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.

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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.

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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


  • 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.

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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

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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.

Veterans Affairs Aid and Attendance Benefits

Posted on July 1, 2013

What Are Aid and Attendance benefits?

Aid and Attendance is a benefit paid by Veterans Affairs (VA) to veterans, veteran spouses or surviving spouses. It is paid in addition to a veteran’s basic pension. The benefit may not be paid without eligibility to a VA basic pension. Aid and Attendance is for applicants who need financial help for in–home care, to pay for an assisted living facility or a nursing home. It is a non–service connected disability benefit, meaning the disability does not have to be a result of service. You cannot receive non–service and service–connected compensation at the same time. Aid and Attendance benefits are paid to those applicants who:

  • Are eligible for a VA pension
  • Meet service requirements
  • Meet certain disability requirements
  • Meet income and asset limitations

Visit for more information.

Who is Eligible for Veterans Affairs Basic Pension and Aid and Attendance?

A pension is a benefit that the VA pays to wartime veterans who have limited or no income and who are at least 65 years old or, if under 65, are permanently or completely disabled. There are also “Death Pensions,” which are needs based for a surviving spouse of a deceased wartime veteran who has not remarried.

What are the Service Requirements for Aid and Attendance?

A veteran or the veteran’s surviving spouse may be eligible if the veteran:

  • Was discharged from a branch of the United States Armed Forces under conditions that were not dishonorable AND
  • Served at least one day (did not have to be served in combat) during the following wartime periods and had 90 days of continuous military service:
  • World War I: April 6, 1917, through November 11, 1918
  • World War II: December 7, 1941, through December 31, 1946
  • Korean War: June 27, 1950, through January 31, 1955
  • Vietnam War: August 5, 1964 (February 28, 1961, for veterans who served “in country” before August 5, 1964), through May 7, 1975
  • Persian Gulf War: August 2, 1990, through a date to be set by Presidential Proclamation or Law.

If the veteran entered active duty after September 7, 1980, generally he/she must have served at least 24 months or the full period for which called or ordered to active duty (there are exceptions to this rule).

What are the Disability Requirements for Aid and Attendance?

Veterans, spouses of veterans or surviving spouses can be eligible for Aid and Attendance benefits if they meet the following disability requirements:

  • The aid of another person is needed in order to perform personal functions required in everyday living, such as bathing, feeding, dressing, toileting, adjusting prosthetic devices, or protecting himself/herself from the hazards of his/her daily environment; or
  • The claimant is bedridden, in that his/her disability or disabilities require that he/she remain in bed apart from any prescribed course of convalescence or treatment; or
  • The claimant is in a nursing home due to mental or physical incapacity; or
  • The claimant is blind, or so nearly blind as to have corrected visual acuity of 5/200 or less, in both eyes, or concentric contraction of the visual field to 5 degrees or less.

What are the Income Requirements for Aid and Attendance?

The claimant’s countable family income must be below a yearly limit set by law. Countable Income means income received by the claimant and his or her dependents. It includes earnings, disability and retirement payments, interest and dividends, and net income from farming or business. A claimant must report all income, but the VA will exclude any income that the law allows. Public assistance, like SSI, is not counted as part of countable income. The annual income limits for the Aid and Attendance program are higher than those set for the basic pension. The maximum Aid and Attendance benefit that can be paid monthly to a single veteran is $1,704, but the veteran must have countable income of $0 to receive the maximum benefit.


Protecting Seniors – Financial Exploitation

Posted on July 1, 2013

Due to a change in life circumstances, you or a loved one is now in need of in-home care services. The last thing on many people’s minds is the possibility of financial exploitation, however, this is the perfect time to protect yourself or family member.

Most service companies do their best to assure that the personnel that they are sending into your home are honest by conducting background and reference checks. Here is the problem, background checks are great for weeding out the prior offenders, however, no background check can detect if someone has never been caught or predict if they are going to steal in the future. Simply put, there is no way to guarantee that you will not be a victim of theft or financial abuse.

There are things that you can do, BEFORE a crisis (right now) to prepare yourself:

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Locate all valuable items, i.e., jewelry, checks, credit cards, etc.  Inventory what you have and identify if you are currently missing something AND if you need to keep it in the house. This will prevent confusion after the fact if you go look for something and it isn’t where you thought it was.

  1. Once you do need someone caring for you at home, secure all financial instruments and jewelry in a lock box or safe in your home. Put the key where only you would know where it is and give a copy of the key to a trusted individual or in a safety deposit box.
  2. Never give your PIN to anyone working for you.
  3. Never allow anyone to go to the bank for you to take out cash, via check, etc.
  4. Report all suspicions or missing items as soon as possible to any company coming in and out of your home. If you are working with a home care agency make sure they are responsive to your concerns and act quickly to resolve the issue.
  5. Do not give cash or check bonuses directly to home care workers, make sure that the agency they work for is notified and has an opportunity to copy the bonus check and document the gift to avoid any future misunderstandings or opportunities for financial exploitation.
  6. If there is a need for a caregiver to handle shopping errands for you, set up a prepaid visa account with your bank (or by a Power of Attorney for your loved one) so that the spending can be monitored via computer daily. Replenish the account as necessary.
  7. If bill paying is too difficult, work with your financial institution to set up automatic bill pay.
  8. If you are receiving pension and social security checks at your home or PO Box, immediately set up electronic transfers to your bank.
  9. If a caregiver asks you for money directly for ANYTHING, immediately report it to their agency. As benign as this may seem, it is considered ‘abuse of position’ and is covered under the law as follows:

Financial Exploitation –Financial exploitation means a situation in which a caretaker or any other person who is in the care or custody of, or who stands in a position of trust to, a resident, takes, secretes, or appropriates their money or property, to any use or purposes not in the due and lawful execution of his or her trust. In the simplest terms, the person who is acting as a caretaker unlawfully takes money or property of the resident. This also includes a request for transfer of property by the resident that was not carried out.

Most caregivers are good people interested in your well-being. They are also hyper-aware that they are most likely to be blamed if something goes missing in your home. If you follow the above guidelines, it should protect both you AND the people working for you.

If you find that you are a victim of financial abuse or theft, PLEASE follow through with filing a complaint with Adult Protective Services and any charges against the person suspected of committing the crime. It is up to you or your family to see that charges are filed. This may be very uncomfortable and stressful but it is VITAL. Without convictions and a subsequent record to detect on a future background check, there is nothing to prevent that same person from moving on to another agency or to hire themselves out privately and continue their predatory ways.

Constant Companions: Our Family Taking Care of Yours

Posted on April 25, 2013

Home Care for San Diego Seniors

Senior home care is often an emotional and difficult decision. Finding the right San Diego home care for yourself or your elderly relative is an important step in the process. Constant Companions understands how hard it is to choose the right home care, especially if needing dementia care or Alzheimers care and we’re here to help you through the process.

At Constant Companions, we view senior home care as our family taking care of yours. Our San Diego senior home care providers are part of a family run business. Since the business is not a franchise, we are able to add a personalized and sympathetic aspect to your care. We understand you and your family are choosing home care because you want specific and individual needs to be met, which often cannot be done in a nursing home environment.

Personable San Diego Home Care

Since our home care will enable you to stay in your hometown in living arrangements you feel comfortable with, we don’t want to turn it into a place of strangers or make you feel uncomfortable with who is coming in and out of your home each day. Therefore, we make sure you continually have the same caregiver, who will be your primary caregiver, and a back-up caregiver, who you will meet and who will take over visits if your primary caregiver can’t make it due to illness or other reasons. We’re able to make this possible due to our high employee retention and loyalty. Constant Companions’ founder, Gabriela Brown, was dismayed when she first started working in the senior home care business to see how the majority of San Diego senior home care providers sent a continual change of caregivers whom were unfamiliar to the clients; it provided a cold atmosphere that was not good for the client or the family. She started Constant Companions in order to offer a warm and personalized service that puts the client first and is in-tune to the family’s needs and wishes. Her desire is to make Constant Companions feel like an extension of your own family.

You’ll also have peace of mind knowing that you’re working with employees, not independent contractors, who have years of experience in providing care to seniors. Constant Companions takes care of all background screening, supervision, payroll, taxes, and paperwork for all of our caregivers.  Our management team at Constant Companions will continually monitor your caregiver and make sure you and your family are having ongoing communication with your caregiver and ensure your needs are met, from medication and nutrition to entertainment and exercise.

To further make you feel like you’re working with a family and not a franchise, we provide all fees up front – there are no hidden fees you have to worry will pop up later. All our services are included in a flat fee that is a reasonable and fair rate. You and your family are able to talk with and interview potential caregivers before they’re assigned to you. We’re also available 24/7 and if you call us, you will reach a member of Constant Companions, not an answering machine.

San Diego Living with Senior Home Care

Since we are a San Diego-based company and have been providing senior home care for over nine years, we understand your environment and strive to keep you enjoying the San Diego lifestyle you love as much as possible. We believe seniors should have a high quality of life and are dedicated to helping them live it. We also know it’s important for seniors to be socially active and engage their mind, and we will assist them in being able to engage in these types of activities.

Dementia and Alzheimer’s Care

For dementia care and Alzheimer’s care, we take care to understand the delicate family matters and emotions that can arise. We understand how devastating it is to have to put a loved one in a nursing home and how frightening it is for the Alzheimer’s or dementia sufferer to be in a new environment away from all that is familiar. Therefore, we do our best to educate families that senior home care is possible for those with these conditions. We provide one-on-one care and enrichment activities such as puzzles, looking at family photos, music, crafts, and other activities.

The Constant Companions Mission

Just because someone is aging doesn’t mean they don’t deserve respect and love from all people they come in contact with – especially if that person is their caregiver. We work and stand by our mission to enrich the lives of each of our clients by providing the best in compassionate care, second only to family. We look forward to speaking with you about how our work family can partner with your family.

Finding Home Care for a Senior Parent

Posted on December 9, 2012

The Right Way to Find Home Care for a Senior

An adult child who is caring for an aging parent may suddenly find that the job of caregiving is too much to handle. The senior parent, who is living at home, may abruptly need someone with them during longer periods of the day and night, or they may even require some skilled care intervention. This is when the search for home care begins.

Assessing the type of home care a senior parent needs
To determine the kind of home care that is essential for the senior, first observe the senior parent. Watch how they senior routine Activities of Daily Living (ADLs) such as bathing and dressing. Also, note any housekeeping or errands that are difficult for them to accomplish. Make a list of all of the areas in which they need help and if outside assistance would improve quality of llife.

The Family Caregiver Alliance offers these guidelines for assessing the home care needs of a senior and for indicating where the caregiver needs support:

  • By assessing each area, the adult child can begin to align support for each need. For example, a friend or neighbor may be able to cover some of the areas of need, or community services, such as Meals on Wheels, can offer aid with other care requirements. If the senior parent has medical needs or requires constant supervision, hiring a home care worker is a viable alternative.Personal Care: bathing, eating, dressing, toileting
  • Household Care: cooking, cleaning, laundry, shopping
  • Health Care: medication management, physician’s appointments, physical therapy
  • Emotional Care: companionship, meaningful activities, conversation

Sure-fire warning signs that a senior needs more help
It is suggested that if an adult child or caregiver notices certain warning signs, the senior probably requires assistance on a more regular basis. Some signs to look for are:

  • Spoiled food that doesn’t get thrown away
  • Missing important appointments
  • Difficulty with walking, balance and mobility
  • Uncertainty and confusion when performing once-familiar tasks
  • Forgetfulness
  • Unpleasant body odor or noticeable decline in grooming habits and personal care
  • Dirty house, extreme clutter and dirty laundry piling up
  • Stacks of unopened mail or an overflowing mailbox
  • Late payment notices, bounced checks and calls from bill collectors
  • Poor diet or weight loss
  • Loss of interest in hobbies and activities
  • Changes in mood or extreme mood swings
  • Forgetting to take medications – or taking more than the prescribed dosage
  • Diagnosis of dementia or early onset Alzheimer’s
  • Unexplained dents and scratches on a car

Where to start looking for home care
Once it is apparent that the senior needs a home care worker or a home health care worker to help them around the house, locating the appropriate individual may present a challenge. Begin by asking people and organizations in the community – friends, local clergy, geriatric care managers or hospitals – if they could recommend a home care worker or a reputable home care agency. Community and local government resources, such as the local Area Agency on Aging, can often give advice on many good options for in-home care.

Whether you’re planning to enlist the help of a home care services agency or hire a personal home health aide, knowing what questions to ask is key to receiving quality assistance. The Society of Certified Senior Advisors has a great list of questions to ask when choosing a home care provider. Click here to read the article.

Understanding what services are offered
Home health care workers provide in-home medically necessary services, such as administering medicine, while home care workers provide in-home, non-medical services such as preparing meals, assisting with hygiene and housekeeping. Either an agency or an independent provider can supply these kinds of services in a senior’s home.

A good assessment by a qualified senior services professional will help align appropriate services, and by not paying for aid that isn’t needed, this assessment can also help keep costs down.

Starting a conversation with a senior parent about home health care
Before approaching a parent to discuss bringing in a home health care worker, put yourself in their shoes. Think about what that senior is most frustrated about and be empathetic. Understanding the situation is extremely important in relating to the senior’s emotions, and timing is crucial in setting the stage. Choose a time when tensions are low and there is plenty of time for a discussion.

To make the conversation the most productive, focus on the senior’s safety and helping them maintain independence. Concentrate on why and how an in-home health care worker can actually make life easier and safer. The Society of Certified Senior Advisors has a comprehensive guide to creating a safe and functional home environment for your loved ones that includes recommendation for home safety changes for each room in the house, what equipment is covered by Medicare and tips for finding the right contractor.Click here to read it.

Jake Harwood, Ph.D., the former director of the University of Arizona’s Graduate Program in Gerontology and the author of Understanding Communication and Aging (2007, Sage Publications), offers tips to help family caregivers communicate with their aging parents on sensitive subjects.

  • Get started. Start observing the senior loved one and gather information carefully and thoughtfully. Don’t reach a conclusion from a single observation and decide unilaterally on the best solution. Base the conversation on multiple observations that are gathered with an open mind.
  • Talk it out. Approach the senior parent with a conversation. Discuss your observations and ask the senior for their opinion about what is going on. If the senior parent acknowledges the situation, ask for their opinion about what would be good solutions. If the senior parent doesn’t recognize a problem, use concrete examples to support the case.
  • Sooner is better. Talk sooner rather than later when a crisis has occurred. If the senior has poor eyesight or has trouble driving at night, begin to address those issues before a problem arises.
  • Maximize independence. Always try to move toward solutions that provide the maximum amount of independence for the older person. Look for answers that optimize strengths and compensate for problems. For instance, if your loved one needs assistance at home, look for tools that can help them maintain their strengths.

Recognize the senior’s right to make their own life choices, especially if a home care worker is coming to the house. The senior is likely to be more agreeable if their concerns or wishes are respected during the decision-making process. The sooner you begin conversations with an aging parent about how they can remain safe and maintain independence by using home care, the easier it will be to approach the topic over the long-term, before any major safety concerns are presented.

Submitted by Gabriela Brown, CSA
Constant Companions Home Care San Diego and SW Riverside

Content by Society of Certified Senior Adviors, Member