(BPT) - November ushers in the festive holiday season and a renewed focus on the home, often the center of long-standing traditions and meaningful celebrations with family and friends. For many, being home for the holidays is a foregone conclusion, but for others — particularly people with disabilities and older adults — being at home may seem out of reach. With the gift of self-direction, however, they can be where the heart is for the holidays and all year long.
Self-direction is a model of care for people who need the type of long-term services and supports (LTSS) that would qualify them for nursing home or other institutional care paid for with Medicaid dollars. This traditional type of care can be costly and isolating, and it tends to take control away from the person receiving care.
On the other hand, self-direction follows a person-centered philosophy. "In person-centered planning, the person needing care is in the driver's seat. They choose who provides their support as well as when and where it's delivered," explains Pearl Barnett, chief operating officer of GT Independence, a financial management service (FMS) that helps people with the administrative tasks that come with self-direction. "Self-direction allows people to stay in their homes and communities, so they can keep making memories and maintain relationships that add joy to their lives."
Rather than have Medicaid cover expensive institutional care, people participating in self-direction receive an authorized budget, seeded with Medicaid dollars, to manage and spend on the services and supports they need. Barnett adds, "For people who access it, self-direction is a priceless gift that recognizes their autonomy and enables them to remain in familiar surroundings, supported by caregivers they know and trust."
Depending on the program, participants may be able to hire close relatives to provide support. Family members often step in, unpaid, to tend to personal care, and they are usually well acquainted with the individual's needs and preferences. By paying family members in this role, self-direction programs are valuing their important work while also alleviating demand on a stretched caregiving workforce throughout the country, and especially in rural areas.
With self-direction, people can and do thrive with the right supports in their homes and communities. Studies suggest that participants experience greater satisfaction with services and a better quality of life than those in traditional institutions.
People who self-direct can remain engaged in their communities, whether it's viewing light displays and attending performances during the holidays or going to school, work, community groups or volunteer gigs throughout the year. Such activity builds connections and relationships that often go missing in traditional care models and that enrich both the people receiving services and people in their orbit.
"Self-direction will allow the person the ability to blossom," says one participant, a disability advocate with a brain injury who is also a published author helping others "to see that things are not as stark as they may seem."
Can't beat home sweet home
Thousands of people from coast to coast are eligible for LTSS, often through Medicaid or other state-funded programs. If eligible for self-direction, they may discover that a holiday wish to stay in their home and community can be granted.
The self-direction journey often starts by reaching out to a state's Medicaid agency to learn about available programs in an area. Other resources for information include state departments that serve older adults and people with disabilities.
Barnett notes that while her FMS isn't in every state yet, "Our customer support staff is ready to point people to resources throughout the country. GT Independence serves programs in 18 states and the District of Columbia, and our reach is constantly growing. Our mission is to help people live a life of their choosing, so they can be home for the holidays and every day."
More information about self-direction is available at gtindependence.com or by calling 1-877-659-4500.
