Category: Benefits of Home Care

Visual Cues and Decluttering for Those Living with Dementia

On Monday, November 13 at 12:30pm the National Aging in Place Council of Philadelphia will present on dementia and the importance of decluttering.  The program is titled “Visual Cues and Decluttering for Those Living with Dementia”.  It will be hosted at the Presbyterian Church of Chestnut Hill.

The goal of the seminar is to educate participants as to how dementia changes our senses and our responses towards external stimuli. Understanding the disease progression is crucial for being able to successfully adapt and to begin the dialogue of decluttering. 

Older adults thrive in an organizes and simplified environment.  By reducing clutter, older adults will be able to find the items they need and minimize the risk of falls.  However, even given the risks, the actual tasks of organizing and decluttering needs to be handled in a sensitive way.  The disposal of an item does not imply that we are forgetting experiences. 

We will also discuss the physical removal of items from the home.  This step must be done in a sensitive way too, understanding that each individual values items differently.  The removal is done in a responsible manner, always considering the possibility for donation, resale, and recycle.   

The presenters are founding members of the National Aging in Place Council (“NAIPC”) of Philadelphia.  Together the NAIPC serves as a consortium of industry leaders who hold themselves to ethical standards in their commitment to helping older adults age in place. 

If you would like to join us next Monday , please email philadelphia@ageinplace.com

Our presenters include:

  • Bode Hennegan, Life Managers & Associates
  • Bill Read, JDog Junk Removal & Hauling
  • Peter Abraldes, NursePartners, Inc.

 

Understanding Behaviors and Adapting Approaches in Dementia Care

Your role as caregiver, family member, or friend evolves with the progression of dementia.  Even faced with challenging behaviors, you can still connect with your loved one and fill their day with meaningful activities.  NursePartners is here to support you while your relationship evolves with the person living with dementia.

 

What is their behavior telling you?

We are constantly learning more about the brain’s ability to comprehend messages.  This includes messages that are delivered through speech versus writing, in a crowded space versus a one-on-one situation, or even a familiar voice versus one of a stranger.

Alzheimer’s disease and other dementias can cause people to act in unpredictable ways. Some individuals become anxious or aggressive while others repeat certain questions or gestures. Messages can be misinterpreted, surprising both the care recipient and caregiver. These types of reactions lead to misunderstanding, frustration, and tension.

It’s important to understand your loved one is not trying to be difficult and that these behaviors are also forms of communication.

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Tips for managing behavioral changes

As carepartners, we need to adapt our delivery process throughout the progression of the disease. When we carry on a traditional conversation, we usually engage in a back and forth volley of information. When a person is diagnosed with dementia, it is important to realize that the three essential language skills for processing and sharing verbal messages need to be supported in different ways. These core linguistic skills are:

  • Vocabulary (the words – the meaning of the content)
  • Comprehension (receptive language – the ability to process the message)
  • Speech production (expressive language – the ability to deliver the message)

Certain retained skills will assist you in conveying a message:

  • Social chit-chat (the back and forth that can mask loss of comprehension, but covers in short simple conversations)
  • Rhythm of speech (this includes awareness of the rhythm of a question that is seeking an answer, as well as ability to sustain rhythm or hear a rhythm that sounds familiar).  Additionally it can and does signal changes in emotion – changes in frequency, intensity, or volume can indicate shifts in emotional state or discomfort.
  • Rhythmic speech as is present in music, poetry, prayer, counting and even spelling.

What you can do:

There are important supportive phrases that can help when they are used in combination with pauses, inflections, visual cues, props, and partial reflective statement to confirm what was said or south:

  1. Seek more information by being nonspecific, try phrases such as  “Tell me more about it.”
  2. Seek demonstration or visual representation with phrases such as  “Could you show me how you would use it?” or“Show me how you’d do it.”
  3. Offer simplified options, by using two options at a time, or encouraging yes/no responses.  Employ the use of object pronouns.

What can help:

Awareness, knowledge, skill and support for both parties.

Mary Stehle, licensed social worker and Senior Care Advisor says, “A person with Alzheimer’s who has lost the ability to understand and communicate through language is always looking for cues from us as to how to interpret the world. They are constantly reading our tone of voice, facial expressions, and body language. When we are tired, stressed, and resentful, they pick up on this and it often impacts them negatively.” It’s important to remember that asking for help is not an act of selfishness, it’s providing better care for both you and your loved one.

We can be by their side when you can’t be. If your loved one need home care assistance or relief – Contact us today.

NursePartners is committed to providing uncompromised care to those living with a diagnosis of dementia. Our carepartners work with each family to enable safety, comfort and happiness through home-care services.

Understanding Fall Risks

Falls are a common and serious problem affecting many older adults. Individuals suffering with Alzheimer’s disease or another form of dementia however, are twice as likely to experience annual falls and fractures. This varies from a range of factors including medication, night waking, shuffling, weakening musculature and balance. The first step in protecting your loved one from a serious injury associated with a fall is understanding the risk factors.

 

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The following are common causes of falls:

Health Conditions

While everyone is at risk for falls, older adults are at the greatest risk due to chronic health conditions such as heart disease, arthritis, low blood pressure, Parkinson’s disease, dementia and other cognitive impairments. While some individuals in the early stages of Alzheimer’s are in excellent physical condition, many others seem to develop difficulties before cognitive impairment even begins. As Alzheimer’s progresses, it can cause lack of coordination, muscle weakness and diminished joint flexibility.

Reaction Time

As we get older, the nerves that carry information to and from the brain deteriorate. This slows reaction time and the ability to navigate around obstacles. This can be hazardous as seniors do not react as quickly in dangerous situations.

Medication

Many medicines also have side effects, causing dizziness, drowsiness and impaired vision.

Environmental Hazards

Many times, falls can happen because of environmental factors and hazards found throughout the home. These include everything from wet or slippery floors, poor lighting, to tripping hazards such as loose rugs, uneven floors, and trailing wires.

Visual-Spatial Problems

Because Alzheimer’s disease can affect the visual-spatial abilities, an individual can misinterpret and misjudge steps, uneven terrain, shiny areas on the floor or changes in floor color.

What you can do:

  1. Identify the risk factors for your loved one. Many people with Alzheimer’s and dementia suffer from poor eyesight, shuffling gait, muscle weakness and generalized frailty.
  2. Minimize or avoid medications that have been linked to falls. People with dementia are also more likely to fall when taking sedatives, tranquilizers, and antipsychotics.
  3. Exercise is important in preventing people from falling, especially if it includes balance and strength exercises. Ask the doctor about leg strength, gait, and balance evaluations. These tests help can determine physical risk factors.
  4. Consider a physical therapist or occupational therapist. These experts can work with your loved one to develop exercises strengthen joints.
  5. Make sure your loved one has eye tests regularly. Low vision is a huge risk factor for falls, and many vision problems come on gradually but steadily.  NursePartners’ use of theGEMTM methodology will also alert us towards changes in vision.
  6. Finally, get a home-safety assessment. Carepartners routinely perform these and can target danger spots and suggest easy improvements. This assessment can focus specifically on the needs of your loved one.

If you or a loved one is thinking about home care assistance, our team would love to help. Contact us today.

 

Sources:
Heerema, Esther. “Common Causes of Falls in People with Dementia.” Verywell.com. N.p., 31 Dec. 2015. Web. 30 May 2016.
 Perkins, Chris. “Dementia and Falling.” Continuing Medical Education 35.1 (2008): n. pag. Web. 31 May 2016.

Daily Care: Late Stage Alzheimer’s Disease

How can we, family and carepartners, support the people we know living with Alzheimer’s disease or another form of dementia?

Keeping loved ones stimulated and providing ability-based care and support cannot be overstated. At NursePartners, we recognize the GEMS™ model as an effective method for providing a treatment plan for individuals affected by dementia.  Click here for an introductory overview of the classification system describing the stages of the journey.

By appreciating what is changing and what is still possible, we can provide care that is more effective and less challenging.

 

Stage 3 – Severe/Late (lasts about one 1-3 years) – Rubies and Pearls

As dementia moves into the final stage, it can be difficult to know how to meet needs. Many lose their ability to control movement and respond to the environment. As memory and cognitive skills worsen, your loved one may need extensive help with daily activities.

The goal of care at this stage is to focus on preserving dignity and quality of life. Although your loved one may lose the ability talk and express needs, you can still connect with them, enjoying interactions and experiences of their past life.

 

About Rubies and Pearls

Rubies

Rubies experience late stage changes as fine motor skills are very limited. Losses in depth perception, as well as limited visual awareness and major sensory changes result in needed assistance with utensils, brushing, buttoning and moving. Hand-under-hand assistance helps rubies feel safe and secure. Suggested activities together include: reading, playing music, and looking through old photos.

Pearls

Pearls are still and quiet, unable to actively move or respond, with limited awareness of the world. Pearls enjoy pleasant sounds and familiar voices, grasping onto moments of connection.  Whether it’s the smell of their favorite perfume, or a beloved radio program, these small experiences can help capture a moment in time and evoke pleasant memories. Being present, patient, and understanding with your loved one will help them escape feelings of isolation associated with late stage Alzheimer’s.

Planning the Day

  • Tailor the environment with the interests of your loved one. This can allow them to emotionally connect to things they previously enjoyed.
  • Plan the days to have a balance of restful and active periods to help your loved ones transition slowly and gradually from one to the other.
  • Observe the person for signs of stress. Keep lights low and noise to a minimum. Consider visiting in smaller numbers.
  • Use your voice to engage and encourage, talking quietly to tell stories and reminiscing about past events.
  • Discover which eye they use for vision.  Do not obstruct their line of site and get on or below eye level when speaking with them.

At this point in the disease, the world is primarily experienced through the senses. You can express your caring through touch, sound, sight, taste and smell.

Activities for Rubies and Pearls

  • Playing their favorite music
  • Reminiscing about past events
  • Reading portions of books that have meaning for the person
  • Looking at old photos together
  • Preparing a favorite food
  • Rubbing lotion with a favorite scent into the skin
  • Brushing their hair
  • Sitting outside together on a nice day

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NursePartners is committed to providing uncompromised care to those living with a diagnosis of dementia. Our carepartners are trained in the Positive Approach to Alzheimer’s and Dementia Care (GEMS™) and work with families to enable safety, comfort and happiness through home-care services.

If your loved one need home care assistance or relief, our team would love to help.

Contact us today.

 

 

Daily Care: Moderate Stages of Alzheimer’s Disease

We can support the people we know living with dementia by keeping them mentally stimulated and providing ability-based care and support. At NursePartners, we recognize the GEMS™ model as an effective method for providing a plan of care for individuals living with Alzheimer’s disease or another form of dementia.  Click here for an introductory overview of the classification system and to understand the stages of the journey.

By appreciating what is changing and what is still possible, we can provide care that is more effective and less challenging.

 

Stage 2 – Moderate/Middle (lasts 2-10 yrs) – Emeralds and Ambers

At NursePartners, we use the “Emerald” or “Amber” classification for clients with moderately developed dementias.  We prefer this terminology because we know that all clients are operate at their best with the right approach to care.

A client normally persists in the Emerald and Amber stages the longest out of the other GEM levels. During this time, damage to the brain can make it difficult to express thoughts and perform routine tasks. It is important to allow your loved one to be involved in their day-to-day routine. Provide meaning through relevant activities that were part of their past because this will provide them with a sense of self-worth and add to their quality of life.

There will be acute changes to their self-awareness and senses.  We need to be able to distinguish daily changes and overall trends.  By having an established relationship with the client, we are also able to tell the difference between a client’s personality quirks and further developments of the disease.

 

About Emeralds and Ambers

 

Emeralds

Emeralds may get lost in time, thinking that are in another place or assuming a former role. They have problems with communication and comprehension, often asking questions that begin with “who”, “what”, “where”, and “when”.  At this GEM level, clients are making small mistakes with their personal care, but may not recognize it.  Some examples of this might be fastening buttons in the wrong holes, putting shoes on the wrong feet, or not changing clothing or brushing hair before leaving the home.  It is not important that we “correct every mistake”, but make changes subtly by using the right approach.  Sometimes this requires relating to the “mistake”, by discussing how we do this ourselves.  We could also pull out another piece of clothing and convince the client how good they look in that particular piece.

Emeralds are most comfortable when doing familiar tasks. They like to engage and help others, as well as feeling like they have a purpose. At a family functions, engage them by asking to help set the table and then clean it up. Choose favorite activities or hobbies of the past, but do not impose time limits for completing each task

Activities at home

Activities around the house can help Emeralds feel involved and provide a sense of normality. Activities such as setting the table, watering plants, and cooking can reflect past hobbies and interests, and can be a good way of retaining skills. Helping in the kitchen can also bring people together, as many experiences revolve around meals: holidays, birthdays, church potlucks, summer barbecues, weddings. Some activities for Emeralds include:

  • Cooking: salads, ice cream, Jell-O, pudding, no-bake cookies and pies, etc.
  • Copying recipes from magazines onto cards
  • Making a grocery list of items needed for recipes
  • Setting the table: Folding or rolling silverware into napkins

 

Ambers

Ambers like to live in moments of time, and are focused on sensation – manipulating, gathering and touching.  They are focused on wants and needs, and sometimes are exploratory without safety awareness. Their communication is limited with difficulty understanding and expressing needs, so activities selected need be familiar and sensory stimulating. Ambers may enjoy sing-alongs or being in visually stimulating outdoor locations.

Family members find it hard to find new ways “to say hello”.  We need to remember that there are other ways to communicate beyond verbally.  This is the time to start using those our methods.

Some activities for Ambers include:

  • Sorting nails, screws, and other hardware.
  • Organizing nail polish and lipsticks by color and shape.
  • Grouping coins, according to date, value or place of origin.
  • Rearranging the order of the silverware drawer by forks, spoons and knives.
  • Categorizing playing cards into decks or suits that match.

Planning the Day

  • Make a schedule and follow it: be structured but allow flexibility.
  • Offer a variety of activities everyday: leisure, work, rest, and self-care.
  • Create a flow for the day: build up and then slow down.
  • Build a foundation of familiar and favorite activities.

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NursePartners is committed to providing uncompromised care to those living with a diagnosis of dementia. Our carepartners are trained in the Positive Approach to Alzheimer’s and Dementia Care (GEMS™) and work with families to enable safety, comfort, and happiness through home-care services.

If your loved one need home care assistance or relief, our team would love to help.  Contact us today.

 

Daily Care: Early Stage Alzheimer’s Disease

 

The early stages of dementia sometimes go unnoticed, especially if the older adult lives alone.  In the cases that we do learn of an early diagnosis, the challenge becomes how to best support the person living with dementia.  Typically the diagnosis may be Alzheimer’s disease, but the reality is that there are over 80 types of dementia and other conditions that produce symptoms similar to dementia.

Keeping loved ones stimulated, and providing ability-based support and care cannot be overstated. At NursePartners, we recognize the GEMS™ model as an effective method for providing a treatment plan for individuals living with dementia. Click here for an introductory overview of the classification system and to understand the stages of the journey.

 

Stage 1 – Mild/Early (lasts 2-4 yrs) –  NursePartners refers to these individuals as “Sapphires” and “Diamonds”

In the early stages of dementia, your loved one may withdraw from activities they previously enjoyed. It is important to help them remain engaged and stimulated. Even the most simple, everyday tasks such as setting the table or folding clothes can help a person with Alzheimer’s or another form of dementia feel connected to “normal” life. Activities linked to hobbies and interests can maximize choice and help build the relationship between that person and the carepartner.

 

About Sapphires and Diamonds

Sapphires

Sapphires may feel “blue” due to changes with the aging process, although there may be no significant changes in cognition.  Sapphires are committed to lifelong patterns, enjoying the things the way they always have. Sapphires prefer being asked what to do when making decisions. Pamper them – spending a spa day or a trip to the barber/beauty salon can help them feel less blue.  Sapphires are not living with dementia.

Diamonds

Diamonds are “clear and sharp,” successful with established habits and routines. Diamonds like to feel competent and valued, and it is important for them to feel comfortable and in control. A diamond can still do things as they always have, but they become more territorial and less aware of boundaries. Diamonds enjoy familiar places, whether that be a family member’s home or a favorite restaurant. Suggested activities include attending concerts or plays and getting fresh air – picnicking or walking outdoors.

 

 

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A stroll in the neighborhood helps animate most older adults.

Activities for Sapphires and Diamonds

  • Thinking: crosswords, jigsaw puzzles, cards, board games, and reading.
  • Physical: walking animals, gardening, walking, swimming, and dancing.
  • Social: visiting with family or friends, or going to a favorite restaurant.
  • Home Activities: folding laundry, feeding pets, cooking and helping in the kitchen.
  • Creative: arts and crafts projects, knitting, painting and drawing, playing music or singing.
  • Daily living: taking a shower, brushing teeth, eating, and getting dressed.

Reminiscence activities:

  • Looking through photo albums.
  • Creating a scrapbook, pasting photos onto the pages and writing notes about the memory beside the photo.
  • Reading saved letters and greeting cards.
  • Life Story Game: Ask your loved one to list the steps and necessities associated with an activity. For example: “We are going on a picnic, what would we bring in the picnic basket? Where would we go for the picnic?”

Some suggestions could be:

  1.   A day at the beach.
  2.   A ride in the country.
  3.   First day at school.
  4.   Getting married.
  5.   Social functions.

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NursePartners is committed to providing uncompromised care to those living with a diagnosis of dementia. Our carepartners are trained in the Positive Approach to Alzheimer’s and Dementia Care (GEMS™) and work with families to enable safety, comfort, and meaningful activity through home-care services.

If your loved one need home care assistance or relief, our team would love to help.

Contact us today.

Exercise for those living with dementia

Exercise is essential for a healthy lifestyle, contributing to physical and mental health, muscle control, coordination, and a sense of wellbeing. It plays a huge role in reducing Alzheimer’s and dementia, by maintaining blood flow to the brain and stimulating cell growth.

These are the benefits of physical exercise for these individuals:

  • improved cognition, sleep, and mood;
  • opportunities for social interaction;
  • reducing feelings of confusion and isolation;
  • improved confidence and self-esteem;
  • reduced risk of breast and colon cancer, stroke, and type II diabetes;
  • improved physical fitness (maintaining strong muscles and flexible joints can help people maintain independence for longer).

Getting started

The Department of Health recommends 150 minutes of physical activity per week. This equates to 30 minutes of activity per day. This can be broken up into shorter sessions throughout the day, with each session lasting a minimum of 10 minutes. Allow your loved one to go at their own pace. Plan a day around physical activities: a fifteen minute walk in the morning, followed by housework or gardening tasks in the afternoon.

It is important to consider ability, stage of dementia, and preference, as individuals undertake physical exercise. Some might be more adaptable to exercise, while others start with simpler activities.

Always talk to a healthcare professional before creating a exercise plan.  Often clients have previously worked with a physical therapist.  NursePartners is able to help clients follow those plans already developed.

What is the right exercise?

An exercise program incorporated into a routine in the early stages of dementia is more likely to be maintained, extending the benefits to health and well-being.

Consider a physical activity that is mentally and socially engaging, such as walking, gardening, dancing, or an exercise group. Repetitive activity such as walking on a treadmill or using an exercise bike can also help reduce anxiety and confusion.

Exercise in the later stages of dementia

If possible, physical activity can be very beneficial in the later stages of dementia.

Some suggested exercises:

  • Have your loved one sit on one end of the bed, and then scoot to the other end while sitting. This exercise is good practice for getting up from a chair;
  • Encourage them to sit in a different chair at each mealtime throughout the day;
  • Help them sit without support. This exercise helps with balance and posture and can form part of everyday activities;
  • Have your loved one walk short distances between rooms as part of a daily routine.  This will help maintain muscle strength and joint flexibility.

Physical activity creates an opportunity for your loved one to socialize with others, as well as working to improve and maintain their independence. NursePartners is committed to providing uncompromised care to those living with a diagnosis of dementia. Our carepartners are trained in the Positive Approach to Alzheimer’s and Dementia Care (GEMS™) and work with families to enable safety, comfort, and happiness through home care services.

If your loved one need home care assistance or relief, our team would love to help.

Contact us today.

NursePartners becomes the second SAGE-certified Pennsylvania home care company

SAGE Care LGBT Cultural Competency Training - 2017 Bronze

NursePartners, Inc. is proud to be the only home care company in Philadelphia that is SAGETM certified for LGBT Seniors.  As an Independence Business Alliance (“IBA”) member and sponsor for many years, we know that aging LGBT seniors face a unique set of challenges when it is time to receive personal care.  If they move into an assisted living community or nursing home, they may have to hide their identities or not participate in favorite activities.  This forced change is not only difficult, but it is one that should never happen.

 

We sought to make a difference by training 25% of our employees to better understand how to connect and care for the aging LGBT community.  The training taught employees the intergenerational and racial nuances that apply to LGBT older adults. We learned how respond to bias behavior, incorporated new vocabulary, and received an overview of federal protections.

Previously these same employees completed the GEMTM training, a 7.5-hour training module that refines approaches for working with clients living with dementia.  This training involves role playing with a dementia coach and working through challenging behaviors.  Many of the techniques in Teepa Snow’s Positive Physical Approach to CareTM can also be applied to clients not living with a diagnosis of dementia.  This is because we focus just as much on our approach as the quality of care delivered.

We are prepared to service older LGBT adults in the Philadelphia region.  The following are some of the tasks our carepartners can complete:

  • Bathing, Grooming, and Hygiene
  • Mobility Assistance
  • Transferring and Positioning
  • Feeding and Diet monitoring
  • Toileting and Incontinence Care
  • Meal Preparation
  • Laundry
  • Light Housekeeping
  • Grocery Shopping/Errands
  • Grocery Delivery Coordination
  • Transportation in private vehicles or public transportation
  • Medication Reminders

All clients receive a care of plan uniquely made for them.  These plans are developed by a registered nurse and adjusted accordingly as conditions change.

NursePartners values the relationship with the client as much as with their family.  We know that the journey may be challenging and we are here to offer support.

Connecting through meaningful activities

One of the common mistakes we make as caregivers is to eliminate the very activities that give older adults a sense of purpose.  Our first inclination is to “entertain” instead of giving older adults a “job-related” activity.  However, older adults also need to feel needed and seen by others as productive members of society.  For many of us, productivity equates to the feeling of importance.

Assigning tasks requires creativity.  It is most successful upon taking the time to understand an individual’s unique history and personality.  For someone living with dementia, traveling back in time is common.  We can anticipate some of possible job-related activities by knowing what our clients did for work 20,30, or 60 years ago.  We piece this puzzle together through a thorough initial assessment and continued conversations with family and friends.

Sometimes job-related tasks can be accomplished by involving the client with their own care. Depending on their GEMTM level and living arrangements, clients may even want to take part in activities for other residents.  In the Diamond and Emerald stages, we need to take care to control for external stimuli that might distract from the schedule or make unnecessary changes.  For later GEM stages, we will then have to adapt tasks to ensure that the client continues to successfully complete them.

We welcome the opportunity to tell you more about our dementia care services.

Why Choose Us?

  • We focus on what our clients can do, not what they cannot.
  • There is a no cost, collaborative health and wellness assessment.
  • 24/7 availability, including holidays and weekends.
  • We are staffed with Certified Nursing Assistances (“CNA”s), not Home Health Aides.  All of our CNAs have years of geriatric experience and exhibit a passion for caring for those with progressive diseases.
  • Regular visits by licensed clinicians to ensure customer satisfaction.
  • Carepartners are employees of NursePartners, not subcontractors.
  • We seek to engage our clients in meaningful activities; we seek to exceed your expectations.
  • Our standards are higher than those set by the healthcare industry.

 

Activities for those living with dementia

During the first week of services, NursePartners puts together an activity box for each of our clients living with dementia.  These give carepartners the tools they need to start building a successful relationship.

Carepartners know to communicate client needs as they arise.  Sometimes by learning more about our clients we can find activities that will best engage them.  Occasionally we bring additional items into the client’s home as we discover new interests.

We recommend keeping the brain actively engaged.  Families are encouraged to interact with the person living with dementia to find new ways to connect “and say hello”.  Jeremy Miller, BSW is a Certified Dementia Specialist who offers recommendations on his website: http://www.engagingdementia.com/engaging-products.

 

It is also recommended to involve clients in their own care.  Clients should feel a sense of responsibility.  Carepartners may accompany them to places such as the grocery store or they could shop for these items online.  Grocery delivery and other similar services are coordinated through our office.

Let us tell you more about how we can help you or a loved one age gracefully in place: 610-323-9800.