“It was pretty evident that my father-in-law wasn’t taking care of himself,” recalled Susan Ward. “We didn’t know what doctors he was going to or not, and what they were saying.”

After spending a week caring for her father-in-law, Susan quickly realized how bad the situation had become. “I started to call different agencies to see what could be done,” she said.

Susan’s frantic phone calls eventually led her to Vikki Dargenio and her medical case management company, A Nurse in the Family. “Vikki really came right at the nick of time,” Susan said. “When we hired Vikki, she knew immediately what needed to be done, and she was able to talk to the doctors and get the right care for Frank.”

Vikki started accompanying Frank to all his doctor’s appointments, helping to eliminate any confusion and ensure that he always had an advocate present. “When I take a patient on, I really become part of their family,” Vikki explained. “I am the quarterback of the healthcare team and my goals are to keep people at home and make sure they get the medical care they need.”

After caring for four of her own family members, Vikki realized that every patient needs an advocate, especially senior patients who are often referred to multiple specialists with limited explanations. “Dr. John Sabatini actually recommended that I start this business after seeing what I had done for my family. He told me that it was amazing and that there was really a need for this,” Vikki recalled.

As a registered nurse with a background in long-term care, Vikki is uniquely positioned to help ailing seniors receive better medical care and remain in their homes longer. Since the initial recommendation that started her business, she has had several medical professionals acknowledge the importance of her services.

“It is very helpful that you come to these appointments. And on top of that, I can tell you really care,” Dr. Daniel LeBovic, a hematologist, told Vikki during one of her many visits to his office with a patient.

For Frank and his family, Vikki’s care and compassion changed everything. The family no longer had to worry about whether Frank was receiving the best possible medical treatment or if he was correctly following the doctor’s orders. By managing all of Frank’s medical appointments and helping the in-home companion caregivers better serve his needs, Vikki made it possible for Frank to continue living at home until he passed away in May of 2012.

“Frank remained in his home, and Vikki was with him until the very end,” Susan remembered. “She was very competent and always knew what needed to be done. She was there whenever we needed her, and she was so good to him.”

A native of Baltimore, Estelle found the perfect retirement community in her beloved hometown.

Except for a brief stay in Philadelphia, Estelle has spent her entire life in Baltimore. She completed her education in the Baltimore Public School System. Upon graduation, Estelle entered Sinai School of Nursing.

After becoming a Registered Nurse, Estelle wanted to enlist in the armed forces. However, there was a height requirement — a minimum of 5 feet; Estelle was 4’ 11”. She recalls “puffing up” her hair so that she would appear taller when she went in for her test, but it didn’t work. Estelle’s career went in a different direction.

Estelle worked for four years in the operating room at South Baltimore General Hospital, which is now known as Harbor Hospital. During this time, she continued her education, completing a certification course at Johns Hopkins University for Operating Room Technicians.

One of Estelle’s superiors took note of her skills and work ethic and suggested that she undertake additional studies to become an anesthetist. It was rare for a woman to enter this field, but Estelle did not shy away from the challenge. Soon after, she packed up and headed to Philadelphia for an 8-month program of study to become a Certified Registered Nurse Anesthetist (CRNA). When Estelle came home, she returned to South Baltimore General, where her successful career spanned four decades.

As a CRNA, Estelle was considered a child specialist; she had a special gift for helping children overcome their fears of medical procedures. As her young patients were being wheeled away from their parents, they were often screaming and crying. “I would walk beside them and once they were away from their parents, I would look at them and say, “Okay, you don’t have to cry anymore, I am not your parent,’” she recalled. Surprisingly, the children would stop crying and settle down.

During her career, Estelle met and married her husband, who was a salesman. The couple had a daughter, Nancy, who followed in her mother’s footsteps. Nancy graduated with her nursing degree from the Villa Julie College, now Stevenson University, and is currently a nurse researcher at the University of Maryland.

Since her retirement, Estelle enjoys spending time with her friends at Springwell playing dominoes, Bingo and word games. She is very close to her daughter, and they both enjoy taking in cultural events. Estelle’s advice to young people just venturing out into the working world is to take the time to find something you really like. “If you enjoy what you are doing, you won’t mind getting up and going into work each day,” she said.

When Bessye Clay (right) utilized the services of a home health agency, she not only received the care she needed, but found companionship with Registered Nurse Angela Lewis.

After different careers in public service, Baltimore City resident Bessye Clay eventually found herself needing a helping hand.  In June 2010, the North Carolina native, known to her family and friends as ‘Miss Bessye,’ had undergone back surgery.

Desiring to return home, it was clear Miss Bessye would need the assistance of a home health care agency when she was discharged from the hospital.

“I didn’t have any problems with the hospital,” she said.  “But I’d rather be in my home.  It’s more comfortable.”

Fortunately, her doctor referred her to P-B Health, an agency that provides skilled nursing, therapy services, medical social work and personal care.  With the agency, Miss Bessye not only received the care and support she needed, but she found companionship.

Angela Lewis, a Registered Nurse who has been with the agency for 14 years, provided wound care for her surgical incision and Miss Bessye also received physical therapy services.

“The nurses would come out and help me with walking and I did all kinds of therapy with them,” said Miss Bessye.

She has also credited Angela with helping her to avoid what could have been debilitating injuries after she slipped and fell in her home last September.  As a result, Miss Bessye has suffered from sciatica, but said things could have been worse had it not been for Angela checking on her and insisting she go to the hospital.

“If she hadn’t insisted that I go, I might not be able to walk right now,” said Miss Bessye.

Thanks to P-B Health, she made her recovery much quicker than expected and would gladly recommend the agency to others.  With the improvement of her health, however, there has just been one downside for Miss Bessye.

“I wish Angela was still coming,” she said.  “I miss her very much. She was an excellent nurse.”

These days, Miss Bessye enjoys spending time with her family in the area and catching up with Dot, a friend she had made in the hospital who also received care from the home health agency.

“Some of the same nurses that came to see me went to see her,” said Miss Bessye.  “We now call each other every day.  We are always laughing and talking about the great service we have had.”

Excerpts reprinted with permission from the article, ‘The Growing Need for Home Health Care Services’ by Ursula Battle in “The Baltimore Times” (December 3-9, 2010). 

Born and raised in Washington, D.C., Beth graduated from Smith College as a music major. After traveling throughout the U.S., Europe and Middle East, she returned to her native city to pursue careers in broadcasting and politics.

Beth worked on President Eisenhower’s campaign and was a staff member of the Senate. She also held a position in public relations for D.C.’s classical music station, but eventually moved in 1963 to become the Director of Public Relations at the Philadelphia Orchestra.

In her new hometown, Beth met the “man of her dreams,” Henry, the president of an investment banking company. The couple had a son in addition to the three children he brought to their marriage. Aside from traveling in their free time, the Glendinnings ran a summer program in economics for high school students.

Although Henry passed away in 1988, Beth continued to stay active with the Philadelphia Orchestra and joined the Boards of the Philadelphia Chamber Music Society, Curtis Institute of Music and Astral Artists.

Despite her involvement with these organizations over the years, Beth eventually knew it was time to make the transition from her home to a community that could not only provide a dynamic atmosphere, but offer a sense of security for her future. Where that community would be, however, was never a question for her.

“I always wanted to come to Cathedral Village because of the diversity of its population,” said Beth. “It’s near Philadelphia and I had friends here.”

Along with the location and vibrancy, it was also the community’s reputation of serving its residents since 1979 that appealed to Beth, so she made the move in 2004.

“I heard the staff was great, but I had no idea how great it was until I got here,” she said. “It’s very well run.”

It is no surprise that since her move to Cathedral Village Beth has not only managed to stay active with her outside organizations, but has become highly involved with those in the community. As co-chair of the Art Studio Committee, she is responsible for choosing teachers for painting programs, but it is her duties as co-chair of the Concert Committee that has let her utilize her roots in music.

“We bring in the most incredible people and present up to 14 concerts a year for the residents,” she said. “Because I’ve been floating around the music world so long in Philadelphia, it’s been easy for me to find the amazing talent.”

Beth credits the staff at Cathedral Village for financially supporting the concert committee and allowing her the opportunity to hire these classically trained artists. The monthly concerts held in the community’s auditorium, Cathedral Hall, are popular among all residents as volunteers bring individuals from the nursing facility to enjoy the experience.

“This is the thing I’m most proud of in the past four years. These are blessed years for me and that is my great joy,” she said.

With a town that is full of talented and diverse musicians, there is no question that her tasks for the Concert Series keep Beth busy, yet she manages to take advantage of the many other opportunities available on campus to stay active. Services that include housekeeping, dining and transportation allow individuals the freedom and luxury to engage in as many or as few activities as they desire, whether it is relaxing on movie nights to reading plays with the drama group.

Cathedral Village offers a range of college courses from Economics to Films and often features guest speakers. Residents can also explore their creative abilities utilizing the craft room, or take advantage of the community’s physical fitness equipment.

“We have a really great pool that I swim in every day,” said Beth. “It’s really beautiful to swim and see the snow falling outside.”

While she appreciates these wonderful amenities and the fact that Cathedral Village is pet-friendly, Beth had also come to the community knowing she would have access to a range of healthcare. This has been especially important lately as she is preparing to have knee replacement surgery and return to Cathedral Village for her therapy.

“You don’t have to go to some rehabilitation place,” said Beth. “You come back home and stay in the nursing facility, but you can come into your apartment and still check in with everyone.”

Now, Beth and her fellow residents also have the peace of mind knowing they can receive assisted living care in the comforts of their apartments.

“We can stay where we’ve all been living and don’t have to pack up our treasures and move, which is a major plus,” she said.

Along with Skilled Nursing and Assisted Living care, Cathedral Village’s supportive services also extends to Alzheimer’s care. The community’s Outpatient Department for independent living residents is managed full-time by an experienced Registered Nurse with a Physician on duty 24 hours a day. A variety of specialists from dentists to audiologists are also brought in for residents at least once a week.

As she looks back on the past five years being surrounded by lively individuals and a supportive staff, Beth could not be happier. Although it had been quite clear as to where she wanted to spend her future, it may be safe to say that Cathedral Village, with its organizations, amenities and care was ‘music to her ears,’ and still continues to be with each passing day.

Helen was born in Ithaca, NY on Feb. 14, 1908 and eventually moved to Washington, D.C. at age nine. She is the daughter of Robert Harold Ogle, one of the founders of the Alpha Phi Alpha organization which began at Cornell University in the same year as her birth.

Over the years, Helen and her sister were raised by her father and grandmothers after her mother had passed away when she was an infant.

Helen, who graduated from Dunbar High School, the Miner Normal School for colored Girls (now part of the University of the District of Columbia), and Howard University, has always been a warm, friendly and outgoing person with a love for poetry.

After 37 years of teaching in the Washington D.C. public school system, Helen retired to utilize her passion and skills to write poetry and children stories. Always wanting to enjoy life to the fullest, she also started a poetry club while traveling to various locations and working feverously in her church.

When arthritis eventually took its toll, she decided it was time to make the transition to an assisted living home. She was looking for a place with a home-like atmosphere in a family setting. With a little research, Helen and her loved ones found the perfect fit at Gentle Steps Assisted Living located in Riverdale, Md.

Here, she is genuinely loved and cared for. She and her family are superbly pleased with the high level of warm professional care that she receives from the staff as well as the cleanliness and ambiance of the facility. “The food is good and I have some friends here to keep me company,” she says.

Another aspect that makes Helen extremely happy is the security in knowing that the owner is a registered nurse who is very visible.

Most importantly, the warm and friendly environment the community provides has allowed and encouraged Helen to recite from memory the hundreds of poems she loves and cherishes.

Though they share similar interests, it is no wonder Josephine and Ray have become great friends as caring individuals who have served others during their lives.

A registered nurse, Josephine utilized her certification in different areas. From working in the emergency room to industrial nursing, she truly enjoyed making a difference in people’s lives, and it is something she has carried with her to this day.

“Up until about two years ago, she continued to have annual reunions with her nursing school class,” said Ann Newman, Josephine’s daughter.

It was when her macular degeneration worsened that prompted her to seek a community with the help of her daughter.

“The day she called, I had gotten an ad in the mail for Arbour Square and I was impressed with the no down payment, month-to-month rental,” said Ann. “I then visited and was so impressed with the building and the wonderful people.”

For Ann, the amenities and services her mother would receive were a great deal compared to other communities that had large entrance fees. Site unseen, Josephine settled into her stylish apartment with a view in 2007 and could not be happier.

Along with group exercise programs at the community’s fitness center, she remains active attending music programs, and of course, playing pinochle every week with her best friend.

Originally from western Pennsylvania, Ray joined the Army and served in the Corps for over three years. When he returned from overseas, he worked 42 years for U.S. Steel and Fairless Steel Works.

After his wife of 60 years passed, one of their three sons suggested he downsize and make the transition to a community that could offer everything he needed.

“My son lived around here at the time and saw Arbour Square,” said Ray. “He told me about it, so we visited and that is when I decided to come here.”

Since his move two years ago, he has enjoyed a maintenance-free lifestyle with his fellow residents as several services including housekeeping, meal preparation and transportation are all provided at the community. This has allowed Ray more time for the numerous available activities as he takes bus trips to casinos and race tracks while showing off his Wii bowling skills.

“I had surgery, so I’m hoping to eventually get back into swimming and playing Golf too,” he said.

From the frequented indoor Main Street to energetic ‘Brain Teaser’ games there are plenty of opportunities for people to stay active. The numerous amenities and services, however, will only expand as staff and residents eagerly anticipate the opening of The Birches, Arbour Square’s Assisted Living Community. This will feature 44 assisted living apartments with an additional 25 in a secure memory care unit.

For Ann, this will be just one more perk for her mother and their new friend.

“This is truly a lovely place,” she said. “The décor is great, there are lots of activities for them, and the people here could not be any more helpful.”

When a person prefers to stay at home but needs ongoing care that cannot effectively be provided by family and friends, home care may be the best option. As the Home Health Care industry grows and advances, more seniors are able to age in place-receiving the care they need in the comfort of their homes. Regardless of age or health conditions, all seniors should consider home care as an option when making retirement living decisions.

In addition to care provided in an individual’s home, home care services are also available to supplement the care received in a hospital or facility; 25% of the care we classify as home care is actually performed in hospitals or facilities.

Home Care Options
An incredibly diverse field, home care can serve a variety of senior need levels. Home Care can include home support care, skilled nursing care, or hospice care. For information about hospice care, please see our hospice section on pg. 89.

Home Support Care is for seniors who are no longer able to perform all of the functions of daily living by themselves but who do not require skilled medical services. A home health aide can help with activities of daily living (ADLs), which include bathing, dressing, transferring, eating, and hygiene. Additional services generally include meal preparation, mobility exercises, light housekeeping, laundry services, medication reminders, and accompaniment to appointments.

Skilled Nursing Care is prescribed by a physician and is administered by a registered nurse. The services provided by skilled nurses include: administering injections, administering medications, wound care, IV monitoring, blood tests, catheter care, respiratory therapy, speech therapy, physical therapy, feeding tube administration, and more.

Home Care Providers
Home Care providers can be classified into three major categories: Medicare-certified Agencies, Private Duty Agencies, and Registries. All of these agencies deliver care to patients either in their homes or in a hospital, assisted living community, or nursing facility. Companies or hospitals may have both a Medicare-certified component as well as a private duty or registry component.

Medicare-certified Agencies deliver “brief and intermittent care” for a maximum of 60 days. Care must be ordered by a doctor. Physicians can renew orders for care whenever they deem it necessary. These agencies are qualified to deliver either skilled nursing care or home support care, which is completed by home health aides. Patients generally receive 1-3 hours of care per day several days a week. The amount and type of care provided will vary depending on the doctor’s specific orders. All Medicare-certified agencies are licensed by their home state and surveyed on a regular basis to ensure that federal quality and safety standards are followed.

When care has not been ordered by a physician, it can be obtained thorough Private Duty Agencies. The amount of care provided can range from round-the-clock or live-in care to companionship services, depending upon the needs and desires of the customer. Private Duty Agencies employ a variety of caregivers and can provide a wide array of services. Caregivers range from nurses to companion care workers, all employees of the agency. Agencies are regulated by their state governments, which enforce strict health and safety requirements.

Home Health Care Registries are much like Private Duty Agencies, except Registries do not employ the workers that are sent to customers’ homes. When you request Home Care Services through a Registry, they will refer an independent contractor to work in your home. As with Private Duty Agencies, the amount and type of care received is entirely up to the customer. Registries can provide services ranging from skilled nursing care to home support care and/or companion style services. Registries are monitored by their state governments to guarantee that they meet stringent health and safety requirements.

Costs of Home Care
Medicare-certified Agencies are reimbursed for their services by the federal Medicare or state Medicaid programs. Private Duty Agencies are generally compensated for their services through private payments. Long-term care insurance may cover some of the costs for Private Duty services; individuals can also use other financing options such as reverse mortgages to pay for care. Services by Registries are also covered by private payments, long-term care insurance, or other financing options.

Home Support Care can be provided by any of the agencies listed above, but must be paid for with private funds unless it is prescribed by a physician and provided by a Medicare-certified Agency. Prices for home support care range from $10-$20 per hour. Most long-term care insurance policies will cover home support care. If you qualify for Medicaid, a government program for low-income individuals, it may pay for some of your home support care needs. Since laws vary from state to state, you will need to contact your local Area Agency on Aging for more information concerning government benefits.

Skilled Nursing Care will be paid for by Medicare as long as it is determined to be “intermittent skilled care,” which includes occupational, respiratory, speech, and physical therapy, and is ordered by a doctor. Individuals who meet income requirements may be eligible to receive skilled nursing services covered by Medicaid. Major medical health insurance will also cover a limited number of skilled home visits. The number of visits covered will depend on your medical diagnosis and your health insurance plan. Costs for these services vary greatly depending upon coverage by Medicare, Medicaid, and private insurance and the degree of services required or purchases are options that should be considered. Assistance provided through the Older Americans Act and delivered by local Area Agencies on Aging includes the cost of some home care services. Individuals are generally asked to contribute to the costs in proportion to their income. Veterans who are at least 50% disabled due to a service-related condition are eligible for home health care provided by the Veterans Administration (VA). Services must be authorized by a physician and provided by one of the VA hospital home care units.

Contact you local Office on Aging or State Department of Health to find out if there are funds from social services block grants available to cover home care costs. Outside community organizations may also cover some or all of the costs of home care. Check with your hospital discharge planner, a social worker, the Area Agency on Aging, or the United Way for more information about resources in your community.

Sources for private payments other than major medical health insurance or long-term care insurance include Medigap insurance, managed care organizations, and CHAMPUS. Medigap is designed to cover the gaps in Medicare coverage. It will generally cover home support care to supplement the skilled nursing services already prescribed by a physician and provided by a Medicare-certified agency. Managed care organizations are group health plans that may cover some home care services; services must always be pre-approved. On a cost-shared basis, CHAMPUS provides skilled nursing services for military retirees, their dependents and survivors, and the dependents of active military personnel.

Finding a Home Care Provider
After determining the type and amount of services needed and the payment options that are available, consumers should begin interviewing potential providers. Choosing a Home Care provider is a highly important and personal decision. Finding a provider that is qualified, reliable, and compassionate is essential to the health and happiness of patients and their families.

While completing this search, keep in mind that home care workers frequently become very close to their patients. The bonds that patients and providers form are natural and beneficial to both parties; however, before allowing a provider to come into their homes, customers should complete thorough research to avoid the negative consequences of unscrupulous providers. Prior to obtaining services from any provider, find out more about how they run their company, their employee policies, and investigate their quality rankings published by the federal government (www.medicare.gov). The questions below are intended to help consumers investigate and interview potential providers.

Questions for Potential Providers:

Is the provider Medicare/Medicaid certified?
If yes, do they also operate a private pay division? (This allows patients that receive skilled care for a limited number of days to continue receiving private pay services from the same provider).

How many years has the provider been in business?

Is the provider associated with a larger health care group or hospital?

Is the provider accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHOP) or by the Community Health Accreditation Program (CHAP)?

Will the agency help you find the best homecare options for you?

Does the provider have a written policy describing the patient’s rights?

Are nurses or therapists required to evaluate the patient’s home care needs? If so, what does this entail? Do they consult the patient’s physicians and family members?

Will the provider give you written information describing how they commence and discontinue services to patients?

What backup does the patient have if their caregiver cannot show up at the scheduled time?

What are the internal complaint procedures?

Will the provider give a list of citations they have received from state surveyors over the past year?

Does the provider have a nursing supervisor on call and available 24 hours per day?

How does this provider select and train its employees? Does it protect its workers with written personnel policies, benefits packages, and malpractice insurance?

What types of reimbursements will the agency accept?

Will the provider give a list of references?

Article adapted and checklist borrowed from the Maryland-National Capital Homecare Association’s (MNCHA) and the National Association for Home Care’s (NAHC) websites. For more information, please visit their websites at www.mncha.org or www.nahc.org.

After over 25 years living and working in the D.C. area, the Arnolds had decided that their ideal retirement included a house on the river, a mountain view, and a lot less traffic. Before retiring, Bruce served as the Technical Director for the Navy Regional Computer Facility. He was responsible for installing communication systems on a world-wide basis.

Some of his more fascinating assignments included the creation of an information management system for the White House situation room in the mid-70s and the installation of a computer-operated communications system for sailors during the Vietnam War. Of the project, he notes, “In the South Pacific, you face a lot of difficulties trying to receive messages in a timely fashion. We had sailors working 12 hour shifts seven days a week, which was a terrible use of human resources. The computer was able to respond more efficiently, and the benefits were obvious.”

After retiring from the government, Bruce spent two more years in private industry. During this time, the couple began their gradual transition to life in the Shenandoah Valley. Linda, a Registered Nurse, who is also a talented designer, supervised work on their new home while Bruce remained in Northern Virginia during the week. She was able to take her time designing and building the house, so that nothing was done abruptly.

Sitting on a slope overlooking the South Fork of the Shenandoah River, the home quickly became the Arnold’s permanent getaway. “Every morning when we are having breakfast, I look down at the river and across at the Blue Ridge Mountains almost touching the river,” says Bruce.

Although just watching the river rumble along may be a tempting past time, the Arnolds continue to work nearly full-time. They have simply shifted their focus to improving their new community. Delivering meals for Food for Friends, a program that provides hot meals to homebound individuals in the Valley, is one of the couple’s many volunteer activities.

As the Chairman of the Board for the Shenandoah Area Agency on Aging, Bruce has dedicated himself to serving the needs of the Valley’s senior population. He points out, “The agency operates two Alzheimer’s respite sites and seven senior centers, which serve congregate meals as well as deliver Meals on Wheels. All of these provide valuable services to individuals who really need assistance.” Additionally, he served as President of the local AARP chapter, which is comprised of other exceptionally active individuals like himself. “At our AARP meeting, we collect the total number of volunteer hours from the small group. They frequently total as many as 400 hours a month,” Bruce recalls.

He concludes, “The spirit of volunteerism is very much alive in this community.” It is this community atmosphere that has made the Shenandoah Valley the perfect retirement destination for the energetic Arnolds. Now, when someone in a passing car throws up their hand, the Arnolds simply smile and wave back.

Of teaching in the Northern Virginia Community College free healthcare network clinics, Mrs. Missett relates, “The clinic system affords us the opportunity to provide excellent nursing care to patients without some of the constraints encountered in more traditional hospital settings. We are able to ‘practice what we preach.’”

When Mrs. Missett’s mother began to suffer from dementia, she decided to move her from her home in Connecticut to Virginia. She knew she would need some assistance, since she was working full-time.

Regina quickly discovered that finding a reliable and trustworthy caregiver is not easy: “My first caregiver was wonderful, but when she quit I had a series of caregivers that I couldn’t rely on. They would show up late if they would show up at all. Some were experienced; others simply were just not qualified,” recalls Mrs. Misset. “I really needed the security of knowing they were going to be there when they said they were and that my mother would be well taken care of while I was at work.”

One of Mrs. Missett’s students recommended Nursing Referral Service (NRS) as a reliable source for caregivers. When she called NRS, Joan Madren, the owner of the company and a Registered Nurse, discussed Mrs. Missett’s needs with her and placed a caregiver in her home within a few days. Mrs. Missett remembers, “The woman they sent out was a jewel; she was knowledgeable and experienced. I really felt comfortable leaving my mother with her.”

Mrs. Missett was so pleased with the services of NRS that she turned to them again when her husband became ill. “I realized that I couldn’t take care of him by myself, and I called NRS again. This time I knew I needed live-in nursing service. NRS had someone moved in and settled in less than two days, and she was wonderful. She assisted me in providing personal care for my husband. Frequently, she helped me out by doing things she was not even required to do,” says Mrs. Missett.

Mrs. Missett was also impressed by the superior level of service provided: “I am a professional, and I knew what I wanted, and I knew how I wanted it done. I have to admit, though, that my caregiver even taught me a few tricks. There are certainly some bad people in the industry, but these caregivers were skilled and reliable.”