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While knowing respite is a temporary break for the caregiver when approaching your funding challenges, it is necessary to learn about the different types of respite care that can be provided.
Respite includes a broad array of service options, many of which are licensed and/or regulated through other program categories, such as child care, residential care, emergency shelter care, home health care or foster care. Respite programs should accept the responsibility to be aware of and in compliance with specific state licensing requirements that may govern their activities.
Many families prefer respite that is provided in the home that offers several advantages for the family or primary caregiver:
A program manager, an individual who agrees to recruit, provide basic training, and keep a database of possible respite providers, may take the lead in coordinating in-home care. Families can be matched with a provider by calling the program manager who will take the lead responsibility for child-specific training, payment, and repeat scheduling.
Listed here is a sampling of the typical models used as in-home respite.
Model 1: Home-Based Services
Home-based respite services may be provided through a public health nursing agency, a social service department, a volunteer association, a private nonprofit agency and/or a private homemaker service. A trained and perhaps licensed employee of the agency provides direct respite services in the home. Ideally, services should be available twenty-four hours a day, 365 days per year, for families to access quality respite when they most need the service.
Model 2: Sitter-Companion Services
Sitter services may be provided by individuals who are trained in caring for children or adults with special needs. Often this type of service is a project of a service organization or specialized agency (Camp Fire, Jaycees, Junior League, local ARC or United Cerebral Palsy Associations) that are willing to sponsor training and/or maintain a register of trained providers for which families can link.
Model 3: Parent-Trainer Services
This model is similar to having a friend or relative volunteer to care for a child with special needs. The primary difference is that the person providing care is identified or selected by the family and trained by a respite program. Providers may be paid or unpaid.
Out-of-home respite provides an opportunity for children and adults with disabilities, chronic or terminal illnesses to be cared for outside the home. This may be a particularly attractive option for adolescents who are preparing to leave the family home for a more independent living arrangement because it gives them an opportunity to experience new surroundings and different expectations. Families are free to enjoy time in their own home without the constraints of constant care and can devote more attention to siblings.
Listed below are some special considerations regarding out-of-home models.
Model 4: Family Care Homes or Host Family Model
In this model, respite is offered in the provider's home. This could be the home of a staff person from a respite program, a family day care home, a trained volunteer's family home, or a licensed foster home used only for respite stays. Offering respite in a provider's home enables a child to receive services in a more familiar setting. Best practice under this model supports homes that seek appropriate licensure under state regulations governing foster homes.
Model 5: Respite Family Day Care or Center-based Model
Some respite programs contract with existing day care centers to provide respite to children or adults with special needs. This is an effective model in rural areas especially, because it allows people with special needs to be in supervised environments in a facility that may be relatively close to home. Clients may be placed in these settings on a short-term "drop in" basis. Day care centers may be housed in churches, community centers, and after school programs. Not all centers are licensed by the state to provide services.
Model 6: Respite in Corporate Foster Home Settings
In some states, foster care regulations and licensing accommodate the development and operation of foster care "homes" that are managed by a non-profit or for-profit corporation. In this situation, several children or adolescents who have disabilities are placed outside their family homes and live together in a homelike environment with the help of trained, rotating staff. These corporation operated foster homes may provide respite care, either as vacancies occur in the homes or as the sole purpose for which the "home" exists. Some adolescents adapt especially well to this situation, enjoying a setting that is like semi-independent living.
Model 7: Residential Facilities
Some long-term residential care facilities, particularly those serving persons with developmental disabilities, have a specified number of beds set aside for short-term respite. Some examples of such facilities are community residences (such as group homes and supervised apartments), nursing homes, and state institutions.
Model 8: Parent Cooperative Model
Parent cooperatives were developed in communities, especially rural areas, where respite services are very limited. In this type of model, families of children with disabilities and/or chronic illnesses develop an informal association and "trade" respite services with each other. This exchange program allows families to receive respite on scheduled dates. In most parent cooperatives, fees are not assessed. This model has proven to be especially effective for families whose children have similar disabilities.
Model 9: Respitality Model
Respitality is an innovative concept for providing respite. It provides a cost-effective partnership between the private sector and respite agencies. Respitality is the process of working with participating hotels to provide the family with a room, a pleasant dining experience, and perhaps entertainment while a local respite program provides respite either in the family's home or in an out-of-home respite situation.
Model 10: Hospital-Based
Facility-based respite occurs primarily in hospitals. It provides a safe setting for children with extensive care needs. This offers a good alternative for a small community with a typically low census using their local hospital, especially on the weekend. A hospital may provide the sense of security parents and caregivers need when considering respite for their loved one. High quality skilled respite care is provided, but usually on a limited basis and must be scheduled in advance.
Model 11: Camps
Camp has been a form of respite for families for many years. Whether or not a child has a disability, camp can be a positive experience for any child as well as a break for parents/caregivers. For persons with disabilities, chronic or terminal illnesses, the chance to participate in either an integrated or adapted camp can be life-expanding. There are many places around the country that offer such experiences, either as day or overnight camps.
Model 12: Church-based
Many community churches have begun respite care programs that provide out-of-home respite for families. These programs are often run one day a month for a few hours, utilizing teams of volunteers that are trained by the church to care for the special needs of the participants. The frequency of service is determined by the church administration. These facilities offer a wonderful opportunity for caregivers to place their loved ones in a caring facility usually for a nominal fee but often free of charge.
A Brief Explanation of Specific Types of Respite Programs
Crisis Nursery Care
Respite for Children at Risk of Abuse and/or Neglect
Crisis nursery programs were developed to prevent child abuse and neglect and to increase family stability thus preventing the need for out-of-home placement. Recognizing that there are times when parenting can be difficult, particularly when a family is experiencing a crisis or extreme stress, crisis nurseries offer temporary relief from child care responsibilities which allows time for parents to address their own needs. Traditionally, parents have received this help from extended family members or close friends. In today’s mobile society, a network of extended family members and/or friends is not always available. In these situations, crisis nursery programs can offer assistance to parents in meeting their caregiving responsibilities.
Adult Day Care
One Form of Respite for Older Adults
Adult day care centers provide a break (respite) to the caregiver while providing health services, therapeutic services, and social activities for people with Alzheimer’s disease and related dementia, chronic illnesses, traumatic brain injuries, developmental disabilities, and other problems that increase their care needs. Some adult day care centers are dementia specific, providing services exclusively to that population. Other centers serve the broader population.
One difference between traditional adult respite, both group and in-home care, and adult day care is that adult day centers not only provide respite to family caregivers but also therapeutic care for cognitively and physically impaired older adults.