YOUNGSTOWN, Ohio – Mahoning Valley organizations and agencies help seniors navigate the challenges of aging, enabling them to remain in their homes longer.
Always Best Care provides at-home care to about 500 clients. Services range from companionship to full personal care.
Pam Puorro, who has owned the home health care company for 14 years, has seen increased demand for services since the pandemic. People heard frightening stories of what was happening inside nursing homes and assisted living centers and many decided they wanted to remain in their homes, she said. That trend continued after the pandemic waned.
“Your home is your home,” Puorro says, “Everybody wants to remain in their own home as long as they possibly can and we feel very, very blessed that we’re able to help make that happen for people.”
A Pew Research report from February states 93% of U.S. adults 65 and older live in their own home or apartment and when asked what they would want to do if they needed care, 60% said they wanted to stay in their home with assistance of a caregiver. Only 18% would choose to move to assisted living.
Puorro says she is always hiring, trying to find not only enough caregivers, but the right ones for the different needs of their clients.
“We have a lot of amazing caregivers,” Puorro says. “It’s not as challenging as it was for a while, but it’s constant hiring and bringing people on and getting people trained to be the correct caregivers.”
Additionally, some clients require companionship, while others need full personal support for bathing, dressing, feeding, meal preparation, medication reminders and more. Caregivers can run errands, such as picking up prescriptions and grocery shopping.
Located in East Liverpool, Always Best Care serves Columbiana, Mahoning, Trumbull, Ashtabula, Jefferson and Carroll counties.
Finding Help
Adult children may not be aware of the scope of their aging parents’ needs. They realize there’s a problem when they visit and call agencies like Puorro’s with a lot of questions.
Many do not know how to get help for their parents. They may work full time, care for young children or live out of town.
“A lot of folks just don’t know what steps to take to get things in line to be able to get care,” Puorro says, adding depending on whether paying privately, using veteran benefits or needing other assistance, she will direct them where to get some assistance.
Often she refers them to reach out to Direction Home of Eastern Ohio.
That agency can connect seniors to resources for home health care and assisted living services, as well as help them find other services in their community.
From a staffing standpoint, Cassandra Valentini, chief of community development and public relations for Direction Home of Eastern Ohio, says the agency used to struggle with staffing. But in 2022, Ohio increased payments to agencies that care for seniors by about 6%. That enabled Direction Home and similar agencies to increase pay for workers in home health, assisted living and other waiver services. There were 615 unstaffed cases in 2022, but by 2023 that dropped to 385 and today there are few. One exception, Valentini says, is waiver nursing in Columbiana County, where a shortage remains.
Joseph Rossi, CEO at Direction Home, says one of the surprising things found by a recent needs assessment was how many seniors are asking for housing assistance, either to move into smaller homes or to help pay for renovations that will allow them to live in their homes longer.
“The home has to be suitable for them to be in it,” says Rossi, adding it may need grab bars, easy to maneuver door knobs, wider doors and first floor bathrooms.
Valentini says many homes in Youngstown and Warren are older with bedrooms and bathrooms upstairs. Those homes require adjustments for people who want to age in place.
Besides help with housing, older adults may need several types of assistance to make their goal of aging in place a reality
“Last year, we did about 12,000 calls for assistance and we were able to help people get connected to a resource in the community,” Valentini says.
In addition to calling the office, Direction Home offers a book, “Older Adults… the Resource Guide,” with more than 90 pages of information on state and local resources with contact numbers, email addresses, physical addresses and more.
Some calls to Direction Home help seniors navigate the systems that have been put in place to help them, including what funding sources can be accessed to pay for it. For instance, Direction Home works with the transportation systems in the various counties and local meal delivery services.
“Right before the pandemic hit we implemented our Get Out and Dine program, which is a restaurant-based program,” Rossi says. “It was valuable for restaurant owners during the pandemic, because they could grab and go.”
Rossi says the federally-funded program helped keep some locally owned restaurants open during the pandemic, but now the Get Out and Dine program gives seniors a reason to visit “mom and pop” restaurants in their area and socialize.
Social isolation can be a problem for at-home seniors, with about a quarter of them living alone. Ohio’s Housing Finance Agency found in 2024 one out of every eight Ohio households was a single adult aged 65 or older.
Valentini says through the program she has heard of people making new friends, restaurants going above and beyond to help the seniors in their community and federal dollars coming back.
While there was more federal funding for senior programs during the pandemic, that money has returned to prior levels. Rossi says all the counties served by Direction Home recognize the need for aging services, passing levies for programs, especially for those seniors who don’t meet Medicaid requirements.
“These are truly individuals who maybe have a little bit of savings because they know they need a new roof, but they don’t need it today,” Valentini says.
Many other government programs require seniors to spend their own finances before they qualify for help. But seniors are eligible for levy services without having to expend all of their money.
“The levy really is that space for folks to be able to sit for a period of time while they’re spending down the dollars to get onto a Medicaid program and making sure that we’re still giving them services,” she says.
Direction Home works with organizations like Second Harvest Food Bank, the Senior Support Action Group and Heart Reach Neighborhood Ministries to get meals to seniors.
According to the Ohio Department of Aging, more than 2.8 million of the state’s residents are at least 60. That’s about 25% of the population. By 2030, the state predicts that number will top 3 million. At least 29% of the population of Mahoning and Trumbull is projected to be seniors.
The Department of Aging recently started an online Long-Term Care Quality Navigator, where Ohioans can search for nursing homes, assisted living facilities and the Program of All-Inclusive Care for the Elderly (PACE) centers. The navigator website also offers a quiz for those unsure of what type of care would be best suited for them, as well as resource information for a variety of questions, including information about covering costs and waivers.
Buckeye Pace
For those with complex medical needs who still want to remain in their home, Buckeye PACE offers all-inclusive care, including medical, therapy, medication management and transportation, says Rashelle Duko, Buckeye PACE’s director of growth. Most of those using PACE services are dual-eligible, both Medicare and Medicaid beneficiaries with minimal out-of-pocket expenses.
“It’s a comprehensive healthcare program to assist our older adult population that meet a nursing facility level medical need… but they meet the needs in their homes,” Duko says. “We want them to stay safely in their homes and in the communities where they want to be, while helping reduce some of those ER visits, rehospitalizations and keeping them with their families, which is their goal. They want to be home.”
Buckeye PACE can coordinate care at home, sending in physical and occupational therapists, nurses, dieticians, social workers, caregivers and light housekeeping services. A team of medical providers meet to discuss the needs of the clients and try to catch concerns early to reduce emergency room visits, Duko says.
Buckeye PACE assists with transportation, meals and dental, vision and hearing needs. The program also provides the opportunity to socialize with others at the centers – Buckeye PACE now has centers in Mahoning, Trumbull and Ashtabula counties. Activity directors at each center coordinate hourly activities for those who come there.
“Buckeye PACE really is more of a proactive approach to healthcare and it’s just so unique to the market,” Duko says. “So being new, we’re really seeing a lot of interest in the program.”
And Duko says proposed Ohio legislation could expand those services and the numbers of seniors who can take advantage of the program. She says it is saving the state money by reducing hospitalizations and the numbers of residents requiring more expensive nursing homes.
Christina Terry, the director of employee engagement and retention at Buckeye PACE, says the interdisciplinary team meets for periodic assessments and care coordination to benefit senior patients.
Duko points to the significance of that team as everyone sees things differently.
“Our homecare [personal care assistants], they know our participants more than some providers at times and they pick up on things, so having our disciplinary and integrated approach is truly key to keeping them safe at home,” Duko says.
Terry says the agency has gotten a good applicant flow when it comes to finding staffing. She emphasizes the need to match personalities with the job.
“We have had great success finding those people that are very mission focused, mission oriented and when you go into the center, you can just feel it,” Terry says. “The employees think of our participants as family. They see them as family.”
Pictured at top: Cassandra Valentini, chief of community development and public relations, and Joseph Rossi, CEO, help seniors navigate service needs at Direction Home of Eastern Ohio.
