Gillian Jones: It takes a 'village' to care for Mom


WILLIAMSTOWN — Is it more economical to take care of an elderly parent at home, or put them in a skilled nursing facility? That is the question.

While either side will claim victory over the other, the reality is, it is actually much less expensive to take care of an elderly parent at home, albeit it more time consuming and complex for the family or those closely involved.

Because of the misconception of home care being more expensive, many don't even consider it. Therefore there are many elders residing in skilled nursing facilities who could probably live at home. Many people have told me they found out their parents may have been eligible to live at home, instead of a skilled nursing facility, only after they have passed away.

Medicaid is the lowest priced payor source for skilled nursing facilities which means lower reimbursement rates, and with the substandard care in many facilities due to under-staffing, home care is a considerably more viable option. And in our own Berkshire County, Sweet Brook in Williamstown was rated by a federal agency as one of the poorest quality facilities in the country according to a Berkshire Eagle story by Haven Orecchio-Egresitz on March 4.

Medicaid is historically thought of as paying for nursing home care only. Usually the co-payment paid by the resident is their total monthly income, from Social Security or other sources. But modern Medicaid programs offer care options outside of nursing homes, in the home or primary place of residence.

Many feel they cannot take care of their parents and that a nursing home is the only choice and perhaps for some, that is the case. Often it is a family member who has to step in and take care of an elderly parent or disabled family member. And that family member often does so at great sacrifice.


But what many don't realize is that even family members can be compensated to take care of elderly parents through various programs. And if the elderly have to be cared for anyway, why not compensate family members for the same job, if they are willing and able, especially if it costs less to taxpayers?

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According to the website Paying for Senior Care, home and community based services, or waivers allow states to pay for care and support services for individuals residing outside of nursing homes. Commonly, they pay for personal care (assistance with activities of daily living, such as eating, dressing, and mobility) and chore services provided for elderly or disabled persons who live in their homes or in the homes of family members.

According to the Money Follows the Person (MFP) Rebalancing Demonstration Grant helps states rebalance their Medicaid long-term care systems. Over 75,151 people with chronic conditions and disabilities have transitioned from institutions back into the community through MFP programs as of December 2016. The Affordable Care Act of 2010 strengthened and expanded the MFP program allowing more states to apply. There are currently 43 states and the District of Columbia participating in the demonstration.

Determining Medicaid or MassHealth eligibility can offer many options for home care.

Furthermore, additional paid caregivers can give relief to family members so they can work, or just get a break, when they are not caring for their loved one. Even programs like adult day health can offer daily respite to family members. And once in a while, a short stay at a nursing home can provide additional respite for caregivers.

Home care is certain to give your loved one better and more personalized care than that received in a facility. And seniors who live at home generally have a better quality of life.

And what is more important to the economy is that caregiving creates jobs! And right now the demand for qualified caregivers is high, whether they are nurses, PCA's or CNA's.

The African proverb that it "takes a village to raise a child" suggests that an entire community of people must interact with children for those children to experience and grow in a safe environment. Shouldn't that adage extend to our elderly population who deserve to experience the same safe environment during the the twilight of their life?

Gillian Jones is an Eagle digital visual journalist who is writing an ongoing series of opinion page pieces on caregiving. Her email is


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