Citizens Voice Wilkes-Barre, PA

The need for a robust home- and community-based service system is a pressing issue not only for Pennsylvania senior citizens but for taxpayers as well.

Home- and community-based services allow individuals to remain in their homes and communities as long as possible, keeping them happier and healthier. These services include, among other things, adult day care, home health, personal care, respite care, transportation, and home-delivered meals.

During my tenure as chairman of the House Aging and Older Adult Services Committee, I worked hard to improve access to home- and community-based services, not only because most seniors want to age in their homes and communities but because it is the right thing to do for our taxpayers. Providing services in the home and community is much cheaper than nursing home care. On average, it costs $57,000 a year to care for a person in a nursing facility compared to $28,000 in the home and community. That is not to say nursing homes are not an important long-term care option; they are and will continue to be for those whose needs are too great to be cared for elsewhere. They shouldn’t, however, be the end all and be all of how we care for our elderly.

Pennsylvania is the third oldest state and rapidly aging. We have 30 percent more people over the age of 85 than we did in 2000. The 65 and older population is expected to grow by 42 percent between 2000 and 2025, coupled with a 37 percent increase of those 85 and older. As the ratio of older adults to working adults will increase significantly, this “silver tsunami” will pose significant challenges not only to our economy but to our long-term care system and corresponding governmental programs.

I applaud the Rendell administration for recognizing these impending challenges and making the expansion of home and community-based services a priority. I was proud to assist in the passage of the assisted living licensure law, which provides another care option for those who require services beyond what is offered in a personal care home but less intensive than a nursing facility. Also, eight years ago, Pennsylvania invested only eight percent towards home- and community-based services compared to 92 percent for nursing home care – ranking us next-to-last in the nation. The current budget, by contrast, invests 24 percent in home- and community-based services.

With that said, adult day care and senior centers are important components of a strong home- and community-based service system. The availability of adult day care often means the difference between placing a loved one in a nursing facility or keeping them at home. Senior centers, on the other hand, provide older adults an opportunity to stay connected and engaged with their community. Unfortunately, many counties do not have an adult day care facility, and the ones that do exist often have hours that are not conducive to the work schedule of the older adult’s family. Likewise, the design, program offerings, and meal options at many senior centers are outdated and not in tune with the preferences of today’s seniors. The Department of Aging has been working to address these issues. I hope the new governor recognizes the importance of continuing this work.

Another important tool is the Pennsylvania Family Caregiver Support Program. The program reimburses eligible family members for the costs associated with caring for an older person at home and provides grants for needed home modifications and assistive devices. Pennsylvania’s program, however, has become outdated. It excludes non-relatives or relatives living outside the senior’s home from accessing the program. The result is that many local area agencies on aging are forced to turn back state funding despite having a waiting list for the program.

To address this need, I’ve introduced legislation the last three sessions to mirror the federal Family Caregiver Support Program, which does not contain these onerous requirements. My bill would also increase the reimbursement and grant limits for the first time since the state program was established in 1990.

This bill is a win not only for Pennsylvania’s caregivers and seniors but for taxpayers. The economic value of Pennsylvania’s informal, unpaid caregivers has been estimated at more than $15 billion a year. That’s why I’m dumbfounded that although this legislation unanimously passed the state House the last two legislative sessions, the Pennsylvania Senate was unwilling to consider it.

Some will say that during these challenging economic times we cannot afford to continue the progress we made in improving access to home- and community-based services for our seniors. I say that we can’t afford not to. Failure to do so not only ignores the wishes and desires of older Pennsylvanians but is fiscally irresponsible to our hardworking taxpayers. I hope the new governor recognizes the importance of not only maintaining but building upon this progress.

State Rep. Phyllis Mundy previously served as chairman of the House Aging and Older Adult Services Committee before her appointment as Democratic chairman of the Finance Committee. She represents the 120th Legislative District in Luzerne County.

It is no secret that the current obligations of the federal government for Medicare, Medicaid, and Social Security are unsustainable. Each year, especially during political season, it is a hot topic. And each year nothing is done to address it. TV analysts are continually talking about the system “going broke”, raising taxes, and so on, but nothing changes, why not? The reality is that these programs are not insolvent, they are not unfunded, and they will exist long into the future—far beyond the lives of anyone reading this article. As an industry serving seniors, and as providers within this industry, we need to recognize where these programs are going, and get there before it is too late.

The Programs:

Medicare is the “social insurance program” created and administered by the federal government of the United States of America to individuals 65 and older. Medicare was created by The Social Security Act of 1965 and signed into law on July 30, 1965, by President Lyndon B. Johnson as amendments to the existing Social Security legislation. Products and services covered by Medicare parts A through D are things such as hospital visits, short term stays in skilled nursing facilities, outpatient services, durable medical equipment, and prescription drugs. The estimate as of Fiscal Year 2009 for the “unfunded obligation” (i.e. the benefits promised with no money identified to keep those promises) of Medicare, over an infinite time horizon (i.e. assuming the program goes on at its current benefit level forever) was approximately $86 trillion, or a mere $34 trillion if you take a 75 year time horizon. Stated in a different way, it would require $34 trillion for the federal government to keep its promises to taxpayers.

Medicaid is a much more complicated program than Medicare or Social Security so I will simplify it to its most essential parts. In essence, Medicaid is a program administered jointly by the federal government and each individual state for families and individuals with low income and assets. Medicaid was created by the Social Security Act of 1965, and the majority of its funding goes towards services for the aging and disabled. Estimating the “unfunded obligation” for Medicaid is much trickier than with Medicare or Social Security for two reasons; First, there is no “Medicaid Trust” as there is with Medicare and Social Security, but rather funding for Medicaid comes from general funds (i.e. the tax revenue in a given year) which fluctuates. Secondly, because Medicaid is jointly administered between the federal government and each individual state, the unfunded portion varies wildly between states. So while we cannot put an exact number on the unfunded portion, it is safe to say that Medicaid, and especially the long term care portion, is a very large number. If we simply take the total number of people added to Medicaid over the next 30 years, 32 million, and multiply by the average cost for nursing home care, $70,000 per year, we get a total of over $2.2 trillion. This of course doesn’t take into account accrual of costs (i.e. a beneficiary receives services for more than one year), but this is inconsequential to the outcome of these programs and our necessary response.

Though technically Social Security includes Medicare and Medicaid, the term is typically used to refer to the Federal Old-Age (Retirement), Survivors, and Disability Insurance portion (i.e. “my social security check”). This program was originally created by the Social Security Act of 1935, and signed into law by President Franklin D. Roosevelt. The current estimates of the unfunded portion of Social Security over an infinite time horizon are $18 trillion.

To summarize, that is over $106 trillion in “current unfunded obligations” for Medicare and Social security, and one big scary question mark for Medicaid. It is easy to see how these numbers and “realities” get thrown around in political banter. They have a high emotional intensity because they invoke fear, and this fear is often used to drive home particular ideological points.

On the rare occasion that a solution is offered to this looming time bomb, it is typically one of two options. I don’t believe that either of these are in the realm of reality, so I will present a third option that is obvious and actionable.

The “Supposed” Solutions:

1. Eliminate the programs entirely. Most often this is not stated explicitly but it underlies much of the rhetoric that is used. Close your eyes and imagine the television ads that would run of a senator or representative that voted to shut down any one of these programs! It should be painfully obvious why this will never happen, no matter how much this option is used in political rhetoric. Right, wrong, or indifferent (it is not my place to say) there is not, nor never will be the political will in this country to shut off these programs completely.

2. Raise taxes. Again this is used as political rhetoric to polarize voters to a particular side of the ideological aisle, but let’s look at the viability of this solution. First, the dollars that are taxed do not go directly to these programs, they go into the general fund (even when they go into the Medicare and Social Security Trust they are tapped for general operating expenses and projects), which Congress people then jockey and fight over to fund different programs and projects. At best a relatively small portion of each additional tax dollar would go to closing the funding gap on these programs. In short this would mean that taxes would need to bring in some multiple of the $106+ trillion liability to close the gap. Second, no matter what side of the political isle you are on, there is simply not enough money to be taxed (no matter how creative the tax program suggested) to close this gap.

I would like to suggest that Medicare, Social Security and Medicaid are not truly unfunded. I would like to suggest that the course of these programs was determined the moment they were signed into law and it is within this course that we as providers find our solution.

3. Gradually erode benefits and squeeze providers. These programs are already funded, it is simply that we do not know exactly what will be cut and when, but this is the unspoken reality of the situation. Senators and Representatives are able to chip away at benefits, provider reimbursements, and provider requirements without any need for new legislation or political will. This process has already begun, and the way it looks goes something like this; “There will be no increase from Medicare for outpatient therapy services in Fiscal Year 2010”, or “Medicare will be issuing a new case mix fee schedule for Fiscal Year 2011”, or “Providers are expected to do weekly nursing visits to monitor quality during outpatient rehabilitation episodes”, and so on (I am inventing these examples for illustration purposes, but you get the idea). There are two general implications to this. First, a senior’s income and assets will purchase less and less over the coming years. Second, the number of providers will be gradually reduced as fewer and fewer are able to survive while margins are compressed. This compression will occur from two sides; First, providers will need to subsidize losses on government programs by raising prices to private pay consumers. Second, private pay consumers will become scarcer as their dollars buy less and less, forcing them into these programs sooner.

So what does this inevitability mean for the industry, and more specifically for providers? As these programs add on requirements to providers, costs will rise. For example, you as the provider may need to provide 24 hour telehealth monitoring as “quality control” to be reimbursed $50 by Medicaid for a med box fill (extreme, but not out of the realm of possibility). We have only three options as providers (other than go out of business or sell):

1. Increase price to the consumer. We have already stated that reimbursements will be capped, if not cut, as a way to fund the current gap in these programs. That leaves the only other option as raising private pay prices to subsidize increased cost of operations. This may help as a Band-Aid, but competition will create downward price pressure, making this strategy relatively ineffective. Ultimately, this approach will simply drive consumers into these programs faster. Leaving us in the same place as when we started. So let’s throw price increase out as an option.

2. Reduce quality. I won’t spend any time on this option, but rather I’ll assume that if you’re the type of person reading this article, you are not the type that will lower your standards. Additionally, competition should drive lower quality providers out of the industry (assuming the government doesn’t switch to monopoly-like licensing).

The third option is the one that I would suggest we must embrace and pursue.

3. Specialize, Innovate, and Collaborate. Economizing (i.e. become more efficient) on the very limited resources each provider will have is the only way to do more with less. We need providers to select an area of focus, and develop innovations that will allow them to perform a particular function two or three times more efficiently than others can. Along what lines it is valuable to specialize will become evident when we as an industry begin doing what we are uncomfortable with, collaborating. Cooperative agreements, partnerships, and joint ventures need to become the norm within the industry. These forms of collaboration give the counter party the confidence that there is a niche market to sell to, allowing them to make the risky investments needed to innovate. For example, there may be a provider that figures out how to do medication management at a fraction of the cost that your agency can. Embrace that, and partner with that provider. Let that small and inefficient piece of your business go. Now I know that there are regulatory barriers to some types of partnership, complicating it further is these restrictions are unique to each provider type; however, these are the arguments we need to be making to legislators and regulators. Forget arguing with them over reimbursement increases. Those arguments are already falling on deaf ears. Tell them that “if you want us to provide for this price, you have to allow us the ability to innovate through collaboration and specialization!”

I welcome your thoughts, ideas, comments and feedback. Feel free to contact me directly at the email address below.

James P. Fetzner
Chief Executive Officer
Comfort Care & Resources, Inc.

JFetzner@ComfortCareResources.com

For senior adults who take pride in their independence, admitting they might need help around the house can be difficult. They might be resistant to the thought of someone in their home on a regular basis, even if that person has their best interests at heart. Preparing both the home and your loved one for in-home care is an important step toward a smooth transition.

The Benefits of In-Home Care

In-home care can provide seniors with the ability to stay as independent as possible, while providing the safety and security they need. They can maintain all the comforts of home while reaping the benefits of a part-time or full-time caregiver to assist them with day-to-day needs.
Discussions with Your Loved One

Talking about in-home care can be a tough subject. Approach the topic with patience and understanding, and keep these tips in mind along the way:

* Emphasize the positive. Point out the many things they can still do on their own. Talk about their freedom to make choices, and assure them that they will still be in charge.

* Talk about what a caregiver can do for them. Ask them what burdens they might want lifted. Do they worry about forgetting their medication? Would they like to have their meals prepared for them? Making decisions together can open the doors to change.

* Talk to the doctor. Sometimes hearing the encouragement of a physician can help overcome resistance to an in-home caregiver. At the very least, the recommendation can open doors to further discussion.

* Interview caregivers together. Make the decision with your loved one. If they know their opinion is valued, they might feel more in control, and be more accepting of in-home care.

Practical Steps to Prepare for In-Home Care

Preparing your elderly loved one for in-home care is the first step. Next, prepare the home. Consider these little “extras” that can make an enormous difference:

* Install anti-scald devices in showers and faucets
* Choose smoke detectors with strobe lights and vibrate features
* Select carbon monoxide detectors with a high sensitivity rating
* Install “grab bars” in the shower and bath
* Consider motion sensors and other security features that alert to a lack of motion

Ease the In-Home Care Transition

By involving your loved one in every step of the decision for in-home care, you are showing them how much their opinion matters. By preparing their home, you are helping to ensure their safety. Both steps can help ease the in-home care transition for everyone.

As a taxpayer and supporter of measures to curb the commonwealth’s skyrocketing Medicaid costs, I applaud Auditor General Jack Wagner for monitoring Medicaid error rates. I also support Gov.-elect Corbett’s commitment to identifying savings in the Medicaid budget.

As executive director of the state trade association for the home health, hospice and in-home personal care industry, I am compelled to introduce another measure, which is sure to not only curb Medicaid costs but also address the aging population’s cries for better choices in long-term care.

When identifying the reason for skyrocketing Medicaid costs and the $5 billion budget deficit, we must examine Pennsylvania’s poorly constructed and antiquated long-term care system that favors funding for institutionalized care over less expensive home and community-based services.

In Pennsylvania, all citizens are entitled to nursing home care — an entitlement that comes with a price tag of about $58,000 per person, per year to Medicaid. What Pennsylvanians are not entitled to is in-home care — the ability to receive supportive and nonmedical services in one’s own home — the overwhelming choice for seniors and people with disabilities.

In contrast to institutional care, the price tag for in-home care is estimated at $22,000 per person, per year to Medicaid, which is less than half the cost of care in facilities such as nursing homes.

The numbers speak for themselves. So, why does the state encourage Pennsylvanians to opt for the most expensive yet least preferred long-term care option? It is a question that home and community-based service providers have been asking for decades. It is a question every Pennsylvanian should be asking, too.

A report by the Rockefeller Institute of Government’s Health Policy Research Center identifies Pennsylvania as “one of the more generous when it comes to doling out long-term care benefits.” This is true.

Nearly 75 percent of Pennsylvania’s Medicaid expenditures go to institutionalized care. But is this spending “generous” or irresponsible given that homecare spending is proved to be less expensive? Overall, the commonwealth spends only 22 percent of its long-term care budget on in-home services, which is woefully shy of the national average of 40 percent.

It is that spending imbalance on institutional care versus home and community-based services that caught the attention of the federal government, which is incentivizing states with up to six percent more federal matching dollars for increasing their home and community-based services spending ratio. That means an additional $300 million for Pennsylvania.

Pennsylvania’s Medicaid problem also stems from policies that barricade access to home and community-based services. If I am 80 and fall below a certain income level, I am presumed eligible for nursing home care and Medicaid will pay for that care. The same “presumptive eligibility” is not granted to an individual or family who prefer in-home care. Instead, individuals are forced to wait more than a month for in-home care at a time when they need it immediately.

Rescuing Medicaid from financial ruin takes more than auditing error rates or an uptick in the economy. It takes a trans-formative redesign to sustain funding for this vital program. Other states have demonstrated overall savings to their entire Medicaid long-term care budget by providing more in-home care even when they serve more individuals through the redesign.

Pennsylvania must act now to increase availability and accessibility to home and community-based care to individuals who need those services as well as those who pay taxes to support the provision of these services.

In-home care can be a wonderful bridge for an elder between being able to stay in his or her own home and needing assisted living or a nursing home. Some elders are able to live their lives out with just in-home care agencies to help. Some use these agencies for short times, only. The flexibility in-home care offers is one of its strengths.

When I began my caregiving journey, in-home care was a new idea. I had been my neighbor Joe’s default caregiver since his wife died, as Joe had only one adult child and he lived half a continent away.

For several years, I was able to provide the daily care Joe needed, but after a bad fall and a dislocated shoulder, the hospital we went to told us about in-home care. We said we’d give it a try. The care was short-term for Joe, as I was soon able to, once again, take over his care. However, it was a new beginning for me as I learned to reach out for help from agencies.

In-Home Care: Uncle Wilkes Needs Help

Shortly after Joe died from complications from a fall, my aunt died from cancer. Her husband, my uncle Wilkes, had survived a second stroke with some disabilities, yet he wanted to stay in his apartment. My parents were aging, but could help Uncle Wilkes with some grocery shopping and visiting. I had small children, but I still was able to help with doctor appointments, errands, and visits. However, he needed more than we could provide.

Some of what he needed was companionship. The company we hired was as good as can be expected, in an imperfect world, about consistency in caregivers. There were three women my uncle liked. He had his favorite among the three, but any of the three could make him smile.

When the agency occasionally had to send another person, he was not happy, but that didn’t often happen. These three carers provided companionship, some light housekeeping tasks, help with bathing and other personal care. We, the family, were happy to know someone was with him and he could afford the cost, so it all worked very well. He had in-home care until another major stroke put him in a nursing home.

In-Home Care: My Mother-in-Law Needed a Bath

The third time I used in-home care was for my mother-in-law. By that time I had, under my caregiving wing, my dad in a nursing home two blocks away from my home (he’d had brain surgery and ended up with dementia), my uncle in the same nursing home, my mother who was frail but in her apartment, and my mother-in-law who was borderline ready for the nursing home, but still in her condo.

Each day, I ran between my own home and children, my mother’s apartment to help her with daily needs, the nursing home for my uncle and dad, and my mother-in-law’s condo. It was a circus, but I kept it up for several years. During this time, one of the biggest issues with my mother-in-law was bathing.

My mother-in-law was, at the time, getting very paranoid from dementia. She’d always been a very modest woman, and while she was delighted that I stopped and brought her lunch, helped with her laundry, and did as many other chores as I could work in, she didn’t want me to help her bathe. She didn’t want anyone to help her bathe and she couldn’t do it herself.

While a daily bath wasn’t necessary, there is a point when cleanliness, or lack thereof, can become a health issue. So, we hired in-home care to bathe her.

In-Home Care: Training and Professionalism Save the Day

It worked. My mother-in-law seemed to look at it more like a doctor visit, since the person coming to help she viewed as a nurse. While she didn’t like it, she allowed it. It was also better for me, as she outweighed my by a lot, so even with a bath chair and other aids, I didn’t feel it was safe for either of us. The caregivers who came from the agency were trained for this duty, and I was happy to turn it over to them.

In-home care, when provided by an agency that puts consistency of caregivers at the top of the list of needs for an elder, can work very well. Scheduling is important. Personalities are important. Training is important. A good care agency provides all of these. The right mix of personalities can provide great relief for the elder and the elder’s family, making in-home care a good way for an elder to stay at home longer.

Understanding the service variations between In-Home Care and Senior Housing can help you make the most informed decision for yourself or a loved one. Take a moment to learn the simple differences and see which alternative is right for your circumstance.

Planning ahead is the best strategy for situations when seniors may need health care. Unfortunately, many of face these decisions before they are prepared. How do you sort out the maze of choices quickly yet effectively? First, you should look at whether you want to use In-Home Care or Senior Housing.

Defining In-Home Care

Receiving assistance in your home setting for a variety of services and functions is the simple definition of in-home care. The types of service you might find available in your home range from housekeeping tasks such as cooking and cleaning through more complicated or medically-related jobs, like assistance with bathing or help in taking medications.

Advantages of In-Home Care

The biggest selling point of having in-home care is the fact that you are remaining in the most comfortable place you know: your own home. The care comes right to your door in the form of a home health aide (someone trained to usually assist you with personal care duties) or a companion (a person who may keep you company or do light housekeeping tasks).

Costs are variable based on the duties you need performed but it can be more reasonable to have this limited help and remain in your own place. Some insurance plans may cover aspects of in-home care so be sure to check with your provider.

The range of services available is diverse and you don’t have to find help alone. There are many agencies that specialize in matching in-home care services to senior clients in need.

Disadvantages of In-Home Care

* Quality of service received by a client depends on the caregiver or agency.
* The cost of remaining at home may be too prohibitive for some clients.

What is Senior Housing?

Options in senior accommodations that are permanent living quarters outside the home include those that are based on a lifestyle model and those that include medical services as well as housing. Here are some of the categories of senior housing.

* Retirement Communities. Retirement communities are a cluster of apartments or housing units for those who meet a certain age requirement for entrance. Normally the community offers a wide range of social activities for the community members but no medical services on the campus. Dining services may or may not be offered.

* Continuing Care Retirement Communities. Continuing care retirement communities offer many different living options (independent living apartments, assisted living suites and skilled nursing care) on one site which allows community members to have access to multiple service levels as their needs change. For instance, a couple may enter the community and share an independent living apartment on the campus. As the needs of the couple change, the wife can relocate into the assisted living area while the husband can maintain his independence in his apartment while still having access to his wife.

* Assisted Living. Assisted living is a housing level in which seniors are given help and supervision with many daily activities and functions such as medication management, bathing, dressing and eating. The amount of assistance is personalized to the needs of the specific client but assisted living clients live in their own apartments but usually dine in a congregate setting.

* Skilled Nursing Facility. Skilled nursing facilities deliver skilled nursing care or care that must be provided by nursing and/or rehabilitation staff. Assistance is still based on the care that each client needs but the level of caregiving interaction in this setting is the most stringent of any of the senior housing options.

Advantages of Senior Housing

There is a housing option to fit almost every situation and need. The different levels of care allow a person to come directly into the stage they need and therefore maintain their independence.

Disadvantages of Senior Housing

* Health care housing can be costly with some options, such as the Continuing Care Retirement Community, even requiring an entrance fee.

* Making a permanent move from home can be a difficult loss to adjust to.

In-Home Care vs. Senior Housing: Making a Decision

To begin the process of deciding whether in-home care or senior housing is right for you, the first step is to determine if the services you require allow you to remain in your own home. If yes, contact your area Office on Aging or Senior Center to get a list of reputable agencies and start calling.

If you need more advanced care, enlist a family member or friend to help you make some visits to check out facilities. Be sure to measure “apples to apples” when you review costs and services provided by each level of care. Once you’ve made your choice, breathe a sigh of relief for you have made an informed decision.

The Home PAC is a fairly new group. The purpose of the Home PAC is to serve as a voice for individuals in the community, regarding their residences and what is best for them in terms of care. The election process is expected to occur sometime in early January 2011. If elected, Fetzner hopes to, “Bring privatized home care into the forefront of the agenda, as well as represent the Comfort Care & Resources perspective.” His ultimate goal is to, “Free people from institutions and allow them to live in their own homes, as well as get them involved and participating in the community.”

As a member of this committee, Fetzner will be expected to work alongside legislators to formulate new initiatives in home care. Fetzner will provide insight to government officials regarding current laws and their impact on the community.

What Kind of Care is Best for Your Loved One?
There are many different kinds of care available for elderly patients. Some will require occasional light help, while others might need round-the-clock nursing care. Knowing your options can help you choose the best one to fit the needs of everyone involved.

• Skilled Nursing Facility. Also known as a nursing home, a skilled nursing facility offers round-the-clock care for those patients who need constant monitoring.
• Assisted Living. Assisted living facilities offer custodial care, or help with the basics of day-to-day life. Grooming, bathing, dressing, and meal preparation are just a few of the ways assisted living can help.
• In-Home Care. Care at home can cover a wide range of assistance. From help with occasional grocery shopping to full-time medical attention, there is an in-home care option available.


The Top Five Considerations for In-Home Care

In-home care is the most popular option chosen by the American public.
Consider the following reasons why in-home care might be the best choice for you and your family as well:

• Independence Matters. With in-home care, patients are encouraged to be as independent as possible. With a few changes for safety, such as grab bars and anti-slip rugs, freedom to move around the comfort of their own home is very possible with in-home care.
• Family Involvement. Those who are cared for at home have the advantage of open visiting hours. Family members can stop in and help out as often as necessary without concerns about intruding on the care of others. In times of illness, the presence of family members can buoy a patient’s spirits and make everyone feel more in-control of the situation.
• Continuity of Care. Home care is often provided by the same nurse or team or nurses, so they always know what kind of care has been given or is needed. The patient can also keep their same doctor, so the continuity of their care stays intact.
• Safe and Personal. The risks of infection are lessened when a patient uses in-home care. The one-on-one care and personal attention also ensures that all your loved one’s needs can be met quickly and without the red tape often found in hospitals or nursing homes.
• Lower Costs. In-home care providers are usually less expensive than nursing homes or assisted living facilities. With in-home care, you also have the option of hiring someone for only the hours when your loved one needs help the most. Lower costs also offer peace of mind to those seniors who are concerned about the financial burden their care might put on their family.


The In-Home Care Option
When you choose in-home care, you are giving your loved one the opportunity to remain in the comfort of their home while receiving the skilled nursing care or custodial care they require. Take the time to research all options! When you make the decision for in-home care and hire someone to help your loved one, you should have the confidence of knowing your choice was the right one.

“We are very excited to be growing and proud to be able to offer such an innovative service to seniors and their families,” says James Fetzner, CEO of Comfort Care & Resources.

With the expansion of Brookside and the construction of new homes in the works, Comfort Care is creating new job opportunities for both external companies as well as internal healthcare jobs. Despite the lagging economy, Comfort Care and Brookside are flourishing and providing seniors and their families with the best quality of care.

This hire comes in a time of great need for the company due to rapid growth, as more and more seniors require care. Wheeler’s particular areas of focus will be on training, quality assurance, client advocacy and coordination for both home care and The Brookside Homes (an alternative to living in a nursing home).

On the promotion of Wheeler, The CEO of Comfort Care & Resources, Jim Fetzner states: “Danielle’s skill and potential for contribution became evident through her work with us as a Long Term Care Consultant… This lead to the decision that her skills, experience, and talents would be utilized to their fullest potential in a leadership position—as we continue to experience tremendous growth.”

When asked about how she felt about her new position, Wheeler claims: “I am extremely excited about this new job. I have many plans for our Brookside Homes especially.”

A contributing factor in this promotion was Wheeler’s previous experience as a leader in a local nursing home. “A very large part of my [previous] job was to provide in-service and performing competencies. I plan to utilize my experience in those areas to make sure our staff is always at the peak of their game.” Says Wheeler.

Starting the position, effective immediately, Wheeler was required to go back to school. She was asked to attend classes in order to obtain her Personal Care Home Administrator license. “I love to learn, and I especially love it when I am able to competently and efficiently provide care to my clients. This is what I want to share with our entire staff!”