Fall Prevention Innovation – A Look at Step2Rest

Posted on October 12, 2015

Step2Rest, The Latest in Fall Prevention Innovation

step2rest photo

A couple of weeks ago, I got a call from Vince Baiera, RN. He wanted to talk about a new product that he had invented that would prevent falls in seniors. I was intrigued. When someone wants to talk Fall Prevention, I am all ears!

In the senior care industry, falls are a perpetual concern and if anyone has a product that can prevent falls, well then, I want to know all about it.

Consider these statistics:

• Over 13.3 million people 65 years and older will fall this year.
• Falls among older adults are a common occurrence that contributes to hospital utilization.
• Falls account for over 60% of all nonfatal-injury emergency department visits in the 65-and-older population. This group is three times more likely to be hospitalized due to fall-related injury than younger persons.
• Fall risk is highest during the first two weeks after discharge from the hospital, as compared to three months later.
• Older adults with diabetes have a higher rate of falling than the general population.
• Seniors with diabetes are twice as likely to break a hip when they fall, and a fracture is 12 times more likely for those with Type 1 diabetes.
• According to the National Safety Council (NSC), more than 30,000 older Americans are injured in falls each week.
• Of all nursing home admissions, 40% are related to falls.

-Source: Philips Lifeline’s ‘Facts on Falls’ Flyer

What Vince presented is a clever and possibly, life-saving apparatus for those with limited mobility to be able to get in and out of bed safely. The apparatus is called Step2Rest. It is a a simple and sturdily designed step with hand rails that can be set up at the edge of a bed that may be just a little to high for safety. By using the small step and the handrails to turn around and sit on a higher bed, you eliminate possible misses and falls due to lack of strength or poor balance. When a bed becomes to high to get in and out of safely, the typical suggestion is to rent or purchase a hospital bed. This is  not always a welcome suggestion as the hospital bed has many negative associations. Many seniors will put off the safety aspect of a hospital bed or a lowered bed for too long.

step2rest 2

Vince came up with the idea after experience with his own back pain and thinking about the challenges that we all have as we get older, especially with getting in an out of bed.  His first design looks nothing like today’s Step2Rest,  but it did have a similar concept, offering a perpendicular rail, a step and a mattress top wedge. Over the last 1.5 years he has continued to remodel the Step2Rest, making improvements along the way. The products biggest value is the step and rail so the improvement focus has been on making the step wider, deeper and sturdier.  While the whole device can be adjusted for proper height, the step is stationary. While the Step2Rest may not be suitable for everyone. It is more palatable fall prevention device when seniors are still fairly mobile with good cognition. Vince is confident that this product will change the way seniors get in and out of bed, increasing safety and the potential to prevent thousands of hospitalizations and even deaths caused by falls.

I thank him for taking the time to show it to me, and I look forward to recommending it to the clients of Constant Companions Home Care.

For more information please feel free to contact Vince Baiera R.N., BSN at 330-418-0113 or vince.baiera@gmail.com.

For product information and video please visit www.Step2Rest.com


Submitted by Gabriela Brown, CSA

Constant Companions Home Care




Live-In Care & Overnight Care Services

Posted on October 5, 2015

Live-In Care and Overnight Care Services are available through Constant Companions, when a loved one needs continuous care and/or supervision.

This is a preferred option of many clients and their families, when the care or supervision required each day exceeds 10 hours.

There may be certain events that precipitate the need for  Overnight or Live-In services:

  • Increase in Fall Risk
  • Decline in Strength
  • Decline in Cognitive Abilities
  • Increased Incontinence
  • Increase in Anxiety
  • Worsening of Alzheimer’s/Dementia Symptoms – confusion, disorientation, sundowning
  • New Diagnosis or Significant Change in Condition

About Live-In Care

Constant Companions is able to provide skilled and experience live-in caregivers that are able to stay with your loved one for consecutive days at a time. They are usually paired up with another caregiver to cover an entire week.  Typical schedules are 4-5 days/week for Cargiver A and 2-3 days/week for Caregiver B. We do not recommend retaining only one caregiver for 7 days a week. All caregivers and clients need a break from each other, and the caregiver needs time to reconnect with their family/personal life.
There is some misunderstanding regarding the use of Live-In Caregivers. Live-in care is a specialty service and there are some guidelines to consider before electing this type of care. We have prepared an information guide for you to read through: What You Can Expect from A Live-In Caregiver.

About Overnight Care

An alternative to Live-In Care is Overnight Care. This option can be used if your loved one is relatively alert and able during the day, possibly receiving visits and help from family members and friends.  Nighttime presents dangers for many seniors due to an increased risk of falling, wandering, anxiety, etc. The Overnight Care option is generally used to have someone present if assistance is needed throughout the night. This allows family and friends to rest and be ready to care for their loved one during the day.

Constant Companions will provide a free assessment of needs and provide you with a fully vetted caregiver of your liking. In addition, we will continuously monitor the care provided and offer guidance and solutions to scenarios and conditions that may present themselves along the way.

Our Live-In and Overnight caregivers will be there to provide supervision, companionship and all personal care services including:

  • Bathing/Dressing Assistance
  • Grooming Assistance
  • Toileting/Incontinence Care
  • Bedridden Care
  • Medication Supervision
  • Exercise/Mobility Assistance
  • Meal Preparation
  • Nutritional Support
  • Light Housekeeping
  • Medical Appointments
  • Errands

Please contact us today to discuss your current needs. We look forward to discussing all of the options with you.


NEW Caregiver Placement & Case Management Program

Posted on September 28, 2015

Caregiver Placement & Case Management
Caregiver Placement
Case Management Program

RATES Start at $17 per hour OR $240 per day

The Traditional Home Care Experience at a Lower Cost.

At Constant Companions, we understand the need to find care at a lower price, WITHOUT sacrificing quality, oversight and accountability. Constant Companions has developed a simple, user-friendly program that combines the cost-savings of a direct-hire with the oversight and case management provided by a traditional agency.

For the Caregivers:

  • Background Screening
  • Reference and Employment Checks
  • In-Person Interviews
  • Psychological Testing
  • Verification of Certifications

For the Client:

  • Initial In-home Assessment
  • Custom Care Plan
  • Care Coordination – Collaboration with Community and Health Resources to ensure optimal care
  • On-going Case Management:
    • Continuous review and update of Care Plan
    • Continuous review of Care Notes submitted by Caregivers to determine the need for a re-assessment or change in Care Plan
  • Recommendation of best matched caregivers based on interview, client satisfaction surveys and CareProfiler questionnaire
  • Terminating Caregiver services, on behalf of the client
  • Scheduling/Replacing Caregivers

Payroll and Human Resources Services:

  • Obtaining W-4 and I-9
  • Facilitating Payroll Process on Your Behalf
  • Facilitating Quarterly & Annual Reporting on Your Behalf
  • Maintaining General & Professional Liability Ins.

Rates are determined by hourly rate set by caregiver upon registration with Constant Companions Home Care and Service Fee that includes all of the activities and services listed above. This option is recommended for those who need 8+ hours/day care at home.

Our traditional home care services continue to be available, including full employment status of the caregiver under Constant Companions Home Care.

Contact us for immediate assistance:
Constant Companions Home Care

Are Home Care Agencies Obsolete?

Posted on September 24, 2015

Personalized Home Care

Personalized Home Care

Recent changes in the employment and regulatory market have made hiring caregivers through an agency financially more difficult for families.

In response, many people have turned to the internet marketplace to essentially, ‘place an order’ for a caregiver ‘at cost’, leaving the traditional agency out of the entire transaction. This begs the question, ‘Are Home Care Agencies Obsolete?’.

Are Home Care Agencies Obsolete? We say, ABSOLUTELY NOT! What a family gets with a reputable home care agency is immeasurable. Quality home care is not a mail-order industry, where you pick a caregiver out of a catalog. Home Care is a very intimate business that requires a personal touch and oversight with experience and accountability. While it is true, going to the website catalogs, that claim to have 1000s of caregivers, may be cheaper, it is important to understand what it is that the agency actually does in order to provide peace of mind and the best home care experience possible for your family.

A common reason for going to the online marketplace that agencies are running away with huge margins, while underpaying caregivers. The truth is that the industry standard for a ‘profitable’ agency is between a 13% and 17% margin. Much of what an agency charges goes into overhead and activities, performed on the client’s behalf:

For the Caregivers:

  • Background Screening
  • Reference and Employment Checks
  • In-Person Interviews
  • Psychological Testing
  • Skill Testing
  • Verification of Certifications
  • On-going Training

For the Client:

  • Initial In-home Assessment
  • Custom Care Plan
  • Care Coordination – lining up additional services that could be needed, in the local area and collaboration with services already in place such as hospice or home health
  • On-going Case Management:
    • When condition of the client has changed the Care Coordination will update the Care Plan and seek additional community resources
    • Regular revision of Care Notes submitted by Caregivers to detect any patterns that would indicate the need for a re-assessment of the client’s condition.
  • Recommendation of caregivers that would work best in each individual situation, based on interview, client satisfaction surveys and CareProfiler questionnaire
  • Terminating Caregiver services, on behalf of the client
  • Scheduling/Replacing Caregivers – due to illness or otherwise

Payroll and Human Resources Services:

  • Obtaining w-4 and I-9 and registering that information with the IRS within 10 days
  • Payroll
  • Employer Taxes
  • Unemployment Insurance Payments
  • Worker’s Comp Payments
  • Handling wage assignments
  • Handling unemployment claims
  • Handling any government paperwork that comes in on behalf of the caregiver
  • Providing for paid sick leave (mandated – 3 days a year)
  • Assuring TB clearance
  • Assuring ongoing training
  • Maintaining a drug-free environment through random drug testing
  • Maintaining a General and Professional Liability Insurance policy
  • Bonding – not attainable by an independent caregiver

Yes, you can get a caregiver from the online catalog for $12/hour, but you DO become the employer and are responsible for all of the items listed in our Payroll and Human Resources section above. When properly paying an employee, that $12/h becomes more like $17/h.  While, no doubt, people will try to avoid the “employer” status by claiming a caregiver is independent, it is a dangerous thing to do. If you are paying your caregiver directly AND directing them on how to do their job, YOU ARE THE EMPLOYER. ONE claim to Unemployment or the Labor Board by that caregiver, can have a domino effect, inviting all employer regulatory agencies to come knocking on your door, resulting in audits and fines, and very likely, unwanted IRS attention.

When you pay an agency like Constant Companions Home Care, you are not just paying for a caregiver, your are paying for customized care, oversight and follow-through. Your are also transferring the burdens of being an employer and all that entails so that you can focus your attention on what matters most, your loved one.

Written by Gabriela Brown
Owner, Constant Companions Home Care

Constant Companions Home Care has been providing quality home care since 2003 to the residents of San Diego, Fallbrook, Escondido, Rancho Bernardo, Poway, Temecula, Murrieta, Menifee, Hemet and Riverside.

Constant Companions is Walking to End Alzheimers #WALK2ENDALZ in Temecula.

Posted on September 12, 2015


Team Constant Companions Home Care is Walking to End Alzheimer’s #WALK2ENDALZ in Temecula.

Walk to End Alzheimer’s #WALK2ENDALZ in Temecula

Constant Companions Home Care is putting together a Walk to End Alzheimer’s Team!

We are very excited to be participating in our first ever Temecula walk and would like to extend an invitation to any and all people in the area who have been affected by this debilitating disease. The walk will be on September 27th at the Promenade Mall in Temecula at 9:00am. If you would like to join us for the walk, registration is at 7:00 am.

Over the years, it has be our privilege to provide Alzheimer’s care for many individuals and their families. Seeing the suffering first hand has made us more committed than ever to providing the loving support that both the client and the family’s needs. Our caregivers are wonderful and compassionate, the clients and their families are amazing and courageous. We strive to provide moments of joy and relief but sadly, it is often not enough to ease the perpetual underlying stress and sadness.

Funding for research remains stagnant while the cost to treat and care for these individuals continues to climb. Currently, 5 million Americans have Alzheimer’s. That number is expected to grow to 16 million by 2050. The costs are staggering, 17.9 billion hours of unpaid care, a contribution to the nation valued at $217.7 billion.

We are committed to working with the Alzheimer’s Association in supporting their work because when one person has Alzheimer’s, it touches so many lives. The Alzheimer’s Association has been amazing in their efforts to fund research into the treatment, prevention and the ultimate cure. It is also a resource and support system for the millions of people that are caring for or living with Alzheimer’s.

If the statistics bear out,  there is a very good chance that all of us will have to face this disease in our lifetime either as a caregiver or the patient. Take a moment to look at our Walk to End Alzheimer’s page and let us know how you can help out. You can walk with us and raise money from your family and friends or you can donate directly to our team.

The goal is $2,000. For the cost of a latte, less than a fast food meal, less than the price of a movie ticket….If every person who reads this post donates $5, we will surpass our goal!

Please go here to sign up and/or donate at Team Constant Companions


Senior Care Basics – Is it Time For a Caregiver?

Posted on September 2, 2015

Senior Care Services with Constant Companions Home Care

Talking about senior care services

Many ‘adult children’ are faced with when to start the process of hiring a caregiver for their parents or looking at other senior care options. Often, older adults become very adept at concealing their increasing inability to maintain their surroundings and to attend to their health.

Here a some warning signs that your parent(s) may need senior care assistance:

  • Unkempt refrigerator with food that is spoiling
  • Weight loss or poor diet
  • Frequent and often unexplained bruising
  • Noticeable unpleasant body odor and decline in grooming habits
  • Resistance to showering or bathing
  • Smell of urine in the house
  • Forgetting and/or missing important appointments
  • Trouble walking, balance and overall mobility, including getting up from a seated position
  • Difficulty performing once-familiar tasks, either due to confusion or forgetfulness.
  • Overall forgetfulness or confusion
  • Continuous loss/misplacement of items in the home
  • Unable to stick to medication schedule, either forgetting or doubling up by accident.
  • Dirty, cluttered, unkempt environment
  • Unopened mail that contains, bounced check notices, late notices or attempts to collect via bill collectors
  • Less of interest in hobbies and activities previously enjoyed
  • Less interest in socializing with friends or family
  • Noticeable changes in mood or extreme mood swings

Not all of these signs will show up at one time.

If you notice that your parent is experiencing an increase in the above warning signs, it is time for the talk. This is an uncomfortable conversation for both of you.  Try to be calm and use the above list to cite specific reasons for your concern in a non-accusatory tone. It is only natural for a parent to become defensive and it will go much better if you are able to make every attempt to reassure them that this in no criticism but loving concern. A good approach in this situation is to remember and remind them that you are in this together,  and the conversation is a two-way street.

If your parent is unwilling to concede that they may need help, it may be fear of losing their independence and having to transition to a new environment such as a nursing home or assisted living facility. It could also be fear of spending money. Outliving one’s resources, is a very common fear.  Instead of deflecting these fears, this may be a good time to discuss all of the options available and take note of what their true wishes are and how you might be able to accommodate now and  in the future.

Many seniors wish to stay in their own homes for as long as possible. Home care, offers one-on-one personal care assistance, allowing them to remain in their home and community. The benefit of home care is that as their needs increase, the level of coverage can increase, so to start, coverage and costs associated can be relatively small. Home care can  provide the appropriate level of care and support as a seniors’ needs change. A reputable home care agency will provide a care plan and on-going case management to address changes and concerns.

Once a plan is made, then there will be the discussion on how to pay for it. Most long-term care, whether in a facility or at home is paid out of pocket. There are a few avenues or revenue to explore:

Long–term care insurance – helps cover the cost of home care  or care at a facility. Most policies require at least the need for assistance with 2 activities of daily living.  It can cover much of the cost of home care – depending on the policy terms.

VA Aid & Attendance Benefit – If your loved one served in the U.S. military, financial assistance might be available to provide a veteran with home care. There is also a need to demonstrate the need for assistance with at least 2 activities of daily living, as with long-term care insurance. We recommend taking a look at VeteranAid.Org for details.

State and local programs – Your local Department of Aging or Area Agency on Aging should have information on any local and state-funded programs that offer care for seniors who meet certain criteria. This care can be limited, but may provide enough coverage to keep them safely at home

Viatical Life Settlements – If your loved one has a life insurance policy, there are companies that offer insurance owners the option to sell their policies in exchange for a lump sum payment that is greater than the cash surrender value.

Government funding – Medicaid programs in most states support home care services as an alternative to nursing homes  for low-income seniors.

All in all, if you find your parent or loved may soon be in need of additional care, now is the time to act. Discussing the options for care and how to pay for it is preferable before a crisis. Let us know if we can be of any further assistance.


Submitted by Gabriela Brown, CSA
Constant Companions Home Care

Home Care Partnership with Lifeline

Posted on August 24, 2015

Philips Lifeline for San Diego and Riverside Residents

Constant Companions Lifeline

Partnership with Philips Lifeline – FREE Lifeline to Home Care Clients of Constant Companions

Starting in September 2015, Constant Companions Home Care will become an official Philips Lifeline partner. We will provide all clients a free Lifeline Alert system if they are using 20+ hours of home care services with us. If a client wishes to decrease hours below 20 hours per week, the Lifeline will be in place and there will be no interruption to their services. The home care client can either continue with Lifeline at their own cost or discontinue the Lifeline services with no penalty.

We have recommended medical alert systems over the years. For many reasons, many clients underutilize direct care services. Having a Lifeline system set up in the home is a low-cost safety net for the more vulnerable client.

Constant Companions Home Care chose to work with Philips Lifeline because they provide excellent monitoring and notification systems.  Additionally, we will be notified if any client falls or is hospitalized. This will enable us to be more proactive in our care management services and to be well-prepared for the transition back home from a hospital or facility.

This offer is valid for all Constant Companions Home Care clients throughout San Diego and Riverside Counties.

For more information, feel free to contact Gabriela Brown at 888.883.8393

To sign up for Lifeline without using our home care services, please call  (800) 533-8954 x54070.


Released by Gabriela Brown, CSA
Constant Companions Home Care

SB 243 – Medi-Cal Reimbursement Rate Increase-Please Support!

Posted on April 17, 2015

SB 243 – Medi-Cal Reimbursement Rate Increase
SB 243 (Hernandez), one of CAHSAH’s priority Support bills, is scheduled to be heard in the Senate Health Committee on Wednesday, April 22. This bill would repeal the implementation of prior year Medi-Cal rate reductions, including the 10 percent reduction for affected Medi-Cal providers and would increase payment rates for specified health care providers up to Medicare payment levels. CAHSAH has secured amendments on this bill which include home health and hospice services.
Please contact all members of the Senate Health Committee (listed below)and urge them to SUPPORT SB 243 to ensure home health and hospice services remain accessible for all Medi-Cal beneficiaries.

Talking Points:

·         With the full implementation of the Medi-Cal expansion under the Affordable Care Act resulting in over 11 million people enrolled in the Medi-Cal program, it makes no sense to continue Medi-Cal provider rates reductions enacted during California’s economic downturn.  We must ensure that Medi-Cal provider rates provide sufficient access to all Medi-Cal beneficiaries

·         Ranked 48th among all states, California already pays its Medi-Cal fee-for-service providers some of the lowest rates in the entire country. Overall, Medi-Cal compensated physicians at only 51 percent of Medicare levels.

·         Medi-Cal provider rates for home health services have not been increased since 2001.  Home health is cost effective care that allows patients to receive care in the safety and comfort of their own home.  Medi-Cal provider rates for home health services do not reflect the current cost of providing care which has steadily increased.

·         Lack of access to home health services will shift care to more costly emergency rooms and result in unnecessary hospital readmissions. Linking home health Medi-Cal rates to established Medicare rates will help to promote access for all Medi-Cal beneficiaries throughout California.

·         Requiring annual increases will help to ensure the end of Medi-Cal provider rate neglect.


Member District Party Room Phone Fax
Isadore Hall 35 D 4085 (916) 651-4035 (916) 651-4935
Ed Hernandez (Chair) 22 D 2080 (916) 651-4022 (916) 651-4922
Holly Mitchell 30 D 5080 (916) 651-4030 (916) 651-4930
William Monning 17 D 313 (916) 651-4017 (916) 651-4917
Janet Nguyen 34 R 3048 (916) 651-4034 (916) 651-4934
Jim Nielsen 4 R 2068 (916) 651-4004 (916) 651-4904
Richard Pan 6 D 4070 (916) 651-4006 (916) 651-4906
Richard Roth 31 D 4034 (916) 651-4031 (916) 651-4931
Lois Wolk 3 D 5114 (916) 651-4003 (916) 651-4903


Dementia Communication Strategies

Posted on April 16, 2015

Dementia Communication Strategies

Dementia Communication Strategies for Caregivers

Dementia communication strategies are necessary for the primary caregiver of dementia sufferers. Often, caregivers become distressed at the changes that occur in behavior or verbalization that happen as dementia progresses. Filters often fall to the wayside and inappropriate or embarrassing outburst can occur. It is important to remember that these outburst or comments are not a reflection of your loved one, it is simply the dementia.

One of the most difficult aspects in dementia care is communication. Dementia sufferers often experience trouble in processing information as the condition progresses. This, in combination with a decreased ability to express their needs, can cause significant distress for the dementia sufferer and those caring for them.

People with advanced dementia are dealing with cognitive deficits and associated behavioral issues. This issues include anxiety, fear, depression and frustration. It is most helpful to be aware of these changes and approach conversations in a caring, compassionate and calm manner.

Other helpful dementia communication strategies:

  • Never appear angry or authoritative, approach an individual with a smile and soothing voice. This will increase the possibility of relaxation and openness to conversation
  • Always state who you are and your purpose for being there.
  • Speak slowly and reduce movements.
  • Speak to them directly, with good eye contact. If a primary caregiver is present, they can provide any clarification or additional information regarding any questions ask.
  • Include them in all conversation. Marginalizing someone will create feelings of anger and confusion.
  • Minimize external distractions, especially if trying to give instructions.
  • Keep sentences short, using familiar words.
  • Wait patiently for responses. It will take them longer to process what you have said.
  • If asking questions, try to use Yes/No questions.
  • If giving instructions, issue one instruction at a time.
  • Give time to answer, if necessary repeat the question slowly and clearly.

If agitation occurs remember:

  • Remain calm.
  • Remain patient.
  • Try rephrasing request or question.
  • Use distraction and redirection if behaviors/responses become inappropriate.

If your attempt to communicate at that moment are not working, be willing to move to another topic or abandon the conversation presently. You can always try again, shortly, when the person calms down. There is no sense in forcing the situation, as this will do nothing more than increase agitation.

Above all, remember that there should be no power-struggle. It will be much more rewarding and effective to attempt to gain consensus and cooperation.

Gabriela F. Brown, CSA
Constant Companions Home Care








Home Care Telephony – ClearCare

Posted on April 16, 2015

Home Care Telephony System - Clear Care

Using The Latest in Home Care Telephony Technology


Recently, Constant Companions launched the use of the ClearCare System and home care telephony program. This program allows us to better track the attendance and activities our home care staff, provide timely updates to care plans, allow real-time access to information and updates to our clients and their families (if authorized by the client).  All care plans are entered into the system with specific activities outlined for each shift.

Before the caregivers can clock out they must update all activities and tasks assigned for the day. If they are unable to perform a certain activity or task, they must leave a verbal message as to why. Additionally, they can record a change in condition for both the agency and the family to hear. This has improved our ability to identify new needs in a timely manner and coordinate additional care and services as well as communicate more effectively with family members.

Home Care telephony technology records exact in and out times of all caregivers as they call in from the client’s home phone, assuring timely arrival and departure. If the caregiver is late in clocking in or out, an alert is sent to the office and is handled appropriately. These telephony logs are used to produce accurate and timely billing, significantly reducing discrepancies and encouraging prompt and full attendance in the home.

We are thrilled with the implementation of the Clear Care System and we are committed to continued efforts to provide access to accountable and experience care to the residents of San Diego and Riverside Counties. Please feel free to give us a call any time with questions or concerns, we welcome all input.

Please visit the ClearCare website for more information: ClearCare: Powerful Home Care Software

Submitted by Gabriela F. Brown, CSA
Constant Companions Home Care