Some services are beyond the financial reach of many older adults. Families may be limited by how much financial support they can provide while also caring for their immediate families. In addition, parents may not feel comfortable accepting financial assistance from their family.

There are services available that are provided on a sliding scale or at no charge to older adults; however, some local, state and federal programs may have long waiting lists.

Congregations can often provide help with services such as transportation, visitation, and meals by using volunteers. Congregations with a Parish Nursing and Health Ministries or Stephen Ministers program may provide some additional health services.


Adult Day Services

Private businesses, senior centers, non-profit agencies, congregations, and local governmental agencies offer adult day care. Several offer fees on a sliding scale; others accept clients receiving support through the Veterans Administration or the Family Caregiver Support Program of the Area Agency on Aging & Disability.

Assessment Of Needs

Determining precisely what services are needed is often the first step to obtaining those services. The Area Agency on Aging & Disability through the Options for Community Living, the CHOICES program, and the Family Caregiver Program all offer service coordination and some services. Agencies providing assistance with assessment, case management, and counseling include senior centers, United Way Family Resource Centers, and faith-based social services agencies such as Catholic Charities and Jewish Family Services.

Financial Help with Food, Clothing, Utilities, Rent and Prescriptions

Many agencies offer financial help with the costs of everyday living; unfortunately, the help is very limited and is not offered on a continuing basis. Some agencies serve only particular areas or zip codes.

Food Services

The federal Older Americans Act authorizes two types of programs: home-delivered meals (Meals on Wheels) and nutrition sites. Most delivered meals are offered at lunch time five days per week. The on-site meals are also offered weekdays at lunch. In some cases participants can be picked up and brought to the site. The on-site meals also provide an opportunity for socialization with other other adults. Your local Area Agency on Aging & Disability can tell you which agency coordinates programs in your area. In addition, some congregations organize meal delivery to older adults. Some programs may charge a small fee or ask for a donation. Check with your county health department to learn if seniors are eligible for the Commodity Supplemental Food Program. In addition, diabetic supplements and nutritional supplements (such as Ensure) may be available for no charge
to low-income persons.

Health Services

The Legal and Financial Chapter of this book discusses programs that can help older adults pay for deductibles and co-payment connected with Medicare. Older adults should remember to take advantage of the benefit where Medicare will pay for flu shots each year. County Health Departments vary in what services they provide—some provide blood pressure checks, physical exams, and dental services at little or no charge. Non-profit clinics often serve low-income persons. Hospice care is reimbursed by Medicare and many private insurance plans. Assistance with prescription costs is now part of Medicare Part D. The State Health Insurance Assistance Program in each state (SHIP) can help families decide on an appropriate plan. In Tennessee the number is 1-877-801-0044. In addition some pharmaceutical companies provide free or reduced price medicines. Ask the physician’s office for information. Veterans are eligible for special help and should contact the Veterans Administration.

Home Care Services

There are many businesses that provide services such as sitters, homemakers, help with cooking, bathing, etc. These can be expensive. However, if there is long-term care insurance, the policy may pay for these services. The Area Agency on Aging and Disabilities coordinates several governmental programs providing some of these services. Call the Area Agency on Aging & Disability to learn the details.


Sometimes older adults are able to remain relatively independent if they are part of a senior housing complex. Socialization with other older adults and perhaps some transportation can provide a bridge between living alone in their own home and institutionalization. The Department of Housing and Urban Development offers Section 8 housing at some residences exclusively for older adults. This means the resident pays 30 percent of his/ her income as rent, which usually includes utilities. These apartments are operated by the local housing authority or by non-profit groups such as religious denominations.

Help with the weatherization of existing homes may be available through the local housing authority or the Community Action Agency. This helpcan take the form of grants or loans to cover home repair, including broken glass and weatherization through insulation, caulking, and weather stripping as well as wrapping water heaters and pipes and installing smoke alarms and window screens.

Assisted living can be costly and the number of sliding scale rooms is limited. Consult COA's Directory of Services for Seniors and online at for up-to-date information. 

Nursing homes can accept private pay, Medicare, and Medicaid, but they are not required to accept all. There are many variables in terms of what particular circumstances each program covers. The Legal Aid Society (1-800-238-1443) has excellent information on this subject.

Legal Assistance

Some bar associations offer free assistance over the phone for simple legal problems. These contacts can be a way to learn if your problem requires additional professional legal advice. The Legal Aid Society also has materials, phone advice, and assistance
available free of charge. They are very knowledgeable on Medicare, Social Security, and Social Security Disability. A listing of Legal Aid Societies is included under General Resources in the Resources and Inventories Chapter. One question a family member may have is whether to become a conservator for a relative. This means being appointed by the court to legally make decisions concerning the care of an incapacitated adult. Some agencies will act as a conservator for seniors on a sliding scale fee schedule.

Utility Company Assistance

Different utility companies provide varying assistance: financial assistance, resolving problems resulting from the due date of the utility bill versus the receipt of one’s Social Security benefit, budget billing to provide equal billing throughout the year, third-party notification (where a designated relative can receive notice prior to cutoff for non-payment), and payment of the bill through bank draft or online payment.

Senior And Community Centers

These centers offer many activities, and most are free or have a very small charge. Meals, health screenings, care management services, wellness programs, entertainment, phone reassurance programs, and transportation are typical services offered.

Transportation (See Transportation Chapter)

Senior centers sometimes offer transportation to medical appointments and shopping. Transit systems offer seniors with disabilities special transportation for a small fee.

Faith-based communities are often a good resource for transportation when older adults need someone to help them in and out of their home and into the vehicle and perhaps to stay with them at the medical facility. Many older adults feel more comfortable with someone from their congregation rather than with a paid outsider.

Veterans Services

Veterans and their spouses are eligible for a variety of services at reduced costs: burial in veterans cemeteries, adult day services, counseling, respite, nursing home care, prescription assistance, healthcare, and assisted living.

With all the above services, eligibilty varies and assistance may not be available in every location. Remember that most older adults wat to stay as independent as possible. Be sensitive to the fact that accepting "givernment help" may be awkward and embarrassing to them.