What is an Adult Family Care Home (AFCH)?

Adult family care homes (AFCHs) are private residences that are licensed to provide housing, meals, and personal care services to older persons and disabled adults who are unable to live independently. AFCHs are owned and operated by licensed AFCH providers who live with the residents they serve. In addition, AFCHs are limited to a maximum of six (6) residents. AFCHs are intended to be a less costly alternative to more restrictive, institutional settings for individuals who do not need 24-hour nursing supervision. The Adult Family Care Homes of Maine (AFCH) program places adults who are not able to live alone safely in the homes of host families willing to care for them. The program is for adults who need daily help with personal care, but want to live in a family setting rather than in a nursing home or other facility. The host caregiver provides a private bedroom, meals, companionship, personal care assistance, and 24-hour supervision. Service providers, including a social worker and registered nurse, train the caregiver and provide ongoing support.

Am I eligible?

To be eligible for Adult Family Care you must meed the following criteria:

• Be 16 years of age or older
• Be unable to live alone because of a medical, physical, cognitive or mental condition
• Require daily assistance with one or more activities of daily living (such as bathing, dressing, grooming, eating, or getting in and out of a bed or chair)
• Cannot require full-time skilled nursing care
• Willing to live in someone else's home
• Eligible for MaineCare or able to pay privately

What benefits will I receive?

You will be treated like a member of the family in your host family's home.
You will receive from your host family:

• Private, and Semi Private rooms available
• Prepared meals and snacks
• Assistance with personal care
• Medication reminders and assistance
• Shopping, laundry, and housekeeping
• Transportation to medical appointments

You will receive from the Adult Family Care agency:

• Careful screening and training of Personal Support Staff
• Case management and service coordination
• Periodic visits by social workers and registered nurses to monitor medical conditions, evaluate caregiver services, and offer support and training
• 24-hour coverage for emergencies

Choosing your care

When you need medical care, you have the right to make choices about that care. However, there may come a time when you are so sick that you cannot make your decisions known. You can stay in charge by putting your choice in writing ahead of time. This is called giving an advance directive.

Do you have more questions about Advance Directives? [ Click Here ] to find out more.

What if I suffer from a mental health problem?

You may also choose to sign a different form, called a mental health directive, that allows you to choose what treatment you want if you become very mentally ill and are unable to make health care decisions.

What rights do I have as a patient?

When you need medical care, you have certain rights, including the right to refuse care.You have a right to know:

• what your medical problem is and what tests and treatments may be needed
• what the doctor thinks can be cone and what the usual risks may be
• if there are other ways to care for you
• what may happen if you refuse care

What else should I know?

Every hospital and many other places that provide health care in Maine have these forms or can tell you how to get them. Just ask your doctor or nurse. They can explain the forms, but they cannot give you legal advice. No one can make you sign a form or stop you from signing it. You also have the right to change or cancel a form at any time. The advance health care directive form does not allow others to control your money or property. It does not allow anyone to violate laws against mercy killing and euthanasia. If you have a complaint about how a hospital or other place of health care handled your advance directive, you can contact:

Licensing Division
Maine Department of Human Services
221 State Street
Augusta, Maine 04333
(207) 624-5443

What happens to the Living Will after I have signed it and given it to my doctor?

Your doctor will put the Living Will in your medical record, where it should be seen by everyone involved in your care. Later on, if you are dying or in a persistent vegetative state, the doctor caring for you will follow the directions in your Living Will. If the doctor is not willing to follow your directions because of the doctor's own personal or religious beliefs, he or she must transfer you to the care of another doctor who will follow your directions.

Will my Living Will be honored by emergency medical personnel, in the ambulance
or emergency room?

Sometimes people who have signed Living Wills are surprised and upset when emergency medical personnel disregard the Living Will and administer life-support anyway. The reason that this may happen is that, in an emergency, the staff may not have time to read the Living Will, to make sure that the patient is in a terminal condition and that it is indeed appropriate to withdraw treatment. If you are already in a terminal condition and feel strongly that you do not want to be given life-support under any circumstances, you should talk to your doctor. Your doctor may be able to notify the ambulance service and the emergency room that they should not give life-support and that they should only give you treatment that will ease your pain and keep you comfortable.

Will my Living will, executed in Maine, be honored in another state?

It is possible that you may get sick, injured, or have to go to a hospital while visiting in another state. You should carry a copy of your Living Will with you in your wallet or purse, since your medical record will not be available right away to the doctors there. You should also have your Living Will witnessed by a notary public or attorney if you travel sometimes and are concerned about how your Living Will will be treated in another state. Whether the doctors there follow your directions depends on whether that state has a Living Will law similar to Maine's. As of June 1992, at least 41 states recognized Living Wills.

Will signing a Living Will affect my insurance?

The law says that insurance companies may not base anything in an existing or future life insurance policy on whether a person does or does not have a Living Will.

Reminder

You can plan in advance for the time when you may not be able to state your health care choices. Talk with your doctor, family members, clergy, and others about your wishes. Put your decisions in writing. This may save your family and others from having to make painful decisions later on. You can use the form in this package, which also includese directions for completing the form. You don't have to have a lawyer, although you may want to speak with one. After you sign the form, put the original in a safe place and be sure to give copies to your family, your doctor, and your hospital. You will have earned their thanks and your own peace of mind. To learn more about advance health care directives, visit the Maine's Office of Elder Services web site.