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I don't know if any of you have or know of someone who has a problem with an older relative and want alternatives to nursing homes. Tennessee has an alternative (and I thought Art might want to know in case he knows of someone with a need like this).

Tennessee: An Alternative to a Nursing Home
Choices enrolls 7,000 Medicaid patients in first year of providing home-based care
Anita Wadhwani AARP Bulletin 3/1/11

Choices represents an overhaul of how the state responds to the needs of older or physically disabled residents needing daily care. For years, Tennessee ranked at or next to the bottom among the states in providing home- and community-based services.

During the program's first nine months, enrollment in home- and community-based services jumped from 18 to 25 percent, which is about 7,000 people.

That includes 256 who went directly from nursing homes to home care. The program allows up to 9,500 people to be enrolled at any time.

The program began in Middle Tennessee last March and went statewide in August.

The Choices program provides a broad menu of services to those who would otherwise qualify for nursing home care based on their income and health, but who can safely live in their own homes. Services include installing wheelchair ramps and arm rails, providing in-home health care, bathing services, transportation, homemaker services, and, in certain cases, helping pay the monthly bills at assisted living facilities.

At-home services in the Choices program cannot exceed the average cost of nursing home care. So far, the average participant costs about $15,000 to $20,000 per year compared with the average annual cost of nursing home care, about $52,000, said Steve Witt, director of the Southeast Tennessee Area Agency on Aging and Disability, based in Chattanooga.
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The problem is that while few people want to go to nursing homes, huge numbers of people would be glad to have servants to provide them with services in their homes.

Costs are bound to explode....

Seattle Pioneer
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I think our neighbor caddycorner across the road on the other side of the stop sign just did another alternative to nursing homes. I think the old guy in the orangish house committed suicide this morning. This morning just a little while ago the police were out there, ambulances, and then the coroner came and my other neighbor, Kim, said she drove by and there was blood all over the inside of the truck.

We were all out there standing in the road and staring down the street trying to figure out what happened. He was a mean old goat. When I'd drive buy I'd wave with a big stupid grin on my face and he'd never wave back. In the summer I used to have my bathroom window up and I could hear them screaming and yelling over there at 3:30 am in the morning. I'd wake up to take a leak and I could hear goings-on over there at his house in the middle of the night. How weird. I'd love to know what happened. Anyway, someone's dead and I'm thinking it was him. Maybe he found out he had cancer or something and just decided to end it quick?

I'll keep ya'll posted. - Art
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Sounds like thenTENN plan is both appropriate and a sensible money-saver for many people. My parents paid for in-home care for my grandparents before that became impossible and they went (at different times) into a nursing home courtesy of Medicare. They both lived to 93. IIRC, Gramps had in-home care for maybe 6 months and just a couple of months in the nursing home. nana was much longer for both--maybe 2 years apiece.She hated living in the nursing home. Partly coz her heart was failing so she felt weak all the time. I prefer to remember grating the Romano for Nana's spaghetti and taking walks with Grmps. Paternal grandfather did it right: keeled over and died while stepping into a bath following a restaurant date with his girlfriend. he was 80. Ate rich food and smoked cigars.sigh. I miss my grandparents! (probably why I want to be so close to my grandson)
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My grandarents didn't like having "servants in their home." But they needed help getting to the bathroom and taking a bath. That's pretty much all they did, plus fix lunch. And watch the soaps with Nana. Do a wee bit o housework.
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