The Use of CareProfiler in Full Swing

Posted on November 6, 2013

Care Profiler was developed to help healthcare organizations find caregivers that are responsible, attuned, and capable of creating meaningful connections with the people they care for.

The Questionnaire takes about 20 minutes to take and looks for strengths and weaknesses in:

Interpersonal Workstyles: 

  • Empathy and EQ
  • Hospitality
  • Dependability
  • Self Control

Care Core Areas:

  • Comforting
  • Motivating
  • Socializing
  • Enriching

Performance Workstyles: 

  • Open to learning
  • Persistence
  • Stress Tolerance
  • Attention to Detail
  • Achievement

The results are then analyzed by the program to provide a detailed picture of each candidate to provide the most compatible placement with our clients. We have been using this tool since June 2012, and it has been a tremendous success for both Constant Companions and the seniors that we serve, as it goes far beyond the resume and interview. Not only can we qualify caregivers based on skill and experience, but we can now provide clients with caregivers that are more attuned to their particular personality and situation, a must when working in the home.

If you would like to learn more please visit our website at If you would like to take the test, go to the “Click Here To Apply’ link on the home page. Indicate that you are taking the test ‘Out of Curiosity’. Please don’t forget to put in your email if you would like us to email the results to you.

The Launching of Affordable Alternatives

Posted on November 6, 2013





Constant Companions continues to serve the senior population of San Diego and SW Riverside with a full-service, employee-based home care model. However, throughout 2011 and 2012, as our care coordinator met with many seniors and their families, they were increasingly turning down traditional home care agency services and opting to look on Craigslist or another private set-up. Private hire caregiving can be risky, if not downright dangerous. We felt we needed to provide a solution to families that offered them the assurance of background checks and care oversight.

In January of 2013, Affordable Alternatives was created. Affordable Alternatives is a separate Home Care Referral Agency that seeks to provide seniors with a safer alternative to inexpensive home care.

All of the caregivers at Affordable Alternatives must pass the same rigorous screening process as Constant Companions’ Caregivers:

  • 7 year/50 state background check
  • Employment/Reference check
  • CareProfiler Questionnaire
  • Interview
  • Orientation

Affordable Alternatives is insured with both general and professional liability in addition to being bonded. All caregivers registered with Affordable Alternatives are independent contractors that are allowed to set their own rates and the agency collects a set fee for care management and administration (billing, payment, compliance, and maintaining insurance).

As with Constant Companions, Affordable Alternatives clients receive a comprehensive in-home assessment, care plan and regular contact to make sure all is going as expected and to make any adjustments in the care plan as necessary.

Rates for Affordable Alternatives begin at  $15.60 per hour and $156/day.

To Reach a Care Coordinator 24/7, please call:  888.713.3268 

Here’s the Skin(ny)—The Importance of Skin Integrity As We Age

Posted on November 6, 2013

No, I am not talking about weight; I am talking about the largest organ on your body, your skin.  As we age, the skin, like every other organ in our body, begins to decline. While we don’t have any way to reverse this aging process there are things that we can do to boost it functioning and help to prevent skin integrity issues, a major complication for many seniors.


What does skin do for us?

·         Helps maintain proper body temperature
·         Wards off infections
·         Waterproof barrier that keeps moisture in and moisture out.
·         Provides sensory information about our environment and injury

As the body ages, the layer of fat under the skin starts to disappear as well as the blood vessels feeding the skin with lots of oxygen. As a result the skin becomes looser, unable to insulate us well, and thinner. The most visible evidence of this is wrinkling and sagging of the skin. As our skin becomes thinner, it becomes vulnerable to tears and pressure sores. Open skin is an invitation to infection and discomfort.

Risks Factors:


·  Diabetes – it is under-diagnosed and under-treated, so make sure you are checking for it regularly with your health care provider. Diabetes causes decreased blood flow to the skin and extremities, encouraging the formation of wounds where there may be pressure points. To make matters worse, it makes the body less efficient in healing wounds, once they have developed.

·  Immobility—Any condition that requires someone to be in bed or confined to a wheelchair for long periods of every day will increase the need to be especially vigilant for skin problems. Daily skin checks for tears and sores are essential. Also, making sure that skin is kept clean and dry is essential. If moisture is a problem, check with your health care provider about the use of barrier creams.

·  Hip fracture—In otherwise health and active people, hip fractures can cause long periods of immobility during the healing and rehabilitation process. This immobility can increase chances of developing a bed sores.

·  Dementia—Dementia can contribute to problems with overall skin integrity due to nutritional factors. Not remembering to eat or prepare balanced meals can cause a drop in weight and nutrients essential to the maintenance of the skin. Additionally, inadequate nutrition can contribute to a higher incidence of falls (weakness from low blood sugar and not enough calories) which can open the skin and lead to infection.

·  Rapid weight loss— The lack of ‘padding’, coupled with the underlying cause for weight loss, i.e. poor nutrition or disease, can be problematic for skin integrity.

·  Cancer— During treatment, immunity is compromised, appetite may decline, and chemotherapy can directly affect the condition of the skin. Special care should be taken to avoid a skin tear and to try to make sure that food and liquid intake is maintained as much as can be tolerated.

·  Smoking or history of smoking—Decreases blood supply to the skin.

·  Neurological damage—This can decrease ability to sense discomfort at pressure points that would otherwise prompt one to shift positions.

What you can do NOW

Nutrition is one of the best defenses against skin break-down. No matter what your current health status, making an appointment with a dietician is a great way to make sure you are getting the adequate nutrition you need to provide your skin the opportunity to keep working for you, not against you.

Nutritional factors that can help maintain skin integrity:

·  Stay hydrated

·  Eat a balance diet that includes protein

·  Include healthy fats in your diet

·  Make sure you are getting enough Vitamin A, C, E, K and minerals zinc, iron and copper

 While there is no cure for what age does to our skin, there are things that we can do to keep it in the best possible condition to help protect us when we are our most vulnerable.

Download – Here’s the Skin(ny)—The Importance of Skin Integrity As We Age

Written by Gabriela F. Brown, CSA

Constant Companions Home Care


Happy 10th Anniversary!

Posted on November 6, 2013

It was on October 14th, 2003, that we accepted our first client! 

We want to extend a heart-felt THANK YOU to all of our referral sources, community partners and clients for their continued faith, feedback and recommendation of our senior home care services.

Our 10-year anniversary is more than just a celebration, It is a time for gratitude, a time to reflect and a time to plan for the future.

Since 2003, we have continually looked for ways to differentiate us from the myriad of other agencies in the community. Over 10 years we have learned a great deal and are continuing to learn as the entire health care industry is facing new challenges including home care, which is facing new state-wide regulatory challenges.

As we plan for the next 10 years, we are very busy learning about these new changes in order to be an asset your organization and the overall well-being of each of our clients.

We will continue to have an open-door policy regarding any suggestions and concerns that you may have in our overall practices, compliance and customer service. In fact, we will be encouraging it as we discover new ways to continue being an asset to the health care community as well as the seniors in our community.

Once again, thank you ALL. We couldn’t have done this with out you. Our deepest wish, at this milestone, is to continue providing excellent services to the seniors of San Diego and SW Riverside for the next 10 years!

-Gabriela Brown, CSA 

Founder of Constant Companions Home Care 

Massage for Seniors: It’s a Good Thing!

Posted on September 6, 2013

There is growing evidence that seniors could significantly benefit from a regular massage session and a new specialty is rapidly growing to provide this service, tailored to the senior’s needs and concerns.


Download Massage for Seniors: It’s a Good Thing!

The benefits of massage therapy are well-documented; however, seniors are less likely to schedule appointments for a variety of reasons including:

  • Modesty
  • Cost
  • Health Conditions

Benefits of Massage:

  • Boosts immune function
  • Increased blood and lymph circulation which can help nutrients get to muscle tissue and increase medication absorption rates
  • Helpful in reducing pain and reliance on pricey meds for conditions such as arthritis, back pain , circulation problems and high blood pressure
  • Widely used to treat chronic pain and osteoarthritis.
  • Beginning to develop techniques to improve quality of life for Alzheimer’s patients
  • Reduces anxiety and depression
  • Decreases stress hormone and proteins related to inflammation and allergic reactions.
  • Increased flexibility
  • Reduced joint pain
  • Better sleep
  • Provides human touch, increasing overall well-being

Geriatric Massage Techniques and Tips:

  • Make sure your therapist is familiar with proper techniques for seniors. Gentle stroking, kneading and application of light pressure on specific points.
  • Most seniors require a lighter touch and shorter sessions.
  • If a general body massage cannot be done, massage to feet, hands or shoulders can produce beneficial results
  • Consult with your physician prior to scheduling an appointment
  • Be honest with your massage therapist regarding any conditions you have
  • If modesty is an issue, your massage therapist can accommodate what makes you comfortable. You don’t have to remove all clothing and you can get assistance on and off the table.

When Massage Therapy Should be Avoided:

  • Open or healing wounds or bedsores
  • Use of blood thinners – can cause bleeding under the skin
  • Thrombophlebitis – Blood clots that can come loose and travel to the lungs during massage
  • Broken or healing bones
  • Recent surgery – still healing
  • Some type of cancer

Uncertain Paths – Transitioning to Home Care

Posted on August 29, 2013

Your mom is in the skilled nursing facility and the social worker/case manager is talking to you about sending her home. It is recommended that she not be without personal care assistance/home care. All of a sudden, there are many decisions to make.

  • Do you bring her to your home?
  • Do you care for her every day in her own home?
  • Do you contact a home care agency or hire a caregiver privately?

No matter what is decided, this is unfamiliar territory that brings to surface many fears and anxiety. Hiring outside help for a parent creates a tremendous storm of emotions.


Download Uncertain Paths – Transitioning to Home Care

Normal thought processes include:

  • You know that no one can care for your parent the way you do, or at least not with as much love and concern.
  • You truly wish you could care for your loved one full-time, you just can’t.
  • Your parent is most likely in a vulnerable state.
  • They may not have ever needed to have an outsider care for them before. Their anxiety about this can easily increase
  • yours.

  • You know that at some point, you will have to get back to other aspects of your life, causing a sense of urgency.
  • You will not be able to oversee every detail of care once that care has been entrusted to a caregiver.

Here are a few helpful hints to follow to assure a smooth transition for you and your loved one.

  • Remember that this is a major life transition for both you and your parent.
  • This is causing anxiety for everyone involved because it is a significant departure from the ‘norm’. Give yourself permission to feel the anxiety, fear and guilt. However, don’t allow it to cause you to make sweeping decisions that might eliminate YOUR anxiety, but create more for your loved one.
  • Make a plan of action that takes into account EVERYONE’s needs and expectations. Don’t leave yourself out of the equation. Decide how much care and support you can realistically provide on a consistent basis and use this as a benchmark when hiring outside help. For instance, you could agree to do the grocery shopping once a week, pick up prescriptions, transport to medical appointments, etc.
  • Remember that your presence and involvement is still crucial. Even if the caregiver is Florence Nightingale reincarnated, your loved one still needs YOU. By continuing to offer assistance and support in a predictable way, you will be providing a sense of a familial continuity that cannot be duplicated. Just remember to set your boundaries so that you are not overextending yourself.
  • Have clear expectations outlined when meeting with your caregiver including housework, meal preparation, care needs and preferences, work schedule, personality preferences, etc. This provides a firm foundation on which to start, eliminating guesswork on the part of the caregiver and frustration on the part of the family.
  • Make sure these expectations and needs are clearly defined in a Plan of Care to be followed by the caregiver with an established system of reporting.
  • Let go. Allow your caregiver the freedom to establish a routine and rhythm in the home. Accept that they are not you and will have a different work-style. As long as good care is being provided and she/he is a good personality fit, you are ahead of the game.

When faced with a major life transition, we are forced to adapt. In order to adapt successfully, remember to be honest with all involved about your limitations, anxieties and fears. There is no ‘right’ way to be/feel. By focusing on the best solution for all involved, you will be able to come through for yourself and your parent, laying the groundwork for a smooth and successful transition.

Great Expectations in Home Care

Posted on August 29, 2013

Home Care is a very flexible and cost-effective way to provide a safety net for senior member of the family to continue living in their own home and communities. Even though home care requires less adjustment than a placement in a group home or assisted living facility, it tends to have strong undercurrents of emotion and expectations for the entire family.

Home care is a life transition. Having a virtual stranger coming into your home to help manage the most basic aspects of daily living can trigger deep emotional responses. For the senior in need of care, loss of autonomy, independence and privacy are very real. This may be piled on top of other recent losses in health and relationships. No one, in my experience, has EVER welcomed the need for home care as it is typically follows some sort of loss or series of losses.

For the family, guilt, fear and inadequacy are feelings that are very relevant and real as well. Many, if not most, adult children wish that they had the time or lived close enough to provide the care they feel their parents deserve. Fear enters in, with the control and direction they lose when hiring someone to provide the care. Feelings of inadequacy can surface, especially if they had attempted to provide the care themselves and it became overwhelming. These emotions are all very natural it is best to acknowledge them as they come to the surface. Often, the act of hiring outside help brings these feelings to the forefront. If left unaddressed, they can have detrimental effects on the success of home care assistance.

Often when people are not aware of or do not want to acknowledge these intense emotions, there is a tendency to place unrealistic expectations on the caregiver. No matter how hard the caregiver works, they will never be a replacement for the adult child. The caregiver is an individual with their own history and personality. They will not immediately understand every nuance and preference of each client.

Clearly defining tasks and reviewing skill is vital to beginning this professional relationship, which most reputable home care agencies will do with an in-home assessment and a plan of care. Once the expectations are established, they should remain constant as the caregiver establishes a rapport with the family and can be adjusted if the condition of the client changes.

At the outset, the focus of the caregiver should always be on the safety and well-being of their client. Housekeeping duties can be included, but shouldn’t be at the expense of quality care.  Obvious adjustments can be made as the caregiver settles in to their routine. Clearly, if a caregiver is just NOT the right personality, that should be addressed as soon as possible. However, if the caregiver is competent and professional, it may help to wait a little while rather than rush into a change. Learning the temperament and rhythms of a new client takes a little time. After a while, the caregiver will develop a regular routine based on these daily rhythms and will increasingly be able to anticipate situations and changes and how best to deal with them.

In short, no one can care for your parents like you can. However, if your situation requires outside assistance, do your best to understand the limits of the professional home care relationship and guard against placing unrealistic expectations. If the home care professional provided is caring and competent, provide space and flexibility for the relationship to develop. This should help everyone ease into this life transition with minimal discomfort and allow this new relationship to flourish.

- Gabriela Brown, CSA

Constant Companions Home Care

Hearing Loss – Bringing Seniors Back into the Conversation

Posted on August 29, 2013

Nearly one-third of people over the age of 65 are hard-of-hearing while nearly 50% of people over the age of 85 suffer from some form of hearing loss. Because hearing loss is usually a gradual process that begins in one’s forties, it is commonly not recognized until it is significant. It is important to be able to recognize signs of hearing loss, have it diagnosed and treated.


Download or Print Hearing Loss – Bringing Seniors Back into the Conversation

Symptoms of hearing loss:

  • Have trouble hearing over the telephone
  • Find it hard to follow conversations when two or more people are talking,
  • Need to turn up the TV volume so loud that others complain,
  • Have a problem hearing because of background noise,
  • Sense that others seem to mumble, or
  • Can’t understand when women and children speak to you.

Hearing loss in seniors can lead to others mistakenly thinking that seniors are confused, difficult or apathetic. Additionally, the senior may be embarrassed by the loss and resist seeking out medical help. The inability to fully communicate can lead to frustration and isolation.

Use the following strategies to bring these seniors back into the conversation:

  1. Make sure that you are looking at the listener and you are in a well-lit area.
  2. Don’t shout, this can often create increased sound distortion.
  3. If there are 2 or more people present, make sure that only one person is speaking at a time.
  4. Address them directly by saying their name before starting a conversation so they have time to focus.
  5. Many people with hearing loss rely on lip-reading. Keep your hands away from your mouth and avoid smoking, chewing gum or eating while talking.
  6. Slow down a little but not too much. A natural and unhurried rate of speech allows the hearing impaired person to capture more words, read lips and facial expressions.
  7. If one ear is better than the other, make sure you are directing your speech to the better ear.
  8. Hearing loss can include certain sound distortions. They may hear your voice but not be able to decipher certain words or pitches.
  9. Minimize extra noise in the environment when have a discussion, like turning the TV or dishwasher off.
  10. If possible, avoid having discussions in settings that may have sudden loud sounds like busy streets, near construction areas or near airports.
  11. Depending on the level and type of hearing loss, certain words are almost impossible to understand, try rephrasing the sentence or find a different word. Don’t repeat the word or sentence over and over again.
  12. Avoid sudden changes of topic. When the subject is changed, clearly state the new topic and look for acknowledgement before proceeding.
  13. Write specific information, such as appointments, directions and schedules down, if you are talking over the phone, have them repeat the information back as many words and numbers sound similar.
  14. Understand that illness or tiredness may affect any person’s ability to follow a conversation.
  15. If the listener looks confused, clarify that they understood what you were saying.

If you suspect hearing loss, see a doctor as soon as possible to determine the cause and treatments available. Remember to be compassionate about discussing the possibility of hearing loss with your loved one. It is important to be supportive regarding the options and opportunity for treatment. Motivation for the decision to seek treatment should be to increase their quality of life by providing the ability to participate in social interactions to the best of their ability.

Emergency Preparedness

Posted on July 1, 2013

Preparing an Emergency Kit for You and Your Caregiver


Download Emergency Preparedeness Checklist

You can use a small suitcase or backpack. Keep your emergency kit in an accessible location in the home or garage and post a note on the refrigerator as to its whereabouts in the event that both you and your caregiver are incapacitated.

  • Water: one gallon per person per day, for drinking and sanitation
  • Non-perishable food: at least a three-day supply
  • Flashlight and extra batteries
  • First Aid kit
  • Whistle to signal for help
  • Filter mask or cotton t-shirt, to help filter the air
  • Moist towelettes (baby wipes), garbage bags and plastic ties for personal sanitation
  • Wrench or pliers to turn off utilities
  • Battery-powered or hand crank radio and a NOAA Weather Radio with tone alert and extra batteries
  • Manual can opener if kit contains canned food
  • Plastic sheeting and duct tape, to shelter -in-place
  • Important family documents-you may consider making copies of these to give to ICE family members.
  • Items for unique family needs, such as daily prescription medication or pet food

Include Medications and Medical Supplies:

  • Especially for oxygen users: assure that they have a 3 day supply of oxygen available at all times.
  • Assure that you have at least 1 week supply of all medications.

Other items that should be included IN the emergency kit :

  • Family contact numbers both in and out of the area.
  • A listing of conditions and current medications with a copy of all prescriptions, including eyeglasses

A copy of your:

  • Medicare/Health Insurance Card
  • Driver’s License
  • Home Owner’s Policy
  • Will and Trust Information
  • Contact information of your doctor

*Consider making copies of all of these documents and sending them to the ICE contacts that you have identified in your plan.

Geriatricians, The Gold Standard for the Golden Years

Posted on July 1, 2013

Between 2010 and 2030, the population over 65 will increase by 73%! Seventy million people (One out of every five Americans) will be over 65. This is the first in medical history. Although a number of medical schools require course work in geriatrics/gerontology, many still have only elective courses or no courses at all.

What Is a Geriatrician?

A geriatrician is a doctor who specializes in the area of senior health, whether it is treatment or prevention of disease in older adults. Geriatricians are board-certified in family medicine or internal medicine, and have also obtained the Certificate of Added Qualifications in Geriatric Medicine.

Why Do You Need a Geriatrician?

Throughout life our bodies are continuously changing. As children we require the special knowledge and skills of a Pediatrician. As older adults, Geriatricians can provide the expertise needed for effective and safe diagnosis, treatment and prevention. Certain conditions and diseases will more likely occur and the treatment options are not necessarily the same as in a younger person. Most of the time, a general internist or family physician can serve as your primary care provider, especially if he or she is experienced in dealing with older people. But if you are especially frail or have complicated medical problems, you might want to switch to a geriatrician. The American Geriatrics Society (AGS) suggests that a geriatrician be consulted when:

  • Significant age-related frailty and impairment occur, which is more likely in older people who have multiple diseases, disabilities, and/or mental problems.
  • The patient’s condition is causing the caregiving team, including family members and friends, to feel significant stress and strain.


The Geriatric Health Care Team

When choosing a Geriatrician, you will be supported by a geriatric health care team that is more likely to approach your care holistically. Your geriatric health care team may include nurses, social workers, nutritionists, physical and occupational therapists, pharmacists, and psychiatrists who have special training or experience in treating older adults.

Your team will work with you to evaluate both current and past illness in order to develop a plan of care that is right for you. In addition, you will work with your team to identify if you are having problems with any so-called activities of daily living (ADLs) like bathing, dressing, meal preparation and eating so that you can come up with proactive solutions for self-care (preventing larger problems) or identifying if some form of assistance is needed for health and safety.


Finding a Good Geriatrician for You

Making a change can be difficult, especially if you have a good relationship with your current doctor. However, if you think a geriatrician might be right for you or for a loved one, talk with your current doctor about your needs. Sometimes it can be arranged to have a geriatrician work with your current physician as a consultant for particular issues or if your situation is complicated, a complete switch may be in order. In any case, your physician should be able to refer you to a qualified geriatrician in your area. Another resource for finding a local geriatrician is the AGS Foundation for Health in Aging, a nonprofit organization that provides a referral service online or by phone at 1-800-563-4916.

When choosing any new physician, list two or three possibilities and call their office and ask any questions you may have before making an initial appointment.

  • How many years has he/she been a geriatrician? How many years has he/she been practicing? What medical school did he/she attend? Where did he/she do his residency?
  • Does the physician accept your insurance?
  • What are his/her hours? What is their after-hours policy?

After you choose a geriatrician, set up an introductory visit. If after your visit you are comfortable with your choice, arrange to have your records transferred prior to your follow-up visit. Many times the physician’s office will have a form to release this information to their office. This information will be vital to the entire geriatric care team to develop your new individualized care plan.