About Our Caregivers – Constant Companions Home Care, San Diego and S. Riverside

Posted on November 27, 2011

We understand that you need a senior caregiver who fits your lifestyle. Our Care Coordinator will begin the process of selecting your caregiver by first studying the client profile and then matching a caregiver’s experience and personality according to your needs, preferences and personality. This way we can assure that the senior caregiver is not only a personal assistant, but an asset to you and your family.

Trust is the foundation of our success in San Diego and S. Riverside. We are continually updating our hiring and supervisory practices. Rest assured that all of our caregivers are thoroughly screened and supervised to enhance your confidence and trust.

Each caregiver must go through a 4 part application process including:

Step 1:

Initial application: Employment history, references and background check are completed. If results are good, Step 2.

Step 2:

Employment Questionnaire, consisting of 17 questions addressing personality and professionalism is administered. If results are good, Step 3

Step 3:

Interview. If results are good, Step 4

Step 4:


From the first placement the process in ongoing, with surprise supervisory visits, satisfaction survey reviews (from clients) and necessary intervention regarding training and policy review.

If our caregivers are unable to reach or maintain our standards, they are warned once and then dismissed on the second violation of any issues regarding professionalism and demeanor in the home. If the caregiver is deficient or unprofessional in any way that violates the law or many of our standards of professionalism, they are terminated immediately and not eligible for rehire. These practices may cost the agency a little more in unemployment claims and hiring costs, but we feel that it is in everyone’s best interest to refrain from ‘recycling’ caregivers that should not be working in anyone’s home.

-Gabriela Brown



A Place For Mom’s Guide To Dementia Care At Home

Posted on November 25, 2011

Even though most dementia cases come from irreversible causes, there is still so much dementia care that families can do to help their loved ones continue to function as well as possible for as long as possible. Creating a safe, comfortable, and supportive environment for someone with dementia can feel like a daunting and even overwhelming task for the caregiver, but fortunately there are now some accepted standards of dementia care that can help guide families to care for their loved one.

Researchers, doctors, and eldercare professionals are still discovering and refining what works and what doesn’t when it comes to dementia care. A lot of different techniques and strategies have been tried, some with more success than others, but clinicians have found that there are some principles and practices of dementia care that can and do work more often than not. For example:
• One of the long term goals of dementia care is to encourage and maintain the independence of the person with dementia for as long as possible. Studies have found that a technique called graded assistance, combined with practice (as in “practice makes perfect”) and positive reinforcement (encouragement and rewarding the desired behavior) can go a long way to maintaining that functional independence. Graded assistance is a method of helping someone accomplish a task with the least amount of aid possible, using a spectrum of assistance from verbal prompts to physical demonstration, physical guidance, partial physical assistance, and complete physical assistance.
• Researchers have also found that music can be very effective in reducing problem behaviors such as agitation and aggression, especially during mealtimes and bathing. However, it’s important to note that the music should be something that the person with dementia prefers, not necessarily what the caregiver thinks would be nice to listen to. Sometimes people assume that the best choices may be “soothing” classical music, but this is not always the case. Soothing or relaxing music can work, but playing your loved one’s favorite types of music is much more likely to be an effective form of dementia therapy.
•Other strategies of dementia care, such as pet therapy, lighting manipulation, and group therapies that concentrate on cognitive skills and/or social activities have also been tried to varying degrees of success.1

The following information is adapted from Caregiver Guide: Tips for Caregivers of People with Alzheimer’s Disease, published by the National Institute of Aging (NIA).2 Although it was originally written specifically for Alzheimer’s care, much of the information is applicable to other types of dementia care, and we have included it here for your reference and information. Remember to consult with your doctor about what is appropriate to your loved one’s condition before following any advice or recommendation.

From the NIA’s Alzheimer’s Care Guide:

Finding out that a loved one has Alzheimer’s disease (AD) can be stressful, frightening, and overwhelming. As you begin to take stock of the situation, here are some tips that may help:
• Study your day to see if you can develop a routine that makes things go more smoothly. If there are times of day when the person with AD is less confused or more cooperative, plan your routine to make the most of those moments. Keep in mind that the way the person functions may change from day to day, so try to be flexible and adapt your routine as needed.
• Consider using adult day care or respite services to ease the day-to-day demands of caregiving. These services allow you to have a break while knowing that the person with AD is being well cared for.
• Begin to plan for the future. This may include getting financial and legal documents in order, investigating long-term care options, and determining what services are covered by health insurance and Medicare.

• Choose simple words and short sentences and use a gentle, calm tone of voice.
• Avoid talking to the person with AD like a baby or talking about the person as if she weren’t there.
• Minimize distractions and noise—such as the television or radio—to help the person focus on what you are saying.
• Call the person by name, making sure you have her attention before speaking.
• Allow enough time for a response. Be careful not to interrupt.
• If she is struggling to find a word or communicate a thought, gently try to provide the word she is looking for.
• Try to frame questions and instructions in a positive way.


For some people with AD, bath time can be a frightening, confusing experience. Advance planning can help make bath time better for both of you.
• Plan the bath or shower for the time of day when the person is most calm and agreeable. Be consistent. Try to develop a routine.
• Respect the fact that bathing can be scary and uncomfortable. Be gentle and respectful. Be patient and calm.
• Tell the person what you are going to do, step by step, and allow him to do as much as possible.
• Prepare in advance. Make sure you have everything you need ready and in the bathroom before beginning. Draw the bath ahead of time.
• Be sensitive to the temperature. Warm up the room beforehand if necessary and keep extra towels and a robe nearby. Test the water temperature before beginning the bath or shower.
• Minimize safety risks by using a handheld showerhead, shower bench, grab bars, and nonskid bath mats. Never leave the person alone in the bath or shower.
• Try a sponge bath. Bathing may not be necessary every day. A sponge bath can be effective between showers or baths.


For someone who has AD, getting dressed presents a series of challenges: choosing what to wear, getting some clothes off and other clothes on, and struggling with buttons and zippers.
• Try to have the person get dressed at the same time each day so she will come to expect it as part of the daily routine.
• Encourage her to dress herself to whatever degree possible. Plan to allow extra time so there is no pressure or rush.
• Allow the person to choose from a limited selection of outfits. If she has a favorite outfit, consider buying several identical sets.
• Arrange the clothes in the order they are to be put on to help the person move through the process.
• If the person needs prompting, provide clear, step-by-step instructions.
• Choose clothing that is comfortable, easy to get on and off, and easy to care for. Elastic waists and Velcro enclosures minimize struggles with buttons and zippers.

• Ensure a quiet, calm atmosphere for eating. Limiting noise and other distractions may help the person focus on the meal.3
• Provide a limited number of choices of food and serve small portions. You may want to offer several small meals throughout the day in place of three larger ones.
• Use straws or cups with lids to make drinking easier.
• Substitute finger foods if the person struggles with utensils. Using a bowl instead of a plate also may help.
•Have healthy snacks on hand. To encourage eating, keep the snacks where they can be seen.
• Visit the dentist regularly to keep mouth and teeth healthy.


Finding activities that the person with AD can do and is interested in can be a challenge. Building on current skills generally works better than trying to teach something new.
• Don’t expect too much. Simple activities often are best, especially when they use current abilities.
• Help the person get started on an activity. Break the activity down into small steps and praise the person for each step he completes.
• Watch for signs of agitation or frustration with an activity. Gently help or distract the person to something else.
• Incorporate activities the person seems to enjoy into your daily routine and try to do them at a similar time each day.
• Take advantage of adult day services, which provide various activities for the person with AD, as well as an opportunity for caregivers to gain temporary relief from tasks associated with caregiving. Transportation and meals are often provided.


Incorporating exercise into the daily routine can benefit both the person with AD and the caregiver. Not only can it improve health and help everyone sleep better, but it can also provide a meaningful activity for both of you to share.
• Think about what kind of physical activities you both enjoy, perhaps walking, swimming, tennis, dancing, or gardening. Determine the time of day and place where this type of activity would work best.
• Be realistic in your expectations. Build slowly, perhaps just starting with a short walk around the yard, for example, before progressing to a walk around the block.
• Be aware of any discomfort or signs of overexertion. Talk to the person’s doctor if this happens.
• Allow as much independence as possible, even if it means a less-than-perfect garden or a scoreless tennis match.
• See what kinds of exercise programs are available in your area. Senior centers may have group programs for people who enjoy exercising with others. Local malls often have walking clubs and provide a place to exercise when the weather is bad.


As the disease progresses, many people with AD begin to experience incontinence, which can be upsetting to the person and difficult for the caregiver. Sometimes incontinence is due to physical illness, so be sure to discuss it with the person’s doctor.
• Have a routine for taking the person to the bathroom and stick to it as closely as possible. For example, take the person to the bathroom every 3 hours or so during the day. Don’t wait for the person to ask.
• Watch for signs that the person may have to go to the bathroom, such as restlessness or pulling at clothes. Respond quickly.
• Be understanding when accidents occur. Stay calm and reassure the person if he is upset. Try to keep track of when accidents happen to help plan ways to avoid them.
• To help prevent nighttime accidents, limit certain types of fluids—such as those with caffeine—in the evening.
• If you are going to be out with the person, plan ahead. Know where restrooms are located, and have the person wear simple, easy-to-remove clothing. Take an extra set of clothing along in case of an accident.

Sleep Problems

Nighttime can be a difficult time. Getting the person to go to bed and stay there may require some advance planning.
• Set a quiet, peaceful tone in the evening to encourage sleep. Keep the lights dim, eliminate loud noises, even play soothing music if the person seems to enjoy it.
• Try to keep bedtime at a similar time each evening. Developing a bedtime routine may help.
• Encourage exercise during the day and limit daytime napping.
• Restrict access to caffeine late in the day.
• Use night lights in the bedroom, hall, and bathroom if the darkness is frightening or disorienting.

Hallucinations and Delusions

As the disease progresses, a person with AD may experience hallucinations and/or delusions.4
• Sometimes hallucinations and delusions are a sign of a physical illness. Keep track of what the person is experiencing and discuss it with the doctor.
• Avoid arguing with the person about what she sees or hears. Try to respond to the feelings she is expressing, and provide reassurance and comfort.
• Try to distract the person to another topic or activity. Sometimes moving to another room or going outside for a walk may help.
• Turn off the television set when violent or disturbing programs are on. The person with AD may not be able to distinguish television programming from reality.
• Make sure the person is safe and does not have access to anything she could use to harm anyone.

Home Safety and Wandering

Creating a safe environment is one of the most important aspects of caregiving and can prevent many stressful and dangerous situations. Caregivers of people with AD often have to look at their homes through new eyes to identify and correct senior home safety risks, as well as to prevent wandering, a dangerous tendency of people with AD.
• Install secure locks on all outside windows and doors and keep them locked, especially if the person is prone to wandering. Consider a keyed deadbolt or an additional lock up high or down low on the door. If the person can open a lock because it is familiar, a new latch or lock may help.
• Remove the locks on bathroom doors to prevent the person from accidentally locking himself in.
• Be sure to secure or put away anything that could cause danger, both inside and outside the house.
• Use childproof latches on kitchen cabinets and any place where cleaning supplies or other chemicals are kept.
• Label medications and keep them locked up. Also make sure knives, lighters and matches, and guns are secured and out of reach.
• Keep the house free from clutter. Remove scatter rugs and anything else that might contribute to a fall. Make sure lighting is good both inside and out.
• Consider installing an automatic shut-off switch on the stove to prevent burns or fire.
• Make sure that the person carries some kind of identification or wears a medical bracelet. If he gets lost and is unable to communicate adequately, this will alert others to his identity and medical condition.
• Keep a recent photograph or videotape of the person with AD to assist police if the person becomes lost.


Making the decision that a person with AD is no longer safe to drive is difficult, and it needs to be communicated carefully and sensitively. Even though the person may be upset by the loss of independence, safety must be the priority.
• Look for clues that safe driving is no longer possible, including getting lost in familiar places, driving too fast or too slow, disregarding traffic signs, or getting angry or confused.
• Be sensitive to the person’s feelings about losing the ability to drive, but be firm in your request that she no longer do so. Be consistent—don’t allow her to drive on “good days” but forbid it on “bad days.”
• Ask the doctor to help. The person may view the doctor as an “authority” and be willing to stop driving. The doctor also can contact the Department of Motor Vehicles and request that the person be reevaluated.
• If necessary, take the car keys. If just having keys is important to the person, substitute a different set of keys.
• If all else fails, disable the car or move it to a location where the person cannot see it or gain access to it.

Visiting the Doctor

It is important that the person with AD receive regular medical care beyond Alzheimer’s care. Advance planning can help the trip to the doctor’s office go more smoothly.
• Try to schedule the appointment for the person’s best time of day. Also, ask the office staff what time of day the office is least crowded.
• Don’t tell the person about the appointment until the day of the visit or even shortly before it is time to go. Be positive and matter-of-fact.
• Bring along something for the person to eat and drink and any activity that he may enjoy.
• Have a friend or another family member go with you on the trip, so that one of you can be with the person while the other speaks with the doctor.

Source: National Institute on Aging, www.nia.nih.gov

1 For more information on the most up-to-date findings that might help you, talk to your doctor.

2Information provided by the NIA is free of copyright and in the public domain. Additional information can be found at the NIA website: http://www.nia.nih.gov/.

3Please also see the reference to research findings on the use of music, located at the beginning of this article.

4 In some types of dementia, such as Lewy Body Dementia (LBD), hallucinations can occur at the first onset of symptoms. For additional information on LBD, please refer to our article on dementia: Understanding Dementia: A Basic Overview.

VA Aid and Attendance Benefit

Posted on October 7, 2011

Submitted by: Gabriela F. Brown, CEO
Constant Companions Home Care, San Diego
email: gbrown@constantcompanions.net
phone: 888.883.8393
webiste: www.constantcompanions.net

The VA Aid and Attendance Benefit is available to many veterans and their surviving spouses. If you qualify, this benefit will assist you in paying for the extra assistance that you may need at home or in any residential setting. We are very excited to be able to provide guidance to this benefit as it has helped several existing clients to continue receiving services that they are receiving from Constant Companions Home Care.

  • This benefit applies to veterans and surviving spouses who require assistance in bathing, dressing, meal preparation, medication supervision, meal preparation and assistance with any other activities of daily living.
  • Qualifying veterans have served at least 90 days of active duty with at least 1 day during active war time.
  • Qualifying surviving spouses must have been married at the veteran’s time of death.

Service Eligibility Dates:

  • 04/21/1898—7/15/1903
  • 05/09/1916—11/11/1918
  • 12/07/1941—12/31/1946
  • 06/27/1950—01/31/1955
  • 08/05/1964—05/07/1975
  • 08/20/1990—present

Financial and Medical Qualifications


  • Assets cannot total more than $80,000 excluding home, annuities, vehicles, pre-paid funeral expenses and other items.


  • A primary care physician can certify a veteran’s need for personal care services.
  • Available to those who need assistance in their own homes, assisted living facilities, board and care facilities and skilled nursing facilities.
  • A veteran can receive up to $1519 per month and a surviving spouse may be eligible to receive up to $976 per month. A married couple may qualify for up to $1801 per month.

The Application Process

Applications can take anywhere from 3-6 months to process, however, payment for services can extend back to the date of the initial application. If you are in need of immediate benefits ask if they can expedite the process.

To apply for this benefit contact your Regional Veteran’s Administration Office.

Three helpful websites:


VA Website: http://www1va.gov/directory/guide/home.asp

VeteranAid.org: http://www.veteranaid.org/apply.php

Submitted by: Gabriela F. Brown, CEO
Constant Companions Home Care
email: gbrown@constantcompanions.net
phone: 888.883.8393
webiste: www.constantcompanions.net


Hiring a Caregiver – Private vs. Agency

Posted on October 7, 2011

During these tough economic times it is more tempting than ever to hire caregivers privately, bypassing any placement service or home care agency. However, after reviewing the following information, we hope that you will see the benefit in contracting with a home care agency when looking to bring help into your home.

There are TRUE benefits of working with an agency. Agencies can save you and your family long-term consequences, both financial and legal.

When you hire a caregiver, the going rate is approximately $15 per hour. When you hire an agency such as ours the going rate is $20+. For this additional $5 per hour you receive the following benefits and protections.

  • The workers are covered by Worker’s Compensation, paid by the agency
  • The workers are covered by Unemployment Insurance, paid by the agency.
  • Employment taxes are split and submitted each payroll, half by the caregiver and half by the agency.
  • The worker’s taxes are pulled and sent immediately to the IRS and CA Employment Development Department (EDD). These taxes cover State, Federal, Liability, Employment Tax and California State Training Tax.

These taxes and insurances must be paid by ANY and ALL employers. The state of California is currently in desperate need of revenue and is targeting individuals that consider themselves, “self-employed” or “contractors”.

If a worker is cross-referenced with an individual employer, the employer can always be held liable for back taxes. The reason for this is that the state claims that many of these individuals do not pay or file their taxes, so they are placing the burden on the employers to collect it and submit it.

In regards to Worker’s Compensation, consider this; your private caregiver is injured on the job. If the Labor Board determines that they are your direct hire, and they WILL, you will be responsible for the cost of their injuries and will be fined $1,000 per caregiver for not carrying Worker’s Compensation on that employee. Additionally, in order to continue to hire that employee, you will be required to take out a Worker’s Compensation policy for them to the tune of 7-9% or higher (through State Fund) of their gross pay, each pay period. You will be audited and you will have to show documentation that you are in compliance. Additionally, your homeowner’s insurance may require an additional premium for having a domestic worker employed.

Next scenario; the caregiver you hire just isn’t working out for you. You manage to dismiss their services (not always an easy thing to do). 2-3 weeks later, you receive a notice from the EDD, an unemployment claim. If your caregiver chooses this route, to recover unemployment payments, they WILL win. The EDD will consider that in any direct hire arrangements that you are the employer and they are the employee, regardless of any contracts, business licenses, etc.

Aside from the legal/tax benefits discussed above, agencies are simply a better choice for the following reasons.

  • You can switch out a caregiver that isn’t working out for you.
  • The agency carries liability insurance, both professional and general for all workers.
  • The agency can supervise and direct the worker.
  • Of course, all of our caregivers are screened. I would hope all agencies do the same.

This is the down-side of private hire. This is not to say that there are not some wonderful set-ups that work out well for all. However, one must consider the possibility that if a person is left without income for any reason, they have a wide variety of available options from which to recover what they may feel they are entitled to. It is always important to remember that it is in the best interest of state-run agencies to find in the worker’s favor. Not only will they assure revenue/justification for their agency, but this caregiver will now be in the “system” and they are better able to pursue them and you if the caregiver has not filed/paid taxes.

There will always be those who will continue to hire privately. However, I believe it is because many are not aware of the serious implications of doing so. I hope this article helps those individuals to at least make an informed decision when hiring outside help for the home.

For further information regarding Employment of Domestic workers, please refer to California Civil Code Section 1812.501 and Unemployment Insurance Code Section 687.2.

Submitted by Gabriela F. Brown, Constant Companions Home Care.
Email: gbrown@constantcompanions.net

Phone: 888.883.8393

Breast Cancer Awareness for Senior Women

Posted on October 7, 2011

The traditional methods for breast cancer screening involve the use of annual mammograms and monthly self-checks. These preventive measures have resulted in a dramatic increase in breast cancer survival for most women, except those over 70. Over the next 30 years, the number of the 85+ population in the United States is expected to quadruple. Life expectancy for women at 70 TODAY is another 15 years. Recent studies have been conducted regarding the survival rate for women diagnosed with breast cancer and many commonalities have been identified.

1. There is still a lot of controversy regarding what age women should discontinue routine mammograms.
2. According to MayoClinic.com, a woman’s chance of developing breast cancer increases after she reaches the age of 60.
3. More than 50 percent of breast cancers occur in women 65 years of age and older.
4. As many as 50 percent of women 65 years of age and older who develop breast cancer die of the disease.
5. A woman’s chance of being diagnosed with breast cancer:
From age 30-39 . . . . . . 1 out of 229
From age 40-49 . . . . . . 1 out of 68
From age 50-59 . . . . . . 1 out of 37
From age 60-69 . . . . . . 1 out of 26
From age 70-85. . . . . . 1 out of 8

Reasons for this increased morbidity and mortality in breast cancer for older women can be attributed to lower screening rates screening rates and a difference in opinion about how to approach treatment options. Until recently, there were no guidelines available regarding screening over senior women over 70. Now the American Geriatrics Society encourages screening mammography for women younger than 85 who have at least 5 years’ life expectancy and for healthy women 85 and older who have excellent functional status or who feel strongly about the benefits of screening. It is important to note that the AGS does not recommend regular mammograms for seniors with severe cognitive deficits or life limiting conditions. As with all diagnostic tools, there is a chance of a false positive which would require more office visits and possibly uncomfortable procedures to investigate a positive. Many well-intentioned spouses, adult-children or other caregivers may be taking the person in for unnecessary mammograms out of a sense of duty and care, inadvertently causing distress, both psychologically and physically.

Historically, most studies have focused on the results of diagnosis and treatments for senior women up to the age of 70. As a result, frequency of these screenings is still controversial with opinions varying between being screened every 1 to 3 years. However, with a 1 in 8 chance of being positively diagnosed, a regular screening schedule should be considered. One way to determine the correct frequency is to evaluate your risk factors:

• Are you overweight?
• Have you had prolonged exposure to estrogen? i.e., early onset of puberty (before 12 years of age), first child after 30, late menopause (after 55 years of age), hormone replacement therapy.
• History of excessive alcohol use?
• Do you have a history of smoking?
• Is there a family history of breast cancer?

If you are diagnosed with breast cancer, treatment options should not be based on age alone. Age is an arbitrary measure. If you are still active with a good quality of life, insist on an open discussion with your physician about the type of tumor you have and the most effective approach to treatment. Treatment should be tailored to YOU specifically. Be completely informed of ALL of your options and evaluate the risks and benefits to your overall quality of life. Many women have received less aggressive treatment after diagnosis if they are over 70. The fear has been that age would decrease tolerance to such treatments. These are valid concerns, all risk factors associated with your individual health profile should be evaluated and treatments should be adjusted to reduce unnecessary toxicity to your body, but that does not mean to avoid a more aggressive treatment. Studies show that if detected early enough and treated appropriately, the survival rates of senior women are similar to those of younger women.

The debate continues, and over the next 5-10 years current studies and the data that is gathered will possibly reveal an effective breast cancer prevention/detection/treatment protocol for senior women in their 70s and beyond. For now (and probably, always), it is best to take a proactive approach to your own care, an approach that reflects your wishes and needs. Make a plan and share it with a trusted primary care provider who will respect and honor that plan.

Read More:






Submitted by Gabriela F. Brown, Constant Companions Home Care.
Email: gbrown@constantcompanions.net

Phone: 888.883.8393

Senior Nutrition

Posted on October 5, 2011

Submitted by Gabriela F. Brown – gbrown@constantcompanions.net
Constant Companions Home Care.
Visit our website at www.constantcompanions.net

By 2030, Americans over the age of 65 will reach 71 million, approximately
20% of our population. Further, almost 90% of Americans over the age of 65 have
one or more degenerative disorders. These conditions were once thought to be a
natural consequence of aging but recently there is evidence that many
conditions like heart disease, cancer, osteoporosis, arthritis, diabetes can be
either prevented or ameliorated by good nutrition and regular exercise.

There are increasing obstacles to proper nutrition as we age:
Chronic illness, recent hospitalizations, depression, mal absorption,
medications, dental problems, diminished taste and smell, restricted diets,
limited income, loneliness and isolation. However, it is important to realize
that without the proper mix of fuel and nutrients, symptoms of malnutrition can
appear and increase the symptoms and debilitation of any of the above listed
conditions. In essence, it is a vicious cycle that can only be broken by a
commitment to learn and apply better eating habits.

Malnutrition can be seen as increased forgetfulness,
dehydration, frailty, delayed wound healing and decreased muscle mass that can lead
to falls and fractures. Indirectly, malnutrition could be a significant factor
in many hospital stays and lengthy rehabilitations. Additionally, it can make
worse any chronic conditions.

Some seniors may be at a healthy or even heavy weight, but still
experience malnutrition. Because metabolism can decline by as much as 30% in
people over 50, it is important to eat fewer calories. With fewer calories, we
run the risk of fewer nutrients, so the foods must be packed with nutrients. A
good start is to limit high-carb,

high-fat, nutrient deficient foods and increasing nutrient rich foods like vegetables,
fruits, whole grains breads and pastas and to add supplement drinks if
necessary. A multivitamin will also go a long way to maintain your stores if
your nutrient values rise and fall day by day.

Good ways to help a senior that you suspect of being

Try to approach the situation delicately. There are many reasons to not eat
properly and you don’t want that person to become defensive and clam up. Eat
with them, observe. Is there plenty of protein, fiber and healthy fats in
each meal? Are vegetables and fruit included in each meal? Are most meals
cooked at home, from scratch and healthy sources? If so, then they are on their
way to good nutrition. Next find out if they are supplementing their diet with
a multivitamin or nutrition shake. This can be done by placing the items in the
home and periodically checking to see if they have been used. See how much they
eat at every meal. A good measure for amount is the size of their fist. If it
less than that, try to determine if they are eating more frequently. Many
seniors cannot eat 3 large meals and choose to eat more often with smaller
portions. As long as the smaller portions and snacks equal 5 a day, throughout
the day, all is well.

If a loved one is malnourished there are several things that you
can do with and for them to encourage healthier/sufficient eating:


Add healthy proteins and health fats, like cheese, nuts and nutbutters. Cheese
can be mixed into a wide variety of otherwise bland and calorie deficient
foods. Nutbutters are great on crackers and a slice of bread, add a little
fruit spread if the diet permits, to moisten and make it easier to swallow.
Nuts are great for snackers. Over the day these calories can add up and they
are providing rich and healthy oils for the body.

Spice it up!

Add some herbs, lemon, seasonings, as tolerated and enjoyed to make the food
more flavorful and enjoyable. Make sure you check sodium levels. An adult
should take in no more than 1500mg per day.


Get them out or invite yourself over. Eating is a social behavior. We all eat
much more when we are in the company of others. This has the dual benefit of
providing an anticipated event and the eventual company, which can help to
alleviate mild depression, a reason for not eating well.

Get Moving!

Exercise gets everything in the body working more efficiently. Encourage
walking, biking, chair exercises, swimming, WHATEVER that is possible to do
safely and comfortably. The idea is to move the body every day. Metabolism will
increase, mood will lighten, and appetite will increase. Again, if you are at a
loss for options, contact your health care provider for resources.


Take a daily multi-vitamin to cover any gaps in nutrition.

Call the Doctor!

If you suspect depression or lack of appetite due to medications or ANY other
underlying issues, call the doctor. Many times they will be able to do an
overview of health and medications to discover or eliminate possible reasons
for a lack of appetite.

As always, my column is meant as general advice based on over 20
years of working with and learning about seniors. It is not medical advice. I
encourage anyone who suspects that they or someone they love is malnourished to
see their health care practitioner as soon as possible in order to establish an
individualized plan that will put you back on track to better health.


Submitted by Gabriela F. Brown, Constant Companions Home
Care. Visit our website at www.constantcompanions.net.

Are you ready for an emergency?

Posted on October 5, 2011

Submitted by Gabriela F. Brown, Constant Companions Home Care.
email: gbrown@constantcompanions.net

Emergency preparedness is an absolute necessity for everyone, however the elderly and infirm can encounter greater challenges due to lack of mobility and strength.

First and foremost, to be properly prepared you must make a plan, write out your plan and go over the plan with all of those involved.

2 ways to get out each room of the house
Your ICE “In Case of Emergency” contacts – In the area and out of the area including family AND neighbors that can assist you or look in on you. Make sure your ICE contacts understand what is being asked of them.

We suggest that our clients prepare double the following list in order to provide supplies for the caregiver that is working with them. Caregivers should carry emergency information with them as it pertains to their own families in the event that they become incapacitated. Also, for caregivers, cell phones are wonderful but they do run out of battery power. Keep your phone charged at all times and know how to text. Texting can get through better during emergencies and they use less power.

Prepare your emergency kit. 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 client and 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.

If you would like to purchase an emergency kit, we located a 3-day pack for one person at http://www.amazon.com/Mayday-Person-Deluxe-Emergency-Backpack/dp/B000EPLKSW  This kit is not complete for the older person, so make sure that you add in all of the items listed below that are necessary.

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.

Other things to consider and have in place:
 If you have pets, make advanced arrangement of what you will do with them as many shelters do not allow pets.
 If you use hear aids or glasses, secure them in a drawer or box beside your bed so that they are not damaged by falling off or having something fall on them during an earthquake.
 Know where the water, electric and gas are connected and know how to turn them off. Use a flashlight to find them after a disaster. DO NOT use a candle or any other type of open flame in the event of a gas leak.
 If POWER is lost, unplug everything, turn off light switches to avoid electrical surges. Avoid opening the refrigerator or freezer. Try to avoid using a generator, however, if you must then place it outside and let it cool down before refilling it. Never connect a generator to your home’s electrical system unless you are doing so through an approved transfer switch installed in compliance with
the local electrical code.
 If you need assistance in evacuating your home due to mobility issues or if you are bedridden, register that need with local government ahead of time.
 If you are able to evacuate on your own or with some assistance with a caregiver, remember to dress adequately, wear sturdy shoes, grab your emergency kit, lock your doors and follow the route that you have been told to take.
If you are told to stay at home, listen to the radio or watch television for updates, information and instructions.

In the event of an emergency it is normal to experience anxiety and a little panic, but with good planning, you can remain calm, knowing that you have everything in place that is necessary for emergency personnel to help get you to safety.

For more information go to http://www.ready.gov/america/getakit/index.html

Submitted by Gabriela F. Brown, Constant Companions Home Care.
email: gbrown@constantcompanions.net