Directory of Services
for
Adults
in
Revised: May, 2010

Carroll County Health Department
Main
Telephone Lines:
410-857-5000 410-876-2152 410-875-3390
This Directory has been prepared by the Carroll County
Health Department Adult Evaluation and Review Services (AERS) Program as a
helpful resource to the citizens of
Please note: The Directory has been cross-referenced
for your convenience, some agencies, contacts, and resources have been listed
more than once.
This Directory may not be reproduced without written
consent from:
Carroll County Health Department AERS Program
TABLE OF
CONTENTS
Quick Reference Guide to
Quick Reference Guide to Bureau of
Aging.................................................... 7
Adult Day Care.................................................................................................. 8
Aide Services, Personal Care, and
Housekeeping........................................ 8
Alzheimer’s and Memory Loss Services......................................................... 9
Crisis Intervention and Counseling.................................................................. 9
Dental Services................................................................................................. 9
Developmental Disabilities............................................................................... 9
Dialysis............................................................................................................... 10
Driver Safety Programs.................................................................................... 10
Educational Opportunities................................................................................. 10
Emergency........................................................................................................ 10
Emergency Call Devices.................................................................................. 11
Employment and Volunteer Resources........................................................... 11
Equipment, Medical (including Rental/Loan)................................................... 11
Financial Resources......................................................................................... 11
Food Resources............................................................................................... 12
Food Pantries and Soup Kitchens................................................................... 13
Health Care
Information…………………………………………………………...14
Hearing - See Vision and Hearing.................................................................... 20
Hispanic/Ethnic Programs................................................................................ 14
Home Health Services...................................................................................... 14
Home Repair..................................................................................................... 15
Housing Options and Information..................................................................... 15
Income Tax Assistance/Obtainment of
Forms............................................... 15
Insurance: Health and Other............................................................................ 16
Legal Services................................................................................................... 16
Mental Health and Counseling Services.......................................................... 16
- 17
Miscellaneous Assistance................................................................................ 17
Newspapers....................................................................................................... 17
Nursing Homes.................................................................................................. 17
Nutrition.............................................................................................................. 18
Ombudsman...................................................................................................... 18
Pharmacy/Medication Assistance.................................................................... 18
Recreation......................................................................................................... 18
Respite Care..................................................................................................... 19
TABLE OF CONTENTS - continued
Support Groups................................................................................................. 19
Transportation.................................................................................................... 19
Veterans Information......................................................................................... 19
Vision and Hearing............................................................................................ 20
Vital Records..................................................................................................... 20
Volunteer Opportunities.................................................................................... 20
Websites............................................................................................................ 21
- 22
Senior Home Safety Guidelines....................................................................... 23
Emergency Preparedness Information
and Documents................................ 24-27
Note Page.......................................................................................................... 28
Quick Reference Guide
Carroll
County Health Department
Addictions................................................................................................................. 410-876-4410/4800
Environmental Health............................................................................................... 410-857-5009
410-876-1884
Nursing Bureau........................................................................................................ 410-876-4900
Quick
Reference Guide
Carroll
County Health Department - continued
Partnership for a Healthier
Shoemaker Addictions Rehabilitation Center...................................................... 410-876-1990
Vital Records............................................................................................................ 410-876-4991
410-876-2152
410-857-5000
Quick Reference Guide to the Bureau on Aging
410-386-3800
Assisted Living Program
Carroll County Alzheimer’s Support Group
Cell Phones for 911 Only
Legal Assistance
Long Term Care Ombudsman
Medicaid Home and Community Based Waiver
Services
National Family Care Givers Support Program
Nutritional Programs
Public Guardianship Program
Senior Activities Centers [See Recreation
Section for Listings]
Senior Care Program
Senior Health Insurance Program
Senior Inclusion Program
Senior Information and Assistance
Seniors Keep in Touch [SKIT]
SMP-Senior Medicare Patrol
Adult Day Programs
Active Day (
Eldersburg Care...................................................................................................... 410-795-4686
410-848-2433
Aide Services, Personal Care, & Housekeeping
AAA Warman........................................................................................................... 301-428-6602
888-243-6602
Almost Home (Unique Services, Inc.).................................................................... 410-756-1727
Always There Home Care....................................................................................... 410-346-7870
443-277-9636
Amedisys Home Health.......................................................................................... 410-751-9904
Carroll County Home Care & Hospice.................................................................. 410-871-8000
888-224-2580
410-876-8044
Elder’s Choice (live in only-not shift care.............................................................. 443-762-4676
Elizabeth Cooney Agency....................................................................................... 410-323-1700
Family & Children’s of Central MD (WEP)............................................................ 410-840-0406
First Choice.............................................................................................................. 410-740-8166
Helpers to the Homebound (South Carroll area only).......................................... 443-920-9113
(associated with Caring
Carroll).................................................................. 410-775-5596
Home Call................................................................................................................. 410-848-5379
Home Helpers.......................................................................................................... 410-239-9998
800-216-4196, x105
Home Helpers.......................................................................................................... 410-239-9998
Home Instead -
Ivory House Health Services................................................................................... 410-823-3153
Lutheran Home Care Services............................................................................... 800-338-4295
Maxim Healthcare Service...................................................................................... 301-631-2255
866-466-2982
Medical Asst. Personal Care Program................................................................. 410-876-4949
Options for Senior America (home health)........................................................... 800-267-8466
Right At Home.......................................................................................................... 866-696-2211
301-696-1122
Visiting Angels......................................................................................................... 410-549-8002
866-683-5392
410-730-4115
Visiting Nurses Association................................................................................... 888-523-5000
Alzheimer’s and Memory Impairment Services
Alzheimer’s Help Line (Alzheimer’s Assoc.)......................................................... 800-443-2273
Alzheimer’s Support Group.................................................................................... 410-386-3800
Assessment Clinic at Copper Ridge..................................................................... 410-795-8808
Direct Line-outpatient clinic...................................................... 410-552-3211
Comprehensive Geriatric Services Memory Clinic
Safe Return Medic Alert.......................................................................................... 888-572-8566
Crisis Intervention and Counseling Services
Catastrophic Health Care Planners....................................................................... 410-871-0751
410-861-8969
Hopeline Network (suicidal emergency Intervention)........................................... 800-784-2433
MD Crisis Hotline..................................................................................................... 800-422-0009
MD Health Care Coalition....................................................................................... 410-539-0872
MD Network Against Domestic Violence............................................................. 800-634-3577
Rape Crisis Hotline (24 hours)............................................................................... 410-857-7322
410-857-0900
Dental Services
Dental Access—CC Health Department.............................................................. 410-876-4928
Donated Dental Program (MD Foundation of Dentistry for the Handicapped
................................................................................................................................... 410-964-1944
Freedom Center...................................................................................................... 301-846-7811
Johns
Just Dentures........................................................................................................... 410-308-0090
Kernan’s Hospital Dental Clinic............................................................................. 410-448-6290
Wednesdays-walk-in free
clinic................................................................... 410-340-3791
Same Day Denture Service.................................................................................... 410-602-2070
Emergency........................................................................................ 410-706-2716
Developmental Disabilities
ARC of
CHANGE.................................................................................................................. 410-876-2179
Flying Colors of Success........................................................................................ 410-876-0838
Guardian Protection Services................................................................................ 800-776-8328
MD TAP (equipment for disabled & handicapped)............................................. 800-832-4827
Service Coordination for Carroll Co. (through DDA)........................................... 410-876-0028
United Cerebral Palsy............................................................................................. 800-451-2452
Dialysis
Driver Safety Programs
MD AARP Driver Safety Program......................................................................... 888-227-7669
AARP Drivers Safety Course-Senior Centers
•Mt. Airy............................................................................................................... 410-795-1017
301-829-2407
•North Carroll...................................................................................................... 410-386-3900
•South Carroll..................................................................................................... 410-386-3700
•
MVA Medical Advisory Board................................................................................ 410-768-7689
Education Opportunities
Education for Adults................................................................................................ 410-386-2550
Eldersburg...................................................................................................... 410-386-4460
Mt. Airy............................................................................................................ 410-386-4470
North Carroll .................................................................................................. 410-386-4480
Taneytown....................................................................................................... 410-386-4510
Elderhostel................................................................................................................ 877-426-8056
Emergency
Ambulance, Emergency, Fire, Police, Sheriff....................................................... 911
American Red Cross............................................................................................... 800-787-0091
City Police
Hampstead..................................................................................................... 410-239-8954
Sykesville........................................................................................................ 410-795-0757
Taneytown....................................................................................................... 410-751-1150
410-876-3100
MD Poison Control.................................................................................................. 800-492-2414
MD State Police (
Sheriff’s Department............................................................................................... 410-386-2900
Emergency Call - Personal Devices
24/7 Medical Alert.................................................................................................... 410-828-5564
Life Alarm................................................................................................................. 800-780-5433
Life Fone................................................................................................................... 800-882-2280
Life Line.................................................................................................................... 800-579-3341
Life Response of MD.............................................................................................. 410-833-1067
Medical Alert............................................................................................................ 800-448-5697
Response Link......................................................................................................... 800-894-1428
Employment & Volunteer Resources
Business Employment Resource Center ............................................................. 410-386-2820
Division of Rehab Services-Vocational................................................................ 410-848-4456
(for persons with
disabilities)
MD Work Tech. for Disabilities.............................................................................. 800-832-4827
Senior Employment Program
MD Dept of Aging........................................................................................ 800-243-3425
Equipment, Medical (rental & loan)
A&A Medical Supply-durable equipment,
Medicaid & MA OAW Provider...................................................................... 410-526-9323
Anchor Pharmacy/Mobility Rehab.......................................................................... 410-848-8900
Arthritis Foundation Equipment-Subsidy
Grant, Primary Diagnosis Arthritis................................................................. 800-365-3811
Family Pharmacy-wheelchair rental....................................................................... 410-239-3100
Home Care Delivered, Inc
(free Diabetic glucometer program)............................................................ 800-565-5644
Little Scooter Shoppe............................................................................................. 888-242-0057
Loan Closets (Lions Club)
Freedom......................................................................................................... 410-549-5466
Mt.
Airy............................................................................................................ 301-829-5466
McDougall’s Pharmacy-wheelchair rental............................................................. 410-795-2662
MD TAP - Equipment for Disabled and Handicapped/MD Equipment Link..... 800-832-4827
Medi - Rents and Sales........................................................................................... 800-540-7252
Millennium Respiration Services-oxygen.............................................................. 410-840-2247
Mobility Rehab-all types of durable medical equipment, portable ramps.......... 410-833-8755
Oxy-Care - oxygen .................................................................................................. 410-871-0887
Financial Resources
American Red Cross............................................................................................... 800-787-0091
Catastrophic Health Care Planners....................................................................... 410-871-0751
City of Westminster-Office of Housing & Community Development.................. 410-848-2261
ESCAPE Ministries................................................................................................. 410-549-7230
Get Connected (Age 0-25)..................................................................................... 410-871-0008
Human Services Program (
Internal Revenue Services...................................................................................... 800-829-1040
MD Cooperative Extension Service...................................................................... 410-386-2760
Mt. Airy NET............................................................................................................. 301-829-0472
NESAP [Northeast Social Action Program]......................................................... 410-239-6216
NESAP Thrift Store................................................................................................. 410-374-9099
Salvation Army [
Shepherd’s Staff (rent, gas vouchers, meds)....................................................... 410-857-5944
Social Security [Local Offices]............................................................................... 410-848-6271
St. Vincent De Paul Society-St. John’s ................................................................ 410-848-8693
Food Resources
Area Senior Centers
Mt. Airy............................................................................................................ 410-795-1017
301-829-2407
North Carroll .................................................................................................. 410-386-3900
South Carroll ................................................................................................ 410-386-3700
Taneytown........................................................................................................ 410-386-2700
Food Sunday............................................................................................................ 410-857-7926
Meals on Wheels..................................................................................................... 410-857-4447
NESAP food pantry................................................................................................. 410-239-6216
SHARE - Human Services [Discount Rate Food
Package]............................... 410-857-2999
Food Pantries
|
Tues-Thurs Saturday-9:00 a.m.- |
|
|
Eldersburg Food Sunday Wednesday only-10:00- |
Eldersburg |
|
NESAP |
Hampstead |
|
Salvation Army |
|
|
Escape Ministries |
Sykesville |
|
Mt. Airy Net |
Mt. Airy |
|
|
|
|
Share: about $30 of groceries for $14 plus
2 hrs of community service, registration is held the 1st Thursday,
|
|
Soup Kitchens –
|
Monday |
Loaves and Fishes United |
|
Tuesday |
Table of Grace |
|
Wednesday |
Loaves and Fishes N. Court Street, |
|
Thursday |
Soup Kitchen Bond & Green Streets, |
|
Friday |
Shepherd’s Table United |
|
Saturday |
Church of the Brethren Park and Bank Streets, |
|
Sunday |
N. Court Street, |
Health Care Information
Access Carroll.......................................................................................................... 410-871-1478
Alzheimer’s & Memory Loss Services.................................................................. 800-443-2273
American Cancer Society....................................................................................... 410-781-4316
888-535-4555
American Diabetes Association of MD................................................................ 410-265-0075
American Lung Association (MD).......................................................................... 800-492-7527
American Red Cross............................................................................................... 800-787-0091
Arthritis Foundation ................................................................................................ 800-365-3811
Carroll County Cancer Center................................................................................ 410-876-5747
Carroll County Health Department......................................................................... 410-857-5000
410-876-2152
Breast
& Cervical Cancer Program................................................................... 410-876-4423
Chronic Disease Case
Management................................................................ 410-876-4949
Colorectal Cancer Screening............................................................................. 410-876-4423
Hypertension Screening (Blood
Pressure):...................................................... Walk-In
basis
M-F,
Carroll Hospital Center............................................................................................ 410-848-3000
Health Access [Physician Directory]...................................................................... 410-848-2244
Immediate Care (walk-in treatment Center -
Leukemia/Lymphoma Society................................................................................ 800-955-4572
Mission of Mercy/ Human Services....................................................................... 410-857-2999
Urgent Care (walk-in treatment center –
Hearing - see “Vision & Hearing”
Hispanic/Ethnic Programs
ESOL/GED -Adult
Education............................................................................. 410-386-2551
United Hands of
Home Health Services
Amedisys Home Health Care................................................................................. 410-751-9904
866-333-5838
Carroll Home Care & Hospice............................................................................... 410-871-8000
Community Home Health/Medi-Home Care......................................................... 800-282-8104
Home Call................................................................................................................. 410-848-5379
Lutheran Home Care Services............................................................................... 410-751-2429
800-338-4295
PT Connection......................................................................................................... 410-751-6858
Rehab on Wheels.................................................................................................... 301-252-5380
Visiting Nurses Association................................................................................... 410-594-9800
888-523-5000
Home Repair
Access Remodeling-independent living
strategist............................................... 301-983-0131
[low interest home repair loans]....................................................................... 410-386-3600
Carroll County Christian Work Camp.................................................................... 410-795-3880
410-781-6464
DORS [Department of Rehab Services]............................................................... 410-848-4456
410-876-1510
Hammer Ministry (South Carroll only).................................................................... 443-920-9113
Rebuilding Together (Jim Huber-Christmas in
April)........................................... 410-857-1722
Housing Options & Information
Bureau of Aging – assisted living
information...................................................... 410-386-3800
City of
410-876-6322
................................................................................................................................... 301-846-7811
Home Builders Association.................................................................................... 410-265-7400
Locust House........................................................................................................... 410-876-7600
Residential Specialist for Mental Health
Consumers – Core Service Agency
................................................................................................................................... 410-876-4440
Ridgely House.......................................................................................................... 410-239-2236
Sunnybrook Senior
The Residence (
Timber Ridge & Ridge Residences...................................................................... 410-876-2550
Tremont Place.......................................................................................................... 410-876-5622
Village House........................................................................................................... 410-795-0606
Income Tax Assistance & Forms
AARP........................................................................................................................ 888-687-2277
for phone numbers]
Insurance – Health & Insurance Programs
Catastrophic Health Care Planners....................................................................... 410-861-8969
Health Insurance Counseling Program - CCBOA................................................ 410-386-3800
Living at Home: MD Community Choices Waiver
Program............................... 410-767-7479
MA Waiver for Older Adults (Registry).................................................................. 866-417-3480
Medicaid Waiver for Older Adults.......................................................................... 410-386-3800
Medical Assistance Card ...................................................................................... 410-386-3300
Medicare................................................................................................................... 800-633-4227
MHIP (MD Health Insurance Plan).......................................................................... 888-879-6447
PAC Program.......................................................................................................... 800-226-2192
Social Security......................................................................................................... 410-848-6212
Legal Services
District Court............................................................................................................ 410-871-3500
Family Law Hotline.................................................................................................. 800-845-8550
Lawyer Referral Services (Baltimore City/County)............................................... 410-539-3112
410-337-9100
Legal Aid Bureau..................................................................................................... 800-679-8813
Legal Services [Bureau of Aging].......................................................................... 410-386-3800
MD Senior Legal Hotline......................................................................................... 800-999-8904
410-951-7750
MD Volunteer Lawyer Service................................................................................ 800-510-0050
410-547-6537
Mediation Services - call
Public Defender at CC Detention Center............................................................. 410-876-2788
Sixty Plus Legal Program....................................................................................... 410-951-7750
State’s Attorney’s Office......................................................................................... 410-386-2671
The Law and
Fax...................................................................................................................... 410-875-2851
Mental Health & Counseling Services
ADAPT (Eldersburg Mental Health-Dr. DelaCruz)............................................... 410-549-6282
Addictions:
Junction, Inc.................................................................................................... 410-848-6100
Mountain Manor............................................................................................. 410-876-2425
Alcoholics Anonymous............................................................................................ 410-663-1922
Carroll County CORE Services Agency................................................................ 410-876-4440
Get Connected......................................................................................................... 410-871-0008
Granite House.......................................................................................................... 410-751-5970
Keystone [Intensive Care Management] .............................................................. 410-875-4694
Fax................................................................................................................... 410-875-4699
MD Health Partners................................................................................................. 800-888-1965
National
On Our Own
Mental Health & Counseling Services - continued
Pastoral Counseling Services of MD.................................................................... 800-427-4027
Pro Bono Counseling ............................................................................................. 410-323-5800
877-323-5800
Progressive Counseling.......................................................................................... 410-848-7848
Prologue [Residential Rehab Services]................................................................ 410-549-3508
Rape Crisis Counseling – 24 hours/day............................................................... 410-857-7322
Office...................................................................................................... 410-857-0900
Re-Entry Mental Health Services........................................................................... 410-876-6149
Tender Heart Day Care (specializes in
patients with mental health issues)..... 410-789-7772
Youth Services Bureau
Miscellaneous Assistance & Information
Bureau of Aging-Information & Assistance........................................................... 410-386-3800
Caring Carroll (Faith in Action; Neighbors
Helping Neighbors
(Contact Maggie Kunz................................................................................... 410-775-5596
Carroll County Emergency Operations Center .................................................... 888-543-8362
DO NOT CALL List (Telemarketers)..................................................................... 888-382-1222
MD Cooperative Extension Service...................................................................... 410-386-2760
Poison Control......................................................................................................... 800-222-1222
Seniors Keep in Touch [SKIT] Safety Calls.......................................................... 410-386-3800
Telephone Directory Assistance............................................................................ 411
Time.......................................................................................................................... 410-844-1212
TriState Moving Solutions (helps downsizing)...................................................... 1-717-359-9099
United Way............................................................................................................... 800-492-0618
United Way of
Voter Registration [Board of Elections]................................................................. 410-386-2080
Weather.................................................................................................................... 410-936-1212
Newspapers
410-751-7900
Nursing Homes
Brinton Woods-Winfield.......................................................................................... 410-795-2737
Carroll Lutheran Village-Westminster.................................................................... 410-876-8113
Copper Ridge-Sykesville........................................................................................ 410-795-8808
Fairhaven-Sykesville............................................................................................... 410-795-8801
Golden Living Center............................................................................................... 410-848-0700
Long View-Manchester........................................................................................... 410-239-7139
Lorien of Mt. Airy...................................................................................................... 301-829-6050
Lorien of Taneytown................................................................................................ 410-756-5884
Nursing Homes - continued
Pleasant View-Mt. Airy............................................................................................ 301-829-0800
Transitions Health Care of Sykesville.................................................................... 410-795-1100
Nutrition*
Carroll County Health Department-Nutritionist...................................................... 410-876-4981
Also see: “Food Resources”
Ombudsman
Bureau of Aging-represents/advocates for nursing home/assisted living
residents
Point of contact: Carol
Purkins………………………………………………410-386-3817
Pharmacies
& Medication Assistance
410-876-0082
Department of Veteran’s Affairs-Benefits............................................................. 877-222-8387
MD AIDS Drug Assistance Program..................................................................... 800-205-6308
MD Pharmacy Assistance Program (MPAP)
Medicare Part D and under 65 ...................................................................... 800-226-2142
Medbank (under 65 –
Medicare Part D Help Subsidy.............................................................................. 800-325-0778
NACP Nat. Prescription Discount Card Contact
local pharmacy...................... 877-321-2652
NESAP {Northeast Social Action Program)......................................................... 410-239-6216
Salvation Army......................................................................................................... 410-876-9358
Shepherd’s Staff...................................................................................................... 410-857-5944
Recreation
Carroll County Senior Centers
Mt. Airy............................................................................................................ 410-795-1017
301-829-2407
North Carroll................................................................................................... 410-386-3900
South Carroll................................................................................................... 410-549-1357
Taneytown....................................................................................................... 410-386-2700
YMCA........................................................................................................................ 410-848-3660
*Also contact local churches for senior
clubs
Respite Care*
Alzheimer’s Association (Timonium)..................................................................... 800-272-3900
Care Giver’s Support Program.............................................................................. 410-386-3800
Family & Children’s Services................................................................................. 410-876-1233
410-840-0406
Senior Care Program-Bureau on Aging............................................................... 410-386-3800
Sitter Service-Bureau on Aging............................................................................. 410-386-3800
*check listings under “Aide Services”
Support Groups*
Alcoholics Anonymous............................................................................................ 410-663-1922
800-296-9289
ALS Association [Lou Gehrig’s]-MD Chapter...................................................... 866-348-3257
Alzheimer’s Family Support Group-(CCHD)........................................................ 410-876-4949
American Cancer Society ...................................................................................... 888-535-4555
American Diabetes Association............................................................................ 410-265-0075
Arthritis Foundation, MD Chapter.......................................................................... 800-365-3811
Breast Cancer Support Group for Couples.......................................................... 410-848-2244
Caregiver’s Support Group (
Carroll Hospice........................................................................................................ 410-871-8000
Hospice Support Groups (bereavement).............................................................. 410-871-7231
*for additional support groups-Alzheimer’s
Association of Baltimore & Central MD............................................................ 800-443-2273
Transportation
Ambulance-Emergency Only.................................................................................. 911
American Cancer Society (patient resource
center within Carroll Co............... 888-227-6333
Blue Blazes............................................................................................................... 410-871-2583
888-602-4007
Carroll Transit System............................................................................................. 410-876-7433
Rills Bus Line............................................................................................................ 410-876-7530
Rohrbaugh’s Bus Line............................................................................................. 410-374-9200
Transcare-Medical Transportation......................................................................... 800-498-0116
Veteran’s Information
Information for MD................................................................................................... 800-827-1000
Medical Centers:
Perry Point.................................................................................................... 410-642-2411
Veteran’s Affairs-Benefits Package...................................................................... 877-222-8387
Veteran’s Hospitals:
Charlotte Hall (veteran’s home).................................................................... 800-522-8387
Martinsburg [
800-817-3807
Vision & Hearing
American Hearing Aid Centers (reconditioned
hearing aids)............................ 410-751-9900
Blind Industries......................................................................................................... 410-737-2600
Hoover Services for Low Vision/Blindness
(DORS)............................................ 800-801-4297
Interpreters for the Deaf.......................................................................................... 410-857-2518
Leader Dogs for the Blind (website:
www.leaddog.org)..................................... 888-777-5332
Library Services for the Blind and
Physically Handicapped............................... 800-964-9209
MD Accessible Telecommunications Program.................................................... 800-552-7724
MD Division of Vocational Rehab.......................................................................... 410-848-4456
MD Society for Sight............................................................................................... 410-243-2020
National Federation of the Blind............................................................................. 410-659-9314
Radio Reading Network of MD.............................................................................. 800-455-5605
Vital Records
Birth & Death Certificates - Carroll
County Health Department
Forms & Information........................................................................................... 410-876-2152
Dept. of Health and Mental Hygiene – MD
Division of Vital Records................ 877-463-3464
Volunteer Opportunities
American Cancer Society....................................................................................... 888-535-4555
Carroll Hospice........................................................................................................ 410-871-8000
Carroll Hospital Center............................................................................................ 410-848-3000
Food Sunday............................................................................................................ 410-857-7926
Meals on Wheels..................................................................................................... 410-857-4447
Human Services Program-SHARE....................................................................... 410-857-2999
Websites
|
AARP |
|
|
Access |
|
|
Administration on Aging |
|
|
Alzheimer's Assoc |
|
|
Amer. Assoc. of Homes and Services for the Aging |
|
|
American Assoc. for Geriatric Psychiatry |
|
|
American Assoc. of Nurse Executives |
|
|
|
|
|
American Federation for Aging Research |
|
|
American Geriatrics Society ( |
|
|
American Health Care Assoc. (AHCA) |
|
|
American Society on Aging (ASA) |
|
|
Association for Gerontology in Higher Educ. |
|
|
Benefits Checkup |
|
|
Care for Elders |
|
|
Care Scout (info site for seniors) |
|
|
Caregiver Stress |
|
|
Caregiver website |
|
|
Caregiving Info website |
|
|
Caring Connections |
|
|
Center to Advance Palliative Care |
|
|
Centers for Medicare & Medicaid Services |
|
|
Community Partnerships for Older Adults |
|
|
Elder Law Answers |
|
|
Families |
|
|
Gerontological Society of |
|
|
Inter-faith Care Partners |
|
|
International Council on Active Aging (ICAA) |
|
|
Life Care Planning Law Firms Association |
|
|
Medicare |
|
|
|
|
|
Mental Health Association of Greater |
|
|
My Final Decisions |
|
|
|
|
|
National |
Websites -
continued
|
National Assoc. of Area Agencies on Aging |
|
|
National Assoc. of Nutrition and Aging Service Programs
(NANASP) |
|
|
National Care Planning Council |
|
|
National Care Planning Council (Long Term Care) |
|
|
Nat. Clearinghouse on Direct Care Workforce |
|
|
Nat. Commission for Quality Long-Term Care |
|
|
Nat. Committee to Preserve Social Security &
Medicare |
|
|
National Council on Aging (NCOA) |
|
|
National Elder Law Foundation |
|
|
National Elder Life Professionals Network |
|
|
National Family Caregivers Assoc. |
|
|
National Hispanic Council on Aging |
|
|
National Hospice & Palliative Care Org. |
|
|
National Indian Council on Aging |
|
|
|
|
|
Older Women’s League |
|
|
Resource Centers for Minority Aging Research |
|
|
United Seniors Health Cooperative |
|
|
YMCA Centers |
1560 Opossumtown Pike Suite A-12 301 663 9230 240 453 0070
![]()
To contact us:


Senior Citizen Home Safety Guidelines*
Please check
your home for the following safety
recommendations and correct any problems
Check your home for the following:
ü
Emergency
telephone numbers are posted on or near the telephone, and you have access to a
telephone if you fall
ü
Emergency
exit plan exists, and an alternate plan exists in case of fire
ü
Smoke
detectors are properly located and functioning
ü
Small
stoves and space heaters are placed where they cannot be knocked over and are
not near furnishings, curtains or rugs
ü
Lamp,
extension and telephone cords are out of traffic flow, are not under furniture
or rugs/carpeting, are not attached with nails or staples and not frayed or
cracked
ü
Passageways,
hallways and exits are well lit and are kept clear
Kitchen area:
ü
Towels,
curtains and other things that might catch fire are not near oven/range
ü
Ventilation
and range exhaust systems work properly
ü
Extension/appliance
cords are not near sink or range
ü
Good,
even lighting exists in stove, sink and counter top work areas
ü
A good,
stable step stool is available
Bedrooms:
ü
Lamp/light
switches are within reach of the bed
ü
Ash
trays, smoking materials and other fire sources are located away from the bed
ü
Nothing
is covering the electric blanket when in use
ü
The
electric blanket is not “tucked in”
ü
A
telephone is close to the bed
Stairs:
ü
Light switches
are located at both the top and bottom of the stairs and the stairs are well
lit
ü
The
steps allow secure footing and the coverings on the steps are in good condition
ü
The
steps are even and the same height
ü
You can
clearly see the edge of the steps
ü
Nothing
is stored on the stairway, even temporarily
Bathroom/Shower
ü
Bathtubs/showers
have non-slip mats, abrasive strips or surfaces that are not slippery
ü
Bathtubs/showers
have at least one grab bar
ü
A light
switch is located near the entrance
ü
Small
electrical appliances such as hair dryers and shavers are unplugged when not in
use
Basement/Garage:
ü
A light
switch is located near the entrance and the work areas are well lit
*Information is provided by the U.S. Consumer Product Safety Commission
Emergency Preparedness Contact
Information
PERSONAL INFORMATION
Name: __________________________
Address: ________________________
________________________________
Phone: __________________________
Cell Phone: ______________________
Birth Date: _______________________
LOCAL CONTACT
Name: __________________________
Relationship: _____________________
Address: ________________________
________________________________
Phone: __________________________
Cell Phone: ______________________
OUT-OF-STATE CONTACT
Name: __________________________
Relationship: _____________________
Address: ________________________
________________________________
Phone: __________________________
Cell Phone: ______________________
1ST
RELATIVE CONTACT
Name: __________________________
Relationship: _____________________
Address: ________________________
________________________________
Phone: __________________________
Cell Phone: ______________________
2ND
RELATIVE CONTACT
Name: __________________________
Relationship: _____________________
Address: ________________________
________________________________
Phone: __________________________
Cell Phone: ______________________
PETS CARED FOR BY:
Name: __________________________
Address: ________________________
________________________________
Phone: __________________________
Cell Phone: ______________________
MEETING PLACES
Outside your home: ________________
________________________________
________________________________
________________________________
Outside your neighborhood: _________
________________________________
________________________________
________________________________
________________________________
SHELTERING-IN PLACE
Meeting Place – Inside your home:
________________________________
________________________________
________________________________
________________________________
ADDITIONAL MEDICAL/PHYSICAL
INFORMTION NOT RECORDED ON MEDICAL INFORMATION LIST:
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
American
Red Cross
Medical
Information
Please complete this form and
distribute copies to your emergency contact people.
|
Name: |
Date of Birth: |
|||
|
Address: |
||||
|
Primary
physician: |
Telephone number: |
|||
|
Hospital
affiliation: |
Type of health
insurance: |
Policy number: |
||
|
Blood type: |
Allergies and
sensitivities: |
Religious
Affiliation: |
||
|
Medications and
dosages being taken (include over the counter medications): *record additional
medications-record on Emergency Preparedness Contact Information form |
||||
|
Specific medical
conditions: |
||||
|
Physical
limitations: |
||||
|
Adaptive
equipment and vendors’ phone numbers: |
||||
|
Communication
difficulties: |
||||
|
Cognitive
difficulties: __________________________________________________________________________________ Immunizations
Received and Dates: Tetanus Vaccine:
_________________________ Pneumococcal Vaccine: ______________________ Influenza
Vaccine: ________________________ Other: ____________________________________ |
||||



Registration
for Residents with Special Needs
*New
Registration Updated
Registration Date Form Completed:
____________
PERSONAL INFORMATION
*Name of Individual
with Disability: _______________________________________________________________________________
Last First Middle
*Street Address:________________________________________________________________________
Street Apt
#/P.O. Box
_______________________________________________________________________________
City Zip
*Primary Phone
Number: __________________________________
Secondary Phone
Number: ________________________________
Email:
________________________________________________
Date of Birth: __________________________ *Sex: M F
*Language Spoken: ______________________ Height: _____________ Weight:
________
Residence Type: House/Duplex Mobile
Home/Trailer Apartment/Condo
Name of
Living Situation: Living
Alone With
Family With
Non-Relative Homeless Transient
CARE REQUIREMENTS/DISABILITY (check all
that apply):
Medical
Dependence on Electricity Mental
Impairment Emphysema
02
Concentrator, Nebulizer Alzheimer’s/Dementia Heart
Disease
Feeding
Pump Respirator
Dependent Stroke
Other: _________________ Speech
Impairment Morbid
Obesity
Assistance
with Administration of Medications Visual
Impairment
Wheelchair
User Hearing
Impairment
Walker/Cane
User Service
Animal
Cognitive
Impairment Incontinence
Anxiety/Depression Dialysis
Dependent
Chemical Dependent Allergies: ________________________________
Other: ________________________________
Medications: _____________________________________________________________________
*Required Fields
REQUIRED ASSISTANCE
Will your personal assistant
be accompanying you? Yes No
Assistant’s
Name: ________________________ Phone Number: _________________
*Is transportation needed? Yes No
*Type: Automobile Van with
wheelchair lift Ambulance
PET INFORMATION (if applicable,
indicate how many)
____
Cat ____ Dog ____ Service
Dog ____ Other: ________________________
EMERGENCY CONTACT INFORMATION
*Primary Contact: ________________________ *Phone:
________________ Relation: _______________
Secondary Contact: ____________________ Phone: ________________ Relation:
_______________
Physician: ______________________________ Phone:
__________________
Home Health Care Agency: ___________________________________ Phone:
________________
Oxygen Provider: ___________________________________________ Phone:
_________________
AGREEMENT
I
understand that completion of this form is merely to assist with an emergency
response and in no way guarantees an emergency response or special priority
during an emergency or disaster. I
understand in the event of an emergency or disaster, if I need assistance,
Carroll County Emergency Management will prioritize use of pertinent County
resources in accordance with County policy.
Therefore, I give Carroll County Emergency Management authorization to
share this information with other local support agencies in the event of an
emergency or disaster. I also grant
emergency response personnel permission to enter my home during search and
rescue operations following a disaster, if necessary, to assure my safety and
welfare.
If at any time a change is
made to the above information, please send an updated form to the Office of
Public Safety Support Services.
*Type/Print Name:
_____________________________________________________________
Person Completing Form (Care Taker): ____________________________________________
ASSISTANCE
If you need assistance or
have any questions regarding the registration please feel free to contact
Christina Calp at
410-386-2296.
If Mailing Send To:
Office of Public
Safety Support Services
Attn: Christina Calp
*Required Fields
Notes: