Senior and Disability Services Through Mediciad

Looking for options for in home care and/or supported services can be extremely daunting if you have never needed any type of services like these before.  

In addition to private duty in home care for seniors, Comfort of Home Healthcare also has two contracts with the State of Missouri to provide similar services to people with disabilities and other Medicaid recipients. 

Comfort of Home Healthcare provides services for people with disabilities though the State of Missouri's, Department of Mental Health (DMH), Department of Health and Senior Services (DHSS) and Bureau of Special Healthcare Needs. These services are initiated through that respected department but includes services such as: (but not limited to)

• Home and Community Based Services; (DHSS) a Medicaid program that helps with Activities of Daily Living and Personal Care. 
• Individual Supported Living or ISL; residential placement in a non institutional setting.
• Residential Supported Living; supporting individuals with disabilities in their homes and in the community. 
• Supported Employment
• Respite Care; short term or temporary care of a few hours or weeks to provide relief or respite, to the regular caregiver, usually a family member.

These Medicaid programs and waivers will get very confusing to someone who is looking for care. Please do not hesitate to call us and we can point you in the right direction on where to initiate these services.

Here is some additional information taken directly from their websites (with links).

Missouri Department of Mental Health

Services for people with disabilities can be found here. (Must have onset of disability before the age of 21)

The Division is committed to individuals having access to individualized services and supports that provide access to opportunities that increase independence, integration, inclusion, productivity, self-determination and health and safety. Individuals and families must have access to a comprehensive and coordinated system that assists in planning, connecting to services and supports within and outside the disability system.

Missouri Department of Health and Senior Services

(Income based to qualify) Most ill or disabled Missourians can remain in their own homes and avoid or delay institutionalization with the help of support services.  Home and community-based services, administered by the Division of Senior and Disability Services (DSDS), are available to eligible persons 60 or older and to adults with disabilities between the ages of 18 and 59

DSDS administers two differentprograms, available in every county: in-home services and consumer-directedservices and can be found here.

Comfort of Home Healthcare provides in home services only (Home & Community Based Services). We do not provide CDS services.

This post is intended to be an introduction to services and not a detailed list of Medicaid services. I am sure you have further questions and if so,  feel free to call us. We are here to help!!

Dementia and Alzheimer's

Dementia and Alzheimer's in the Elderly

Your family is not alone. The effects of dementia and Alzheimer's are devastating, not only to the one suffering from dementia or Alzheimer's, but also to the family members who are coping with this new reality. You may feel alone in this battle, but there are many other families who are struggling with these same circumstances in their own family. Coming to a better understanding about the symptoms and effects of dementia and Alzheimer's, may help change your perspective on this issue. Also, we will provide you will a couple resources that may help you get the support you need during this time. 

First, it is important to understand that although the terms "dementia" and "Alzheimer's" are often used to mean the same thing, they are defined and diagnosed differently. Dementia refers to, "A loss of mental ability severe enough to interfere with normal activities of daily living." This can encompass a wider variety of diseases, but Alzheimer's disease accounts for 60 to 80 percent of dementia cases. 

Although Alzheimer's is most commonly found in and associated with the elderly, it is not a natural part of the aging process. Alzheimer's is a progressive disease that gets worse over time; the intensity and form the symptoms take will change as the disease progresses. For example, in the beginning stages an individual might experience minor memory loss, but in later stages an individual may experience more severe memory loss, affecting their ability to function independently. 

Some of the general symptoms of Alzheimer's include:

• Memory loss, ranging from mild to severe. 
• Disorientation.
• Mood and behavior changes. 
• Deepening confusion about events, time and place.
• Suspicions about family, friends, and caregivers.
• Difficulty speaking, swallowing, and walking.

If any of these symptoms are occurring in you or your family member, a doctor should be seen right away. Although there is no cure for Alzheimer's, there are a few helpful intervention methods that can slow down the process. Early diagnosis is key for Alzheimer's treatment. There are very noticeable changes that take place in the brain scans; Alzheimer's prevents nerve cells in the brain from accurately performing their job. This causes the brain to lose function, resulting in many of the symptoms seen above. 

The best way to communicate with your family member who has Alzheimer's is to meet them where they are at, and be aware that this may change from day to day. This disease is completely out of their control, and should not be handled with anger and frustration. It is important for family members to get support during this time, because it can become too big of a physical and emotional burden, especially on family members who also have the responsibility of being the main caregiver.

Here are a few helpful resources in regards to this topic and support for your family:

Support for Alzheimer's/Dementia

Alzheimer's: Dealing with Family Conflict

Affording In Home Healthcare...Can I afford to keep my loved one at home?

One of the main reasons people choose not to invest in in-home healthcare (1 on 1 care) for their loved ones is because of the possible financial burden or the lack or resources the individual has. Comfort of Home Healthcare wants to make in-home healthcare not only comforting and convenient for your family, but also financially affordable. As a business, we try to keep costs down as much as we can, but there are also resources for your family to participate in that will dramatically change your financial outlook on in-home healthcare services. 

But before we get in to some of the resources, Comfort of Home Healthcare would like to point out that if your receive in home care for two people. E.g. Parents/ grand parents
It is very feasible to financially keep your loved ones in their homes!! In a facility setting (nursing home) you will have to pay out of pocket for each person. In home care is priced by staffing and not each individual person. 

This is so important because this will allow you to; 
1. keep your loved ones in their home! 
2. You will have one staff taking care of both of them as opposed to one CNA per 10+ people!

Unfortunately this is not case for most of our clients. For those of you who are looking for care for a loved one (not a couple). Comfort of Home Healthcare has provided a list of resources that will offset costs, for you to consider. Here are several of those resources and how you may qualify to receive these benefits: 
(Not all scenarios work for every person. This simply a list of all options available)

• Veterans Benefits: If you or your loved one was a veteran.

• Veterans Widows Benefits: If you or your loved one was married to a veteran.

• Medicaid: If you meet the financial guidelines to qualify for Medicaid, they have potential opportunities for assistance. 

• Long Term Care Insurance: If you or your loved one has purchased a Long Term Care Insurance Plan.

• Life Insurance: If you or your loved one is terminally ill, a life insurance plan is a valuable resource. 

• Life Insurance (Viatical Settlement): A viatical settlement is the sale of a life insurance policy to a third party, usually a funding company owned by a group of investors. 

• Life Insurance (Loan): A policy owner may be able to make a loan against the cash value of the policy, based on what type of policy is owned. 

• Reverse Mortgage: If you or your loved one has equity in their home, they can probably qualify for a reverse mortgage.

• Area Agency on Ageing: There can be local organizations such as the Area Agency on Ageing that can help with some of the costs of in-home care.

If you have questions about the specific details (contacts and phone numbers) of these resources, Comfort of Home Healthcare would be happy to talk to you about the resources that will best fit your family and your family's individual needs. 

We care about your family and we want to provide the best possible service at the best price for your family!

Elderly Care is a Family Affair

Elderly Care is a Family Affair

Your elderly or disabled loved ones are at crucial points in their life, filled with many changes and new circumstances. During this time your loved one needs support and help in planning their future and making sure all of their needs are properly addressed. No one should walk this road alone, and so the care of your loved one needs to become a family issue. Often family members are the caregivers to their elderly or disabled loved one, so they too may be experiencing many life changes. The best way to care for your family is to make sure that you are coming together as a family, making compromises when necessary, and making decisions based on the needs of the entire family. 

"Seniors are at a vulnerable stage of life. They often face multiple health concerns and loss of physical and cognitive function. More than ever, seniors need the support and love of family members. Seniors often have difficulty expressing their needs, desires and preferences, so they must have someone to advocate for them. And who is more qualified for that than the people who know them better than anyone else in the world?"

To be able to be the advocate for your loved one during this often difficult time, is such a rewarding opportunity. If you and your loved one are able to work together and communicate effectively, this will increase the positive outcomes in both of your lives. 

It is not uncommon for family members to be the sole or primary caregiver for an elderly or disabled family member. "A new study of caregivers says that one out of three adults in the U.S. currently serves as a caregiver." Caregiving is no easy task, and takes up much of the caregivers time and energy. If you are in this position it may be necessary to consider some in-home healthcare options for your family. In addition to this, it is important to ask the right questions when you are considering a plan for your elderly or disabled loved one's care. 

Here are some questions that may be helpful to consider:

• What is the best way to talk to my parents or loved one about their healthcare needs?
• How will the care they need be funded?
• What is the safest, most comfortable, most appropriate care option for my loved one?
• Is there a family member nearby who can be of assistance at a moment's notice?
• What types of services or help does my loved one need-- for instance, bathing, eating, transportation, medications, etc.?
• How do my loved one's religious affiliation and personal preferences influence the care decisions we need to make?
• What types of senior care are available? How do they differ? How does each one address my parents specific needs?

Here is a resource that gives more statistical, and practical information on this subject:

Caring for Elderly and Disabled is a Family Affair

It's Hot out There! Tips to Battle Heat Stress...

Beat the Heat:

Tips to Battle Heat Stress among the Elderly

As temperatures rise, the elderly have to battle the effects that heat can have on their bodies and everyday activities. As a caretaker or the family member of an elderly loved one, it is crucial that you become aware of the dangers that accompany heat stress in an individual, the signs and symptoms, and the treatment or first aid options you have as a caregiver. Being proactive in this area will help you “beat the heat” when it matters the most.

Heat stress is the general term used to describe the body’s inability to cool itself down; under the umbrella of heat stress are illnesses caused by heat, which include heat cramps, heat exhaustion and heat stroke. The elderly are more susceptible to heat stress for several reasons—the ability to recognize changes in body temperature decreases with age, they have underlying health issues that cause their body to adapt to heat at a slower rate, and prescription medications may make them prone to dehydration or unable to regulate body temperature properly. These added risk factors make the summer season a more dangerous time for seniors and their health.

Being able to recognize common signs and symptoms of heat stress will allow you to approach the hottest time of the year with caution and care for your family. Several of the typical symptoms of heat stress include, but are not limited to:

·       High body temperature

·       Rapid or strong pulse

·       Red, hot, or dry skin

·       Headaches

·       Dizziness or fainting

·       Nausea or vomiting

·       Chest pain

·       Trouble breathing

The severity and fluctuation of symptoms may indicate the level of heat stress that the person is experiencing, whether it be heat cramps, exhaustion, or stroke. The chart below helps to clarify which symptoms align with which heat-induced illness, and gives essential first aid tips for each illness. 

  Taking action and providing appropriate first aid is necessary in situations where signs and symptoms are present, but there are precautions that can be taken in order to avoid heat stress to begin with. Use these tips during high temperatures to help keep not only the elderly safe and healthy, but also yourself and your family.

•  Drink plenty of liquids to avoid dehydration, especially water and juice. Avoid alcoholic or caffeinated drinks.
• Wear appropriate clothing that allows your body to “breathe”; choose light-colored, lightweight, loose-fitting clothing and hats when necessary.
•  Stay inside during the hottest parts of the day. Avoid going out for extended periods of time between the hours of 10 a.m. to 6 p.m.
• Take it easy and try to avoid strenuous activity, especially if it is outdoors.
• Watch the heat index, which will help you stay up-to-date on the current conditions.
• Seek out air-conditioned environments to regulate body temperature.
• Get plenty of rest and take a cool shower or bath to cool down.
•  Know the warning signs of heat-related illness and be quick to act when they are present.

For more information, here is a resource on this topic from the CDC:

http://emergency.cdc.gov/disasters/extremeheat/older-adults-heat.asp

Good Nutrition for Your Loved One

Good Nutrition for Your Loved One

Proper nutrition is always an important aspect of a persons health, but it is especially crucial as people age and begin having health issues. The elderly need to make good nutrition a priority. Good nutrition will help avoid unnecessary health problems and may prolong the amount of quality life they have.

As their body goes through the aging process many changes will be taking place. Their body needs to be taken care of in every way possible. This will keep them as healthy as possible and will give them more energy. 

Sometimes it is hard to know exactly what changes to make in nutrition and eating habits. It is overwhelming to try and figure out a diet that best suits an individual person. There are people out there who can help during this process. The articles below give some good general rules to follow when encouraging your elderly family members to have good nutrition. 

The effects of good nutrition will always be seen in the long-run and will enhance a persons quality of life. Read the articles below to see how you can implement these nutrition tips into your life or your family members life. 

Encouraging Good Nutrition

  Helping your care-receiver develop and maintain a healthy, well-balanced diet can be a considerable challenge, especially if you’re an adult child taking care of an aging parent.
     As a body ages, the digestive system is more prone to heartburn and constipation. Dental problems may make chewing painful. Some medications suppress a person’s appetite or promote weight gain. Depression can bring on a change in appetite. Dad may simply not care about food. If Mom has memory loss, she may forget to eat or may think she has eaten. Finances may be tight. Some older people, after paying rent and utility bills, have little left over for buying food.
     It can also be difficult to eat properly when you’re alone. It’s so much easier to skip a meal or nibble on less nutritious foods when no one else is there.
     And then, too, we each develop our eating habits over a lifetime. While we may know about the basic food groups or the food guide pyramid, that doesn’t mean we always follow those guidelines. Changing lifelong habits is very difficult.

     As the adult child of an aging parent, you can encourage your mother or father to eat well. This doesn’t mean being pushy or disrespectful. It doesn’t mean ignoring a parent’s wishes. In fact, the more your care-receiver is involved in the process, the more likely it is to succeed.

     ●A first step may be to talk to your loved one’s doctor and ask for the help of a nutritionist who can tell you what he or she specifically needs.     Your care-receiver may have to keep a daily journal of exactly what he or she eats. (The results can be surprising, but we would probably all be surprised if we kept track of what we ate each day.) A nutritionist will recommend an appropriate diet — low salt, low sugar, or low fat; high in fiber or calcium; and so forth. Encourage your loved one to keep this diet. When the family gets together, make sure that foods on the diet are included in the menu. Don’t serve your loved one food he or she isn’t supposed to have. 

     ●Check with the pharmacist to find out if any of your care-receiver’s medications would react negatively to particular foods (like milk, for example).

     ●Be careful with vitamin pills. They aren’t a catchall that makes up for poor eating habits. It’s possible to take too many vitamins. And they’re expensive.

     ●Keep in mind that some older people find it easier to eat six smaller meals throughout the day rather than three regular-size ones.

     ●Make food preparation as easy as possible for your care-receiver. Freeze small portions that can be heated in the microwave. Make sure the food looks appealing.

     ●Check out local community resources to see what kinds of meal delivery programs are available. Maybe your parent would like to go to a “nutrition site” at the local senior center and have a hot meal in the middle of the day. Help arrange transportation if needed.

     ●Remember that no one likes to eat the same foods day after day. Encourage your loved one to eat a variety of foods within the prescribed diet, and make sure your care-receiver gets the items he or she prefers.

     ●When grocery shopping, realize it’s easy to fall into the trap of buying only ice cream or cookies or some other single food because “That’s all she wants” or “That’s all he’ll eat.” Like all of us, your loved one would prefer to live on a single, favorite treat; like all of us, he or she needs nutritious food for the best health possible.

Nutrition Tips for the Elderly

Try these 10 simple tips to improve the overall health and nutrition of the ones you love.

1. Serve several small meals rather than 3 large meals. Many elders have a decreased appetite and can only eat small amounts of food at a time. Serving more frequent meals helps make eating less overwhelming and can help provide the nutrition your loved ones need.

2. Provide water frequently. As we age, we lose our sense of thirst. This makes dehydration a common problem in the elderly. Make sure that water is always available and encourage your loved ones to drink even when they are not thirsty.

3. Make meals colorful and attractive. Use different colors, shapes and textures of foods to encourage elders to eat a variety of foods.

4. Use herbs and spices to add flavor. Because taste diminishes as we age, it’s important to make food taste good. Rather than using salt to add flavor, try dill, parsley, cinnamon, nutmeg, onions, lemon and other herbs and spices to make food taste flavorful. 

5. Encourage eating protein. Many elders do not consume enough protein. This can lead to muscle weakness, edema (fluid build-up), fatigue and a decreased ability to fight infection. Good sources of protein include chicken, fish, meat, eggs and milk.

6. Encourage foods high in omega-3 Fatty acids. Foods high in omega-3 fatty acids help decrease the risk of heart disease, decrease inflammation (which can help those suffering from arthritis), and improve mood. Foods high in omega-3 fatty acids include tuna, salmon, sardines and walnuts.

7. Encourage eating foods high in fiber. Eating a high fiber diet can help prevent constipation, a common complaint in elders. Foods high in fiber include whole grains, beans, fruits and vegetables.

8. Encourage eating foods with zinc. In elders, zinc deficiency is common due to an inadequate intake of zinc, decreased absorption of it, increased needs and more interactions with medications. Deficiency can result in decreased appetite and decrease sense of taste already common occurrences in the elderly. Good sources of zinc include fish, poultry, enriched grains and beans.

9. Make mealtimes enjoyable. To encourage eating, make mealtimes enjoyable. Eat with the ones you love, invite guests or simply engage in pleasant conversation.

10. Encourage getting physical activity. Even in the elderly, activity has been shown to be essential for decreasing the risk of chronic disease, maximizing mental capacity and having healthier muscles and bones. It also results in greater flexibility, more lean body mass, a better sense of balance, increased blood flow to the brain, a stronger immune system, less falls (and therefore less broken bones) and better overall health.

The Sandwich Generation

The Sandwich Generation
Caring for Your Children as You Care for Your Aging Parent

Many families today are put in a position to care for both their growing children and their aging parent at the same time. Their combined role as both parent and caregiver can bring great stress, exhaustion, and tension into a family environment. For many people it is a priority that their aging parent stay in the comfort of their own home, so it is important that the caregiver has a balanced view of their new role; which will help them thrive in various circumstances.

It is possible to raise your kids and provide care and comfort for an aging parent, but you can't do it alone without completely overwhelming yourself and your family.

The good news is that this task does not have to be taken on alone and there is help available to those willing to take it! The following articles give some helpful tips about how to effectively juggle child-care and parent-care. There are specific things you need to remember during this time when addressing your child's needs, your aging parent's needs, and your own needs. Every person is affected uniquely by the new family dynamic, and so every person needs to be taken care of differently.

From experience we know that there will be challenges along the way, but this time will be rewarding for every family member involved.

Articles from youragingparent.com: 

Caring for Your Children as You Care for Your Aging Parent

Caring for Your Children
as You Care for Your Aging Parent

     If you’re a member of the “sandwich generation,” if you’re taking care of your aging parent as well as your children, it’s hard to shake the feeling that if you focus on one generation you’re losing sight of the needs of the other.

     It can help to remember – to realize – that your taking care of your parent is good for your children, too. How so?

     You’re right that your kids also make a sacrifice because you can’t be around as much as the they would like you to be and, most likely, they have to do more – become more responsible – because you can’t be there. (Maybe they have to make their own lunch to take to school. Or you can’t be a chaperon at some school event even though you were able to do that a year or so ago.)

     Yes, in some ways a child is being deprived of what a parent might be able to give if he or she didn’t have caregiving obligations to an older family member (or to a spouse who is ill or to a child with special needs) but – from another perspective –Mom or Dad is giving something to that child or those children that he or she otherwise couldn’t give. We mean a front-row view of love in action without any possibility of mistaking the unchangeable fact that true love demands service and sacrifice.

     Still . . . it can be a lot to put on little shoulders. All they may see at first glance is that Mom or Dad isn’t there (or is there but is exhausted from caregiving and holding down a job) and they miss not just what that parent does for them (nice meals, rides to practice and so on) but also that person himself or herself. They miss time spent together. With that in mind, here are a few suggestions if you’re taking care of an aging parent and your children:

     --Talk about caregiving at a time when neither you nor your child are tired and emotions are not running high.

     --Do something special with each child, one-on one.

     --Explain what it’s like to be a care-receiver, how it can be hard to accept help. Talk about why you’re taking care of Grandpa or Grandma and explain – in an age-appropriate way –what his or condition is.

     --Work at establishing a link between your children and your parent. Let them have some time together.

     --Remember children can, in small ways, help with caregiving, too.

     --Teach what respectful care means and explain the difference between “dignity” and “dignified.” Yes, at times, a situation may be less than “dignified” but a person must be treated with dignity.

     --Remember to thank the child for making sacrifices and for helping you help your mother or father.

The Sandwich Generation

The Sandwich Generation

     The "sandwich generation" is a good description. There's pressure from both sides and sometimes it gets messy in the middle. That's what it can feel like if you're taking care of not only your children but your aging parent as well.

     Add in a spouse and a job and it's no wonder it often seems a twenty-four-hour day and seven-day week just aren't enough for all you have to do.

     Then, too, from the time all of us were little we were taught there is a right way and a wrong way to accomplish a task. To meet—and overcome— challenge. Maybe your parent took care of Grandma or Grandpa. Your spouse took care of your mother- or father-in-law. Your friends or co-workers seem to be able to handle their situations. But you . . . .

     When you realize, when it becomes so painfully obvious, you can't do all the things you're supposed to do—all the things other people have done or are doing—you feel so inadequate. So guilty.

     You think you're letting everyone down. If you just worked a little harder. Slept a little less. Sacrificed a little more. Then somehow . . . .

     If you find yourself in that situation, or feel yourself sinking into it, these suggestions might help:

     ● Remember there is no single "right" way to do this. Trying to exactly mimic what another person has done probably isn't going to work. Each case is unique because the personalities and problems in each case are unique.

     ● If you don't take care of yourself—take time to eat, sleep, catch your breath and pray—you will burn out quickly and be of little use to anyone, including yourself. The situation in which you find yourself is not a sprint, it's a marathon. Yes, someday it will end but that may be a long, long time from now. In the meantime, if you do not pace yourself, sometimes even pamper yourself, you won't be able to keep going. That's not because you're weak, it's because you're human.

     ● The big picture can look and feel overwhelming. Sometimes it helps to break it down into the many tiny pieces that make up the whole. What you have to do for your parent. Your children. Your spouse. Your job. Yourself. The lists may be long but somehow no single item is overpowering.

     ● Prioritize your tasks. Making those lists helps. Obviously, getting Mom to her doctor's appointment is more important than vacuuming her apartment.

     ● Give away some of the low-priority duties. Someone else can be hired to do the apartment cleaning. Someone else—the bakery department at the local grocery store—can supply the brownies you're supposed to send to the next Cub Scout den meeting.

     ● Get support for yourself. Groups for caregivers and organizations that focus on your parent's particular illness or condition can help you deal with what you are facing. Doctors, social workers and the Area Agency on Aging can give you local contacts.

     ● Write it down. Dates and schedules and all that information from doctors, therapists, pharmacists, teachers, coaches, your boss, your spouse, your kids . . . . There's no way a person can remember all the things you need to remember.

     It may seem the day is completely packed but if you jot down your own "to do" list, you may discover there's half an hour free here. Twenty minutes there. A little oasis like that gives you something to look forward to. A short break to at least partially recharge your batteries before you have to go, go, go again.