Senior Care in Columbia and Greene Counties: Hudson, Catskill and the River Towns

Two old counties on the river

Columbia County has the oldest population of the nine counties we cover, with a median age of 50.3, and Greene is close behind at 46.8. Many residents moved up from the New York City area to retire, and many live in rural towns far from services.

Columbia Memorial Hospital in Hudson, part of the Albany Med Health System, serves both counties; Greene County has no general hospital of its own, so Catskill and Coxsackie residents cross the Rip Van Winkle Bridge or drive north to Albany.

What is licensed

Most of the assisted living here holds Assisted Living Program beds, which means Medicaid-eligible residents have real options. What the two counties lack is SNALR memory care: a parent whose dementia requires a secured setting will need a residence in Albany or Rensselaer County, or a nursing home.

Different ombudsman, same rules

Columbia and Greene counties are served by the Long Term Care Community Coalition's Hudson Valley ombudsman program at (845) 229-4680, while the other seven Capital Region counties use Catholic Charities in Schenectady. Everything else, from licensing to the Medicaid regional rate of $14,783 a month, is the same as in Albany.

The Columbia County Office for the Aging is at (518) 828-4258 and the Greene County Department for the Aging at (518) 719-3555. There is no PACE program in either county.

Planning across the river

Families here often plan around two questions: how far is the hospital, and who will visit? A residence in Catskill may be close to home but 40 minutes from Albany specialists; a residence in Albany may be near the specialists and far from friends. Write down who visits most and how often before choosing.

Home care is harder to staff in the hill towns of eastern Columbia and the mountaintop towns of Greene. CDPAP, which lets a relative or friend be the paid aide for a Medicaid recipient, fills that gap for many families.

Nursing homes in the two counties

Several of the two counties' nursing homes carry low CMS ratings, and two are listed by CMS as Special Focus Facility candidates, which means their inspection histories place them among the homes with the most persistent problems in the state. Others rate well. Read each home's page carefully, compare staffing and inspection results, and visit before choosing.

Because the choice is narrow, many families also look at homes in southern Rensselaer and Albany counties, where options are wider but visits are farther.

Legal and benefits help

The county Offices for the Aging can arrange benefits counseling, HIICAP Medicare advice and referrals to legal services. Medicaid applications go to the Department of Social Services in the county where your parent lives.

Families who own homes in both counties and elsewhere, a common situation for retirees from downstate, should get elder law advice early, because property in another state can complicate a Medicaid application.

Respite and adult day options

Family caregivers in the two counties can ask the Offices for the Aging about respite programs, caregiver support groups and adult day options, and some residences offer short respite stays when they have an open apartment. Respite is easiest to arrange when it is planned weeks ahead, so call before you are exhausted.

Medicaid covers licensed adult day health care for eligible people. Ask each program whether it provides transportation from your parent's town, since distance is the usual barrier in rural Columbia and Greene.

Some families also use a short respite stay as a trial run for assisted living. A week or two in a residence lets a parent experience the routine, the meals and the company without committing to a move, and it often turns a reluctant parent into a willing one. Ask each residence whether it offers respite stays and how far ahead to book.

If dementia is part of the picture

Tour SNALR residences in Albany and Rensselaer counties early, while your parent is still safe at home, and ask about interest lists. Compare that option with a nursing home dementia unit closer to home. Bring your parent's doctor into the timing; a written assessment helps residences decide quickly when a bed opens.

The Alzheimer's Association's helpline, 1-800-272-3900, can point caregivers to support groups that meet in the two counties.