ComForCare Home Care Serving Somerset & Northern Middlesex Countries

Archive for September, 2019

New Jersey Home Care Standards & Accreditation Explained

Monday , September 23 , 2019

New Jersey Home Care Standards & Accreditation Explained

As a licensed agency providing care for seniors and the disabled in their homes, my agency has a lot of “masters.” Foremost among them are our clients. We respond to their needs in all that we do, and we answer to them for the quality of our services. That much is straightforward.

What is less obvious to most people is that we also answer to the NJ Division of Consumer Affairs (who grants us our license), the NJ Board of Nursing (who writes detailed best practices governing our standards and day-to-day practices), and an accrediting agency approved by the state to inspect and review every aspect of our business.

As of 2019, accreditation is now a requirement for any home care agency in the state, and the Division of Consumer Affairs has committed to shutting down those agencies who don’t comply.

Certification in New Jersey

New Jersey has some of the most stringent regulations in the nation governing the provision of care services to seniors in their homes.

On March 18, 2019, Governor Murphy signed and enacted Senate Bill Number 2773, which clarifies the definitions of Health Care Service Firms and Homemaker/Home Health Aides. The bill ensures that “all firms acting as health care agencies for our elderly, including the ones using the Internet to arrange and provide companies or health care services, are properly registered.”

While most other states do not require that an employee who provides personal care be certified or show proof of any training. In New Jersey, any aide who touches a client, whether it is to help them into a wheelchair or to give them a sponge bath, must be “certified.”

To receive certification, the aide must successfully complete a training course approved by the Board of Nursing. Once they have passed, they may call themselves a CHHA (a Certified Homemaker Home Health Aide.)

And that’s only the first step!

CHHAs must renew their licenses every two years, and the state will not grant that renewal unless the aide can prove that he or she is working under the supervision of a registered nurse. In other words, they must work for a licensed agency like ComForCare who employs RNs to assess patients, write detailed care plans, and supervise the home care aides.

Home Care Best Practices – It’s the Law!

Clients are sometimes surprised (and sometimes annoyed!) at how in-depth our initial assessments and bi-monthly reassessments are. It generally takes our nurses at least two hours in the home every 60 days to review and document according to state regulations and our accreditation standards. This thoroughness can seem excessive to clients, but the NJ best practices were written to safeguard the health and safety of home care clients.

Our nurses can (and do) catch problems that doctors and families are unaware of—everything from flagging fall risks in the home to addressing the potential for skin breakdown that can lead to life-threatening pressure ulcers. They connect clients who have balance and strength problems to physical therapy, catch medication errors such as duplicate prescriptions under different medication names, and flag cognitive decline that would indicate a need for more safety supervision.

In addition, the RNs are regularly supervising and evaluating our HHAs to make sure they adhere to nursing standards and understand what is required under the patient’s plan of care.

Final Thoughts

Over the past couple of decades, the home care industry was wide open to just about anyone who wanted to set up shop. Some agencies followed best practices in hiring and supervising aides, but others simply operated as “matchmakers,” much as current online registries operate.

When it comes to providing care for vulnerable seniors in private homes, choosing an accredited agency is the safest way of ensuring quality of care and accountability.

Posted in: Home Care

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Adaptive Homes Allow Seniors to Age in Place

Tuesday , September 17 , 2019

Adaptive Homes Allow Seniors to Age in Place

If you ask an older adult what they fear most about aging, it’s often the loss of independence. Given the choice, most Americans would stay in their own homes for the duration of their lives, rather than move to alternative retirement accommodations.

Most houses, however, are not built with seniors in mind. Staying in the “standard” American home can be risky for an older adult as their physical and mental abilities change.  In fact, more than 95% of US homes lack aging-in-place features to make them safe and accessible for wheelchair users and seniors with other mobility challenges.

According to the Centers for Disease Control (CDC), environmental factors, such as tripping hazards and poor lighting, lead to about half of all injuries that occur at home. In addition, a lack of modifications, such as stair railings and ramps, can create further in-home danger.

Luckily, older adults have options, from adapting their existing home to finding a new standalone home that meets their needs.

Adapting your existing home

Adapting your home can be as easy as removing throw rugs and installing grab bars in the bathroom, or as costly as an entire remodel including wheelchair ramps and wider doorways. To ensure best results and protect your home’s value, it’s a good idea to work with a Certified Aging-in-Place Specialist affiliated with the National Association of Home Builders.

Some commonly recommended modifications include:


  • Replace the standard tub with a walk-in shower or tub
  • Install grab bars for toilets and tubs
  • Replace your standard toilet seat with an elevated model (with armrests, if you have problems getting up)
  • Consider open shelves to keep essentials easily accessible
  • Replace ceramic tile floors with hardwood or vinyl for safe standing (this applies to other rooms as well!)


  • Replace the cabinets with drawers and pull-out shelves
  • Move commonly used items to lower areas to avoid the need for a step stool
  • If possible, lower counter and sink heights
  • Install an elevated dishwasher or one with drawers for easy access
  • Replace old stoves with induction cooktops to help prevent burns
  • Consider adding seated workspaces to avoid a lot of standing


  • Install bed rails to make getting into and out of bed easier
  • Consider an adjustable bed that can be raised and lowered at the head and foot for the most comfortable sleep position
  • Make sure the bed is not too high
  • Have a sturdy chair handy for sitting while dressing

Living room:

  • Remove unnecessary throw rugs and fasten down rugs or floor runners to prevent slipping
  • Move furniture to create clear walking paths
  • Replace your recliner with a lift chair, which will enable you to sit down or stand up with ease

General spaces:

  • Consider a lightweight aluminum walker to make getting around the house easier (choose one that folds vertically for easy storage)
  • Keep objects off the floor and coil or secure cords to the wall to prevent tripping
  • Replace doorknobs with lever door handles
  • Apply non-slip tape on uncarpeted indoor and outdoor steps
  • Replace standard light switches with rocker-style switches
  • Increase the width of doorways and hallways to accommodate wheelchairs
  • Repair or replace loose handrails and install adequate lighting in stairways
  • Install threshold ramps when you can no longer walk safely up or down the steps
  • Provide proper lighting (seniors need two to three times more lighting than younger adults!)

Financing your remodel with Medicare

Medicare will provide coverage for a lot of upgrades and equipment – but not everything. Here’s what’s covered and what’s not.

According to PHC Online, Medicare will cover:

  • Manual wheelchairs (capped rental)
  • Power wheelchairs
  • Some positioning devices
  • Walkers
  • Scooters
  • Seat-lift mechanisms for lift-chairs
  • Mattress over-lays (capped rental)
  • Hospital beds, semi-electric type only (capped rental)
  • Patient lifts (capped rental)
  • Oxygen equipment (capped rental)
  • Durable medical equipment, such as wheelchairs, if it has been prescribed by a doctor and the coverage criteria is met

Medicare will NOT cover adaptive daily living aids, such as:

  • Ramps
  • Reachers
  • Sock-aids
  • Utensils
  • Transfer benches
  • Shower chairs
  • Raised toilet seats
  • Grab bars


Other finance options

Caregiver Homes lists several other finance options on their website, such as:

  • PACE (Program for All-Inclusive Care for the Elderly): “An innovative Medicare program that provides frail individuals age 55 and older comprehensive medical and social services coordinated and provided by an interdisciplinary team of professionals in a community-based center and in their homes, helping program participants delay or avoid long-term nursing home care.”

  • Reverse mortgage: A loan that allows qualified homeowners aged 62 plus to take part of their home’s equity as cash, either as a line of credit, a monthly or lump sum payment, or a combo line of credit and payments.

  • SHA Grants: Veterans with certain service-connected disabilities can use a SHA grant to adapt of purchase a home to accommodate the disability.

  • A 203K loan: If you don’t have enough equity in your home to borrow against, you may qualify for a 203K loan. A borrower with good credit and a stable mortgage payment history can apply for the loan when certain requirements are met.

  • Charitable organizations: “Many organizations organize repair projects for elderly persons or persons with disabilities. Organizations may include your neighborhood association or community groups, churches, synagogues, Lutheran Social Services, Catholic Charities, Little Brothers of the Poor, Jaycees, Agency on Aging, senior centers, building trade unions, Boy Scouts of America, Girl Scouts of America, Kiwanis Clubs, sororities, fraternities, high school volunteerism, YMCA, Knights of Columbus, Rotary Clubs, Lion’s Clubs, B’nai B’rith, Masons, or 4H Clubs. Inquire about interest in a community project or see if you can propose one.”

Nothing is more important to successful aging than preventing unnecessary injury. And few things are more important to happiness and quality of life than having an environment that supports the activities you enjoy.

Fortunately, for a relatively modest invest, the safety of most homes can be significantly improved to provide the best of all possible worlds: a safe, comfortable environment for aging that feels just like home because it is home.

Posted in: Aging, Home Care

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Disaster Preparedness for Older Adults

Monday , September 9 , 2019

Disaster Preparedness for Older Adults

With the Bahamas and the Southeast United States so recently pummeled by yet another hurricane, it seems like the perfect time to ask: Do you have an emergency preparedness plan?

Studies show that the vast majority of seniors, though they know they need a strategy, do nothing to make it happen.

Older adults often face unique challenges during an emergency. For example, you may have mobility issues or chronic health problems and no one nearby to help out. Or you may receive support services, like Meals on Wheels, that aren’t able to make it out for an extended period of time.

Other issues, such as difficulty hearing or reading, may make it impossible to access or understand emergency instructions, even if they are provided.

The key, then, to successfully navigating a hurricane, tornado, flood, or other natural disaster is to have a plan in place that you review regularly – and make loved ones aware of.

Build a personal support network

The American Red Cross suggests creating a personal support network made up of several individuals that will check in on you during an emergency to ensure your wellness and safety.

There are seven steps they recommend you discuss and implement with your network:

  1. Make arrangements, prior to an emergency, for your support network to immediately check on you after a disaster and, if needed, offer assistance.

  1. Exchange important keys.

  1. Show them where you keep emergency supplies.

  1. Share copies of your relevant emergency documents, evacuation plans and emergency health information card.

  1. Agree on and practice methods for contacting each other in an emergency. Do not count on the telephones working.

  1. You and your personal support network should always notify each other when you are going out of town and when you will return.

  1. The relationship should be mutual. Learn about each other’s needs and how to help each other in an emergency.

Note: If you have neighbors that you’re close with, they make great additions to your support network, since they’re already nearby.

Create an emergency supply kit

After an emergency, you may not have access to clean water or electricity. And, even though you have a support network, it may take a little while for anyone to be able to reach you.

Experts suggest being prepared with enough food, water, and other essential items to last for at least 72 hours (some say 7 to 10 days).

At the most basic level, your kit should include:

  • Non-perishable foods such as dry cereals, canned fruit and vegetables, granola bars, or peanut butter crackers
  • Bottled water
  • Medication
  • Spare clothing
  • Pet food (if you have pets)
  • Extra keys to your house and car
  • Glasses or contact lenses
  • First aid kit
  • Waterproof matches
  • Flashlight
  • Swiss Army knife
  • Can opener
  • Basic toiletries
  • Cash
  • Cell phone charger
  • Spare hearing aid batteries
  • Battery powered radio
  • Whistle to signal for help

Also, consider creating a care plan and keeping a copy in your emergency supply kit for first responders, so they can be made aware of any special needs. The CDC has an easy template.

Familiarize yourself with local resources

Whether you’re a senior yourself or a loved one/caregiver, it’s important to familiarize yourself with local resources before a disaster takes place. Most areas should have an emergency shelter nearby, planned escape routes, and a viable source of medical assistance. In addition, you should also have contact information for your local:

  • Police department
  • Fire department
  • Hospitals
  • Water supplier
  • Power supplier
  • Animal control
  • Poison control

Final thoughts

At ComForCare, an important part of our client assessments is having our RN assign a “Class Code” to each client. Keeping an up-to-date list of our client codes helps us quickly determine, in the event of a emergency situation, which of our clients are at the highest risk. Those who have “live-in” aides are sure to have support, but those who rely on our home health aides reaching them may have delays in service. Our office will be in touch with clients, family members and our employees and we will do everything possible to get timely help to those who need us.

During Hurricane Sandy, we had intrepid aides on the roads the morning after the storm navigating around downed trees and power lines to make it to their shifts, while Roger and I charged our phones in the car so we could stay in touch with clients and aides.

And when big snow storms have hit, we have had aides stay overnight with their clients, even sleeping on the floor at times, to be sure they can be there in the morning for client who truly needs them.

But at times there can be delays in service, and being prepared individually prepared is the best way to be sure of making it through an emergency situation safely and as comfortably as possible.

Further support

The following resources can offer additional information and assistance in the event of an emergency or disaster situation:

  • Register Ready – New Jersey’s Special Needs Registry for Disasters. This allows New Jersey residents with disabilities or access and functional needs and their families, friends, caregivers and associates an opportunity to provide information to emergency response agencies so emergency responders can better plan to serve them in a disaster or other emergency.
  • SMART911 or Code Red are additional services that can help first responders identify people who might need assistance right away
  • FEMA Emergency Financial First Aid Kit
  • FEMA Pet Owner’s Fact Sheet
  • gov tips on building and storing your Emergency Kit

Posted in: Aging

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