to stay in their home for as long as possible with daily support, visits to their PACE center, transportation, and other services. The admissions team can help patients apply for long-term Medicaid, which would fully cover the cost of the program. PACE would take over care completely and act as the PCP, similar to someone entering into a long-term care facility.
Facility-Based Care: such as an Assisted Living Facility (ALF) or a long-term Skilled Nursing Facility (SNF). Medicaid is optimal for this option; the facility will help apply for that. Complete an FL2 form (below) and send to the facility of their choice.
FL2: https://files.nc.gov/ncdma/Adult-Care-Home-FL2-Form–NC-Medicaid-372-124– 9.2018.pdf
NC Care 360: Directory of statewide resources and call center powered by NC 211.
NC DHHS Aging and Adult Services: Directory of services such as nutrition, senior centers, Area Agencies on Aging, Elder Housing locator, Transportation, Caregiver Support, and in-home aides.
Resources for Seniors: Directory of home and community-based Wake County resources. Call 919-872-7933 or visit
Wake County Human Services: Senior & Adult Services. Information about senior services in Wake County.
Wake Network of Care Directory of services, organizations, and supports in Wake County.