VA Aid and Attendance Benefit

Posted on October 7, 2011

Submitted by: Gabriela F. Brown, CEO
Constant Companions Home Care, San Diego
phone: 888.883.8393

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:

Submitted by: Gabriela F. Brown, CEO
Constant Companions Home Care
phone: 888.883.8393


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.

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, 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.

Phone: 888.883.8393

Senior Nutrition

Posted on October 5, 2011

Submitted by Gabriela F. Brown –
Constant Companions Home Care.
Visit our website at

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

Are you ready for an emergency?

Posted on October 5, 2011

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

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  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

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