A young doctor / nurse visiting an elderly sick woman holding her hands with caring attitude.

Private Duty Nursing

When a loved one has chronic health conditions, or needs medical care beyond the abilities of family members, it often seems that the only option is to place them in a skilled nursing facility. Such a decision is fraught with uncertainty about the quality of care, isolation of the loved one, and the ability for the patient to someday return home. Families want their loved ones to receive the care they need, without upsetting them and suffering the guilt of moving them to a skilled nursing facility. These highly emotional, and sometimes traumatic, decisions can be avoided with Private Duty Nursing Services provided by LivHOME.

LivHOME July Graphics-01

Private Duty Nursing services provide skilled nurses who deliver high quality, clinically appropriate care to seniors at home, resulting in better outcomes and increased comfort for the patient and the family. At a time when hospital acquired infections are the focus of concern for healthcare providers, the ability to treat a patient at home can be the preferred option for their safety. Private Duty Nursing is the closest thing to merging the home and clinical environments.

Numerous studies have shown that the ability to remain in one’s home can enhance healing and improve a sense of well-being. It’s easy to relate to the power of being home. One only has to reflect on the welcome relief of sleeping in one’s own bed after a long trip, or going home after day surgery, or even an hour in the dentist’s chair! At-home services for seniors provide care for their psychosocial and clinical needs, so they can heal from challenging health conditions and return to a healthy quality of life.

Private Duty Nursing services from LivHOME are comprehensive in scope and include diabetes management, routine injections, IV infusion, wound care, ventilator/tracheostomy management, foley catheter management, and management of many chronic health conditions. The approach of LivHOME skilled nurses is to not only deliver care, but to ensure patients are knowledgeable about their condition, and that their environment is safe and free of hazards. Our nurses:

  • Perform a full clinical assessment of the patient and develop a customized plan of care
  • Deliver specialized care for the treatment of the client’s illness
  • Provide important teaching for self-management of chronic diseases
  • Provide a home safety evaluation, fall risk assessment and medication reconciliation

Together, these services provide greater continuity of care between inpatient care, the physician’s office and home; proven to be the most successful strategy to improve health, increase wellness and deliver high-quality outcomes for patients.

To learn more about LivHOME Private Duty Nursing, and our services that recently launched in the state of Massachusetts, call (781) 416-2000 or log onto livhome.com. LivHOME will expand the Private Duty Nursing Service nationally throughout 2017 and 2018.

Helper Serving Senior Woman With Meal In Care Home

Quick and Easy Recipe Ideas

Chances are that the senior in your care is not interested in big, heavy meals. They can be hard to digest and either cause sleepiness in the afternoon or interfere with a solid night’s sleep. Light meals can be just as nutritional as big ones, more appetizing for the senior and easier for the caregiver to prepare. LivHOME caregivers are experts at preparing appealing meals for seniors.

Here are some of the highly nutritious, easy recipes they like to prepare:

Oatmeal and fruit: It’s such an old-fashioned meal that it’s easy to overlook. Oatmeal is low fat, low salt, high in protein and fiber, warm, and delicious. It can be cooked to eat in the morning, or in the slow cooker with a bit of brown sugar, raisins and other add-ins.

Multi-grain waffles: These are surprisingly versatile. They are great for breakfast out of the toaster. They can be the foundation for a wide variety of creative sandwiches, and they can even be topped with freshly cooked chicken, slices of fruit or yogurt.

Yogurt parfaits: Pleasant to look at and good to eat — yogurt parfaits are filled with low-fat dairy, fruits, grains and, if you use Greek yogurt, protein. They can be made ahead of time and placed in the refrigerator for breakfast or snacks.

Egg and red potatoes: It takes a minute to chop a red potato and sauté it in butter until soft. Pour some lightly beaten eggs on top and you have a warm and delicious breakfast, lunch or light dinner.

Wraps: Buying flatbread, pita or tortillas for wraps turns leftovers into a delicious sandwich. Leftover meat, chicken or fish, along with a few chopped vegetables, fruit, grated or shredded cheese, even scrambled eggs makes a good meal.

Pasta: Hot or cold pasta is a great multi-purpose food. Cook pasta for a hot meal at night. Use the leftovers to toss a quick pasta salad with chopped sweet red peppers, broccoli, cubed chicken and low-fat yogurt instead of mayonnaise. For those with a sweet tooth, add mandarin oranges to the salad and bit of honey to the yogurt.

LivHOME August Graphics-05

If a liquid diet is required, there are still many flavorful options that can be prepared for the senior. LivHOME caregivers rely on these items for nutritious, liquid diets:

• Yogurt
• Cranberry Juice
• Thin oatmeal or cream of wheat layered with applesauce or other smooth fruit and brown sugar for flavor
• Smoothies
• Soups, puddings, Jell-O
• Protein shakes
• Protein supplements such as Ensure

It’s not easy for tired caregivers to take on cooking responsibilities as well. These easy meals make cooking simpler and nutrition easier to digest.

Visiting an elderly woman

Healthy & Easy Cooking Tips for Caregivers

Cooking for someone in your care can be a bit tricky. Even when you have planned the meal and the senior is looking forward to the meals, cooking can be a chore. Here are some tips on making meal preparations easier and quicker for caregivers:

Cook One — Freeze Three: If you are going to cook you might as well stretch it as far as you can. Cook enough for two to four meals at a time. Freeze them and the senior in your care has delicious meals whenever they want them. Chicken soup is a good example. In order to make chicken soup you either have to purchase a cooked chicken or cook it yourself. Use one third of the chicken to make the soup. Use one third of the chicken to make a chicken and rice stew. Use the last third to freeze boneless chicken meat that can be used for a sandwich. One cooking session- three meals.

The Blender is Your Friend: Plan ahead for smoothies. Throw bananas and baggies of strawberries and melon balls in the freezer. If you are in charge of breakfast, snacks or light meals for a senior, a smoothie made with frozen fruit, milk, low-fat yogurt and even a bit of peanut butter is a nutrition powerhouse. There can be as many as 4 to 5 servings of fruit in one 8-ounce smoothie.

High Nutrition Shortcuts: Think powerful nutrition in small packages. Seniors may not want to eat big meals. Small meals and snacks throughout the day can be just as nutritious. You can make quick breads that are full of high-nutrition ingredients — like banana, pumpkin, lemon breads. Use three ripe, very well-mashed bananas, instead of 1/2 cup butter, lard, shortening or oil or substitute one cup of applesauce per one cup of these fats. Add wheat germ, dry milk, or protein powder to ramp up the nutritional value. Quick bread can quickly become full of protein and fruits.

Slow Cooking Quick Meals: Slow cookers are wonderful inventions. You can cook a large quantity of food and then freeze it in individual portions. The slow cooker brings out the natural juices and flavors of the food so reducing fat and salt becomes extremely easy. And, the house is filled with appetizing smells. You can find many slow cooker recipes online.

Rely on Experts: If the senior in your care has a specific diagnosis or chronic disease, chances are there is an association and a website dedicated to it. For example, the American Heart Association, the American Diabetes Association and others are very good at providing meal plans and recipes that are delicious, nutritious, and address the dietary restrictions of the disease. Health centers and large hospitals also often post meal plans with full recipes.

LivHOME August Graphics-06

LivHOME provides skilled caregivers that can assist you with meal planning and preparation. Busy caregivers are not alone when LivHOME skilled professionals are available for support and help.

healthy living-caregiver health-elderly-eldercare-caregiver-caregiving

Healthy Meal Planning Tips for Caregivers

As a caregiver, it’s important not to underestimate the value of intentional meal planning for the senior in your care. What does that mean? It means planning meals that combine highly nutritional foods with the personal tastes of the senior while incorporating dietary restrictions that illness or chronic disease may create. It also means that you include the senior in the meal planning. Even dementia patients know what tastes good and what doesn’t. Encouraging the senior to help in meal planning creates a positive activity between senior and caregiver and gives them delicious meals to look forward to during the week. LivHOME caregivers can help to plan meals, buy groceries, and cook for seniors.

LivHOME August Graphics-02

Here are some tips that we find most helpful for meal planning:

Find expert support and help.
If the thought of meal planning fills you with frustration, find help. Many senior centers offer nutritional support. Hospitals have dietitians for their patients and diabetes programs have educators that provide dietary support. If the senior in your care is being discharged from the hospital, ask specifically for nutritional support. The services exist but may not be pro-offered unless you ask. Post-hospital diet is very important for a successful recovery. Newly diagnosed diabetic or cardiac patients need to learn new dietary guidelines to remain healthy and avoid hospitalization. When caregivers ask for help, everyone learns, and a neutral person, like the staff at LivHOME, is providing the new guidelines for eating.

Be creative.
Aging taste buds and other senses may reduce the joy of eating. That’s why it’s time to get creative. Although high salt levels should be avoided in most cases, numerous other spices can make food smell and taste good. If medications have changed the senior’s mouth or tongue, flavorful smoothies, puddings, and egg dishes taste good without being irritating. Read recipes with the senior in your care; if it sounds good to them, chances are it will taste good to them too.

Cook together.
Cooking incorporates many positive activities for seniors; it is stimulating cognitively, encourages fine motor skills, and is enjoyable socially. Caregivers can spend an afternoon cooking a week’s worth of meals with a senior. If time is short, LivHOME caregivers are trained in planning, shopping for, and cooking nutritious meals.

Don’t forget the benefits of grazing.
Leftovers and snacks are a great way to encourage seniors to eat healthfully. If delicious treats are available in the refrigerator and kitchen cupboard, then the senior can eat tiny meals throughout the day. They can taste good and be highly nutritious. A cup of soup warmed in the microwave can be a power packed lunch. Cut up pieces of cheese and whole grain crackers are a nutritious snack.

Encouraging a senior to eat can be fun. Create a calendar that is placed on the front of the refrigerator with fun pictures for each meal. Place the same image on a food label, and the senior may smile while also eating well each day of the week.

Old woman eating a slice of  bread at home

Signs of Poor Senior Nutrition

Studies show that two out of every five seniors who live alone suffer from poor nutritional health. The good news is that caregivers can actually see the symptoms of malnutrition and take action to address it before it results in hospitalization or severe illness.

Often the factors that accompany aging impact nutrition, such as taking three or more medications, poor eyesight and fatigue. And eating alone doesn’t make for a good appetite. Watch for these signs when you visit your aging loved one:

Overall loss of appetite: Seniors who were traditionally good eaters, looked forward to meals, and appreciated good food can lose their appetite. If the senior you care for has lost interest in food, ask them why. Check to see if they are suffering from an illness or if they are depressed. Losing interest in eating is one of the most reliable signs of depression.

Cognitive changes: Check in on the senior’s behavior. Do they say they forget to eat and yet they are home all day? Do they insist they eat all the time, and yet there is expired and moldy food in the refrigerator? These factors could indicate cognitive changes such as memory loss and dementia. Schedule an appointment with a neurologist as soon as possible. If they are suffering cognitive decline, intervention is critical.

Physical changes: Keep track of the senior’s appearance and make note of the following items:
• Weight gain or loss of more than 10 pounds in the last six months
• Skin tone that is dry, sallow
• Cracking or inflammation around the mouth
• Hair and nails are brittle
• Diarrhea
• Unexplained, sudden fatigue

LivHOME August Graphics-04

In addition to keeping track of the senior’s appearance and behavior, caregivers can proactively support good nutrition:

Look in the refrigerator: Throw out any expired or spoiled food. Wash the refrigerator. Place labels on food that will expire, and in large letters post the date that it should be thrown out.

Look in the cupboards: If the cupboards are bare, find out why. If the senior cannot physically get to the supermarket, LivHOME has support services to remedy the situation. If the senior cannot afford groceries, community services may be able to help.

Take the senior shopping: Today there are many nutritious foods that have a long shelf life. You can stock the senior’s cupboard with appealing, low salt foods that will improve nutrition. Make sure to purchase bottled water to remind the senior to drink more.

Studies show that 46 percent of seniors who live alone consume few fruits, vegetables or milk products. It is possible to get these healthy staples into the senior’s kitchen, without concern for expiration dates and moldy fruit. Most stores now stock milk in cartons that does not have to be refrigerated, dried fruits and nuts are good for snacking, and whole wheat crackers and breakfast bars provide whole grains.

LivHome knows there is no substitute for enjoying a meal with family. When that isn’t possible our caregivers will step in to support the senior’s nutrition, assist them with grocery shopping and cooking, and even eat with them to improve their health and well-being. We are just a phone call away.

cognitive decline-slowing cognitive decline-dementia-dementia awareness-vascular dementia-Alzheimer's disease-Alzheimer's disease awareness-elderly-eldercare-caregiver-caregiving-seniors-senior citizens

How to Find the Best Caregiver Job

Becoming a professional caregiver is a weighty responsibility- one that requires skill, training, compassion and caring. The best caregiver jobs are with employers that provide on-site training, a solid package of benefits and a strong support system that provides oversight and advice. LivHOME believes that these are important elements of a supportive work environment, and we provide them to the experienced care providers that we hire.

LivHOME July Graphics-09

LivHOME has grown to become one of the nation’s largest providers of professional care because we hold ourselves and our caregivers to strict standards of care. We hire only the best caregivers, expect them to deliver high quality, highly skilled care to each client, and support them in achieving that goal.

We hire caregivers through a rigorous employment process that includes in-person interviews, reference checks, skills evaluations, drug testing, and criminal background checks. All of these must be successfully completed before a caregiver is considered for employment.

Once hired, LivHOME caregivers receive competitive living wages, benefits, 401k matching retirement plans, and frequent on-site training and support. We believe that when caregivers receive good wages and benefits, they are free to give their best to their clients. As a result, LivHOME offers the highest quality caregiving and private duty nursing services available today:

  • Caregivers are available 24/7 with full support and supervision from credentialed professionals
  • Caregivers are fully bonded and insured for the protection of each client and each family

LivHOME has created what we believe are the highest standards for caregiving in the industry today. When you look for caregivers, make sure they hold the following characteristics:

Sound judgement and confidence. The best caregivers provide care that is based on experience, skill and an intuitive sense of what the senior needs, especially those who may be non-verbal.

Alert and quick to respond. Experienced caregivers have internal alarms that go off when they sense that something is wrong. They don’t hesitate to act, and have the training to know what to do when, to protect the senior in their care.

Compassionate and caring. Little things can make a world of difference. Any clinically trained caregiver can give medications and care for wounds. It’s the special ones that will serve a nutritious snack, give the senior a soft blanket to hug, or play music that is comforting.

Control and Communication. Skilled professionals know when to insist on specific care for their seniors, and are excellent communicators with family members and physicians. Caregivers may not be related to the patient and may not be physicians, but caring for a senior every day gives them unique and intuitive understanding of the patient’s status. The best caregivers will fight for the seniors in their care and make sure that the people in decision-making capacities listen.

Elderly woman with her caretaker in the nature

Caregiving During the Warm Weather Months

We all look forward to summer and the fun it holds. People of all ages enjoy activities under the sun, but when seniors are involved, staying cool takes on added importance. Caregivers need to make sure that fun and safety go hand in hand so that seniors can enjoy being outdoors without ending up in the emergency room. Sun stroke can occur quickly and without notice, but thankfully there are easy ways to avoid it. Here are some ways to make sure that caregivers keep seniors safe in the summer heat.

LivHOME July Graphics-07 (1)


Drink, Drink, Drink

As people age, and/or are experiencing ill health, their body may lose its ability to signal thirst. Sometimes it is a factor of declining senses and other times it is a side effect of medication. Regardless of the cause, caregivers of seniors need to keep a close eye on fluid intake to make sure they stay well hydrated, especially in the summer heat. If the senior has a history of heart failure or kidney disease, make sure to strike the right balance so they don’t become over-hydrated.

  • Keep track of every cup of fluid the senior drinks and aim for at least eight, 8 ounce glasses of fluid each day. Offer them fluids throughout the day- every sip adds up!
  • Ice cream, popsicles or slushies count as good fluids, but sugary drinks, coffee and tea can actually dehydrate.
  • It’s best to drink in the morning and afternoon to avoid waking frequently, and/or incontinence at night.

Fun in the Sun, Relaxation in the Shade

  • Walking is great exercise and it’s best to do so during the cooler hours of the morning or the evening. Walk a shady route, preferably one with benches for resting. If shady routes aren’t available, bring along an umbrella and wear hats that provide shade.
  • Always bring water along on a walk.
  • For those who are fragile, a short walk from the house to a chair on the deck, porch or garden is good exercise. It will increase mobility, lubricate the joints, and give the senior a pleasant view of the outdoors and some fresh air.
  • If the senior has access to a pool, water exercise is one of the best activities to maintain strong, flexible muscles. The water provides resistance to exercise muscles, while providing buoyancy that protects the joints and avoids injury.

It’s important to remember that those who are aging or in ill health may have diminished mental capacities. Think twice before leaving them in the car alone. Those suffering from dementia may play with the air conditioning controls, or try to operate the car. They may lock themselves inside or out of the car, creating additional hazards. Caregivers must always remain one step ahead of the senior to keep them safe and out of harm’s way.

lungs-lung cancer-lung cancer awareness-elderly-eldercare-caregiver-caregiving-seniors-senior citizens

Healthy Ways to Help Avoid Caregiver Stress

Caring for someone with Alzheimer’s Disease is an all-consuming task. It feels much bigger than a 24/7 job. The caregiver cannot make a cup of coffee for themselves without first making sure that the person in their care is out of harm’s way. Watching a loved one disappear into the disease exacts an enormous emotional toll. Yet, family members frequently care for relatives with Alzheimer’s Disease, and professional caregivers put their heart and soul into the job. LivHOME recognizes the heavy toll of caring for those suffering with Alzheimer’s and offers many different types of support and assistance. If caregivers exhibit any of these signs or symptoms, they need support, and possibly a break, from caregiving:

    Excessive stress and tension
    Debilitating depression
    Persistent anxiety, anger, or guilt
    Extreme irritability or anger with the dementia patient

These symptoms hold the very real potential of making the caregiver physically ill. Therefore, it is extremely important that the caregiver adopt a strategy of self-care.

    1. Stay active/Exercise regularly
    Walking, jogging, yoga — all of these work the stress out of the body. The person feels more energized, relaxed, and the brain and heart receive new oxygen and fresh blood. Every inch of the body is better and the brain renewed when a person exercises regularly.

    2. Keep a daily journal
    One does not have to be Ernest Hemingway to keep a journal. Think of it as talking to your best friend, but through a pen or pencil. Write down your raw thoughts and in the process you will relieve stress. Once it’s on paper, throw it away. The point of journaling is to get rid of stress, so why keep the writing?

    3. Talk through things with people you trust
    Don’t hesitate to ask for support. Caregivers by nature are in charge, but remaining that way through times of stress can be costly, mentally and physically. Take your trusted friend or relative out for coffee and bend their ear. They will feel honored that you trust them to vent, and you will feel better for having done so.

    4. RELAX — meditation, deep breathing, and mindfulness
    The ancient arts of yoga and meditation have been around for hundreds of years because they work. Slowly these relaxation methodologies have been adopted by the Western world. There are many free online sources that teach meditation and post guides to deep breathing and mindfulness exercises. They are highly beneficial in reducing stress and are worth considering.

    5. Continue to develop emotional awareness
    Alzheimer’s Disease alters the patient and the dynamics of their relationships. The disease is cruel to everyone involved. Creating loose expectations, and adopting the philosophy that daily change is now the norm will help greatly to cope with the disease. Love is in the moment at hand, and any micro-second of awareness is to be cherished. Everything else is up for grabs, and that type of emotional awareness can reduce stress and increase joy.

LivHOME Creative Assets Week 1-04

caregiver-caregiving-eldercare-elderly-elderly resolutions- New Years resolutions- senior citizens-senior resolutions-seniors

Home Safety Tips for Someone With Alzheimer’s Disease

When caring at home for someone with Alzheimer’s Disease, it is important to look at the house through their eyes. The general deterioration of the brain caused by the disease results in a breakdown of normal associations. Things are no longer identified as dangerous, poisonous or sharp. They are regarded merely as unfamiliar objects to be explored — knives aren’t sharp, cleaning products aren’t considered poisonous, and most anything is acceptable to be tasted. If caregivers keep this in mind, it makes it much easier to “Alzheimer’s-proof” the house, much like would be done for a toddler.

LivHOME Creative Assets Week 1-03

It is also important to adapt the home to accommodate the physical changes experienced by Alzheimer’s patients, including changes in vision, hearing, stability while standing and walking, and depth perception. LivHOME specialists can help you to prepare your home for the advanced stages of Alzheimer’s disease because they understand it, and the behaviors of those who suffer from it.

    1. Be sure that all safety devices are in working order — smoke detectors, carbon monoxide detectors, fire extinguishers, etc.
    This is good advice for everyone, but is especially important when an impaired person is living in the home. Early warning is essential to safety. A good rule of thumb is to change the batteries in all battery-powered detectors when the clocks are moved ahead or back seasonally.

    2. Lock up all hazardous materials — prescription medication, cleaning products, weapons, etc.
    Do not assume that these items are safe tucked under the sink or out of sight in the medicine cabinet. Curiosity is a strong motivator, and Alzheimer’s patients are just as likely to taste cleaning fluid as they are juice. Lock up medications, cleaning products, weapons and any other hazardous materials, including materials that can be hazardous if ingested improperly.

    3. Make sure the home is well lit.
    Aging impacts eyesight, whether or not Alzheimer’s Disease is involved. When it is, and depth perception is impaired as well, the best thing to assist declining eyesight is bright lights. Make sure that the maximum watt light bulb is used in each fixture. Remove as many shadows as possible, especially where there are stairs and thresholds. Make sure lamp cords don’t prevent a tripping hazard and that floor lamps won’t be leaned on for support.

    4. Remove clutter in the home — keep things as simple as possible
    We all accumulate too much stuff. Caring for an Alzheimer’s patient is as good a time as any to clean out some of that clutter. Piles of paper on the counter, magazines on the floor, layers of rugs, and collections of bottles all present a dust, infection and trip hazard for the aging. Keeping surfaces in your home clean and clear will not only make a healthy home, but experts say it also contributes to a healthy mind. For the Alzheimer’s patient, it makes it easier to get around, and is a much less confusing environment.

Music fun

5 Beneficial Activities Caregivers Can Do With Alzheimer’s Patients

Alzheimer’s Disease is the most common form of dementia and occurs due to generalized deterioration of the brain, including the areas that control speech, movement, touch, taste, and vision. That is why the most effective therapy for Alzheimer’s patients is to provide recreation that makes the brain work. At LivHOME, we find that patients respond well to fun activities that encourage movement and activate the senses. Here are some examples of sensory stimulation that patients enjoy.

    1. Walking and/or light exercise
    The most enjoyable walk for an Alzheimer’s patient is one that moves slowly along an interesting path. In suburban or rural areas, plants and flowers provide fragrant beautiful things to look at and talk about. In urban areas, parks and playgrounds provide flat surfaces with greenery and friendly faces. Don’t worry about a long walk; fresh air and movement are the important factors.

    2. Playing familiar music (possibly of the patient’s choosing)
    Music rests in the brain stem. That is why even non-verbal Alzheimer’s patients can sometimes sing along with a song. It seems that the power of music can usurp even the ravages of a disease as devastating as Alzheimer’s. Playing familiar music is soothing, reassuring, and brings forth pleasant memories for the patient. For those Alzheimer’s patients who may suffer from explosive episodes, music can be a calming tool.

    3. Painting and/or simple art projects
    Alzheimer’s Disease will at some point take away fine motor skills, but that doesn’t mean that painting and simple art projects can’t be positive pursuits. Paint brushes with easy to hold, round handles can be used, as can sponges and bath scrunchies made of tulle. Water based paint is important, and thick paper must be used because the patient won’t be able to carefully control the amount of paint that is used. Having fun, encouraging movement and the observation of color are the keys to this exercise.

    4. Watch old family videos
    One never knows when an Alzheimer’s patient will have a moment of recognition, or be stirred with the grace of a loving memory. Watching old family videos, or looking through photo albums together provides the opportunity for those precious moments to occur. Even when the patient can no longer recognize loved ones, or know they are part of a family unit, the experience of watching other people is comforting.

    5. Cook/bake simple recipes together
    Any activity that involves close human interaction is a positive one. Closely supervised, simple baking can be reassuring to those who always liked to bake. Giving the Alzheimer’s patient a wooden spoon to hold, or flour to put in a bowl are productive activities. Be careful to keep their involvement very simple, and avoid giving them a list of things to do that might cause frustration. Being with another person, laughing and enjoying the moment is the benefit of baking together.

LivHOME Creative Assets Week 1-01

LivHOME provides support to families trying to find appropriate care for an aging loved one. We learn the needs of the senior and family through a detailed clinical assessment. Then, based on the assessment, the Care Manager develops a personalized Plan of Care. Our professional Geriatric Care Managers, specialists in the field of gerontology (RN, licensed social workers, and/or mental health professionals) coordinate all resources and manage specially trained Caregivers to deliver personalized, at-home services. The important part is not to stand by and suffer alone.