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At Home Care

Differences between communal living and at-home care

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Nearly 9 in 10 elderly people want to live at home for as long as possible, according to the AARP.

Why?

There are many reasons why a person might choose to age in place rather than move to an assisted living center or other communal living arrangement: cost, independence and the level of personal care needed all have a role in the decision-making process.

One of the most  obvious reasons why individuals might choose to live at home instead of in a communal facility is that it’s what they’ve always known. Living in their own home is what they’re used to; it’s comfortable. They can sleep in their own bed, use their own kitchen, enjoy the window views they’re familiar with and more. Whether it’s in Lynden, Ferndale, Bellingham, Everson or somewhere else, home is… home.

Related: Is your mom or dad ready for care?

Here are some other simple – but important – reasons why people might want to age in place:

  • Not having to share sleeping spaces. Among the simple benefits of living at home is not having to share a room with other elderly residents. Living at home means more privacy, more individual freedom. An at-home caregiver can provide services in support of the individual’s independence, offering as much or as little care as is desired.
  • Being able to set the heat. Living at home means being in control of your home. It may seem simple to be able to set the heat to one’s desired comfort level, to listen to music (or not) when desired or to turn on or off the lights when needed. But in a communal living environment, those choices aren’t always possible. There’s good reason for that, of course; in an assisted living home, the needs of many people must be met at once. At home, there’s just one person whose needs are most important.
  • Choosing what and when to eat. Communal living offers the convenience of having all meals prepared and served by someone else. That can free up an individual’s time for other activities. However, there’s some loss of choice in that, and many older people choose to have an at-home caregiver help with meal preparation – and even grocery shopping, too – to enable them to retain control over dining options.
  • Maintaining easy access to family and friends. Living at home, there are no restrictions on visiting hours. There is no need to keep voices down, meet in shared spaces or limit who is allowed to visit. Instead, family and friends can continue to visit grandma as they always have – at grandma’s house.

Of course, these aren’t the only things to consider when deciding between aging in place or moving to an assisted living facility. Cost can be a factor, as can the amount of care needed and the ease of completing activities of daily living. For some people, medical or other needs are great enough that moving to an assisted living center is the right choice. For many others, an at-home caregiver can be brought in to provide whatever assistance is needed, extending the amount of time that older people can continue to live at home – which, as we’ve seen, many people want to do.

Related: How can I fulfil mom’s desire to live at home?

Before and after surgery: Why you might need help at home

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Going in for a planned surgery often includes the need to prepare for days ahead of time and to recuperate for days or weeks afterward.

If your mom or dad has a surgery planned that requires a lengthy prep or at-home recuperation period, you’ll want to ensure that they have help with daily needs. Even for surgeries with relatively rapid recovery times, help at home after surgery often is essential. As you prepare for your loved one’s surgery, be sure to talk with the surgeon about expected recovery times and recommendations for post-op care for seniors.

Your mom or dad’s specific needs will depend on the type of surgery involved, but in general there are several reasons why someone might need at-home care before or after surgery in Whatcom County:

Food and medication management: Correctly managing dietary and medication plans during preparations for surgery can be difficult. Often, the instructions can be confusing. Specific plans and timings – eat this food now, fast for this long, take this pill at 6 and that one at 8 – can be challenging for people of all ages to understand and abide by.

Pain management and regulation: After the surgery, the management of pain medication can be difficult – but oh, so important. Your mom, dad or other loved one might be taking medications that could cloud thinking and judgment. Having someone around to help your loved one follow the medication plan and recognize when slight adjustments might need to be made is valuable. This can help prevent overmedication while providing valuable support in managing pain for the first few days.

Getting here and there: Speaking of pain medication and management, it’s important that people who are taking pain medication do not drive. The pain management regimen could go on for days or weeks after the surgery. An at-home assistant can help ensure that the shopping gets done and that the patient has a ride to and from follow-up appointments.

Personal care: Before and especially after surgery, it might be necessary to have someone help with various tasks related to daily living. Assistance might be needed to provide and/or prepare meals, change dressings, fetch ice packs and keep your mom or dad hydrated.

Reducing the likelihood of a return to the hospital: Hiring a caregiver to manage the post-hospital care such as wound dressing, medication management, mobility aid and doctor communication can make all the difference between smooth post-op recovery and a return to the hospital if things go south.

When the elderly must have surgery performed, often they rely on family members to help. But what are they to do if family do not live nearby or are otherwise unable to help? At at-home nursing assistant can provide invaluable support in situations like this. To learn more about how Take My Hand At-Home Care provides help before and after surgery for people in Lynden, Ferndale, Bellingham and throughout Whatcom County, please feel free to give us a call or read this information about our in-home assessments.

Help! I have questions about caring for an aging parent.

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As we’ve mentioned before in previous TMH Client Profiles, at Take My Hand At-Home Care we hear often from adults who are wondering when and how to decide that mom or dad needs a higher level of personal care and attention.

These certainly are not easy decisions to make, and every situation is different. But read on for an example situation that may include elements of what you’re going through. Perhaps it will help you make those important decisions.

Mom is still pretty active. She lives nearby, so sometimes I accompany her to doctor visits in Bellingham or take her shopping, but she typically can do those things just fine on her own.

The other day, when we were working in her garden, she mentioned that she loves her home — she’s lived in the same home in Lynden for 50 years, after all — and doesn’t want to leave. When she eventually needs care, she said, she wants to stay at home. She doesn’t want to be moved to a long-term care center or assisted living facility; she’d rather just stay right at home.

The problem is that I’m not able to spend the time caring for her that probably would be required. I have a family of my own to care for, and I have to go to work every day, too. How can I meet mom’s desires to stay home while also being sure that she’s taken care of? Sometimes it keeps me up at night.

This is a common concern. Adults in the sandwich generation — those who are sandwiched between caring for aging parents and caring for their own young children — often find themselves having to make difficult decisions about how to spend their time and money. Do I sacrifice my family time to spend evenings and weekends caring for mom? Do I dip into our family savings to pay for upgrades to mom’s home so she can age in place? How do I even know when mom is ready for extra assistance around the home?

No single solution is a perfect fit for every family here in Whatcom County. However, there are some good options for adult children in situations like this to consider:

  • Set up a consultation with a home care provider to discuss your situation. A trained provider with experience in at-home care situations can take a look at your loved one’s situations and offer personalized advice. Take My Hand offers complimentary in-home assessments for folks in Lynden, Ferndale, Bellingham and throughout Whatcom County.
  • Ask an at-home care provider for part-time shifts to cover basic needs. This would help your mom or dad get used to the idea of having people other than family members in the home. Plus, part-time home care would help set a baseline for the care needed. At-home care situations can be new for everyone, and starting off slowly is often a good idea.
  • Caregivers like us are fond of saying that the best caregivers are those who are able to care for themselves and meet their own needs. Honestly, that’s critically important. If you, as a family caregiver, are constantly giving and never receiving, you’re going to run your own batteries so low that you won’t be able to help anyone. Please know that your family — spouse, kids, yourself — needs and deserves your attention, so don’t feel guilty if you can’t be with your aging parent as much as they might like.
  • Independence and self-sufficiency are good things for older adults. We try to keep them from becoming reliant on outside help too early; if they can do something for themselves, let them and encourage them! Of course, pay close attention to signs that they might need extra help — increasing bouts of forgetfulness, difficulty getting around, declining eyesight, lack of ability to process and understand doctors’ orders, etc. — and step in when necessary, but don’t feel obligated to help just because your parents are getting older.
  • Now is a great time to start considering payment options for long-term care. You never know what you might need in the future, and how much it might cost. Consider your family financial situation and the amount of money mom and dad have saved up and start investigating options that might work for you. Long-term care insurance can be a good choice, as can Medicare and private-pay options.

If you’d like to have a discussion about any of these aspects of eldercare in Whatcom County, please feel free to give us a call or send an email.

Providing care to elders at home during COVID-19

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Dear clients, family members and loved ones,

During this time of distancing, we at Take My Hand At-Home Care wanted to let you know that you’re on our minds, even if we’re not able to see some of you in person right now.

We are still caring for our wonderful clients in their own homes, of course, and it’s to that end that we wanted to share important information about limiting the spread of COVID-19 in our vulnerable communities.

Everyone has a part to play in managing public health threats such as this one. Older populations are particularly at risk from this new coronavirus — and from many other viruses as well.

According to the Centers for Disease Control and Prevention, older adults and people who have severe chronic medical conditions such as heart, lung or kidney disease appear to be at higher risk for more serious COVID-19 illness.

That is why Take My Hand has outfitted all of our caregivers with gloves and masks to wear while they are providing care. We also are carefully monitoring staff for potential signs of illness and ensuring that those who are feeling sick are staying home.

When TMH representatives drop off supplies for clients and caregivers, we are leaving them at the door to minimize physical proximity.

Take My Hand caregivers continue to work as hard as possible to meet all client needs in light of the current healthcare crisis, which is affecting everyone not only here in Whatcom County but around the world.

We ask that you continue to keep us in your thoughts and prayers as we fight the spread of this disease together. If you would like to help in other ways, too, we would appreciate donations of thermometers, gloves and masks. If you would like to make a donation, please reach out to us at 360-543-5777 or sue@takemyhandathome.com. Thank you so much!

In light of the ongoing COVID-19 situation, here are some things you can do to connect with your loved ones even during times of physical isolation:

  • Conduct video chats. For those who are familiar with the technology, a face-to-face video chat via FaceTime, Hangouts or Facebook could be a wonderful way to stay connected. You could share a virtual meal, hold an online book club or play a game together. Think outside the box!
  • Make phone calls. Consider setting up a schedule in which various family members are assigned certain days or times to pick up the phone and call elderly loved ones. These moments can be precious personal times that everyone is able to look forward to.
  • Have packages delivered. During the current “stay at home” order in Washington state, online ordering is still an option. Consider having packages of gifts or home essentials delivered via Amazon or some other service.
  • Visit through the window. As long as you are observing social distancing guidelines, it’s still OK to go outside. Consider dropping by your loved one’s house and visiting through the window. Maybe tape a note or photo to the outside of a window for your loved one to read. Sing a treasured song or hymn, play a musical instrument, juggle… there are so many possibilities!

Thank you for trusting Take My Hand At-Home Care with your needs! It is an honor to serve you. We will get through this together if we all continue to do our part.

How to help widowers connect with others and find new purpose in life

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Elderly man in a sailboat on the water

Imagine one day losing the spouse you’ve had for decades.

Having lived with the same person for most of your life, the loss would be phenomenal. Not only would you lose the love of your life, you’d also need to start doing everything on your own — cooking, cleaning, grocery shopping, visiting the doctor… the list goes on.

Elderly man in a jacket sitting and looking at the camera

You’d also lose a social connection and a major reason to stay involved with others in your community. Without your spouse at your side, you’d be less likely to attend events, go out for meals and travel.

Here at Take My Hand At-Home Care, we have come across numerous situations just like this. Losing a spouse later in life happens quite frequently to senior citizens in the Whatcom County community.

Not only must widows or widowers deal with the loss of a loved one, but they also must cope with major lifestyle changes. They lose the person with whom they used to watch TV or go on walks. They lose the person who used to remind them to take their medications; they lose the person who used to help them plan fun things to do. They lose their social connections.

These are all real consequences of losing a long-time partner, and the effects can be drastic.

Loneliness after the death of a spouse

According to the National Institute on Aging, social isolation and loneliness are linked to increased risks for high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease and even death.

“Losing a sense of connection and community changes a person’s perception of the world,” according to the NIA. And it’s not just perception. Biological defense mechanisms are activated in those who experience chronic loneliness because they feel threatened and mistrustful.

While older women are more likely than men to report being lonely, the effects of loneliness can be more drastic in older men, who are more likely than women to be depressed and suicidal when lonely, according to a recent study published in the American Journal of Men’s Health.

How to help people stay connected to life after loss

What can change someone’s outlook after loss?

Being social provides an enormous benefit, as does having another person around to provide support and motivation or to offer assistance with daily tasks of living. In particular, men benefit from having purpose in life, according to the AJMH study, which notes that improvements in mental health and purpose in life can help reduce loneliness — and thus reduce many of its negative consequences — in older men.

Elderly man taking photos outdoors, with mountains in the background

Pursuing hobbies and other passions is one great option for combating the consequences of loneliness. Joining a senior center, too, can help the elderly make new friends and find new hobbies. Those who have experienced recent loss might also benefit from having their family and friends take them to activities and events, or even just pick up the phone and invite them to dinner.

Help at home: An out-of-the-box gift idea that can make a difference

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Approximately 85 percent of caregivers in the United States provide care for a family member or other loved one — mother, father, child, friend, grandparent — and spend, on average, between 24 and 40 hours per week at the task. And that’s often in addition to trying to hold down a job or take charge of other responsibilities.

It’s a lot of work.

Do you have a family caregiver? Or do you know someone (a husband or wife, maybe, or a devoted child) who provides care for an aging loved one in Whatcom County?

That caregiver needs recurring breaks.

The day that a family caregiver can take a break is the day he can go into Lynden for Bible study. It’s the day she can get her hair done at her favorite place in Ferndale. It’s the day he or she can head into Bellingham and knock out all of the shopping and errands for the next couple of weeks, relieving a giant stress.

The night that a family caregiver gets a break is the night he or she can finally get some sleep, free of the stress of worrying about caring for an elderly loved one.

This holiday season, consider the immense blessing that the gift of a day off can bring. Time away from the stress and pressures of work is an important part of self-care for family caregivers.

It’s not uncommon for caregivers to experience burnout, stress, depression and high blood pressure. And the list certainly doesn’t stop there. Family caregivers do their work because they are committed to do it; they made a promise to the person they’re caring for, and they want that person — their husband or wife or mom or dad or brother or sister – to know they will be well cared for.

But commitment doesn’t make the work of caregiving easier. That doesn’t keep feelings of guilt, anger or resentment from occasionally toppling a caregiver’s sense of serenity or purpose. When a person is caring for a spouse, the relationship sometimes changes from experiencing shared joys and intimacy to taking care of someone in need of constant attention. Sometimes, that person has dementia, and the caregiver must bear the burden of watching their loved one slowly disappear.

That caregiver needs a break.

This Christmas, consider who in your life needs a day away from the burdens of caregiving. One eight-hour shift per week — or even every other week — could provide enormous relief for a family caregiver. Maybe this person is someone caring for you, or maybe it’s a sibling caring for your mom or dad. No matter who it is who could use temporary respite, the gift of regular caregiving assistance will continue to pay dividends all year long for Bellingham, Nooksack Valley, Ferndale and Lynden family caregivers.

Take My Hand At-Home Care provides a range of respite and caregiving services for individuals and families throughout Whatcom County — from 24-hour live-in care to part-time caregiving assistance a few days per month. These services allow people who need a preliminary form of assisted living to remain living at home, and they allow family caregivers the break they need to  recharge.

Eldercare: Paratransit vs. private transportation

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The bus rolled up outside her home. The driver engaged the wheelchair lift and helped her maneuver to the sidewalk. He was so helpful! As she rolled toward her home, she eyed the temporary ramp leading to the front door. It was starting rain; she was nervous about navigating that ramp on her own.

Thankfully, she had arranged for a private caregiver to be there to help her get up that ramp and settled into her home. The friendly caregiver was walking toward her now and greeting her by name. What a relief!

The benefits of paratransit services

Paratransit from Whatcom Transportation Authority is a fantastic service at a great price (just $1 per ride, generally). They help many, many people move around Whatcom County, including the elderly, disabled and those with mobility challenges.

To be eligible for paratransit rides, an application needs to be submitted to the transit operator. Riders (or their representatives) may be able to take part in a phone interview as an alternative. Either way, the paratransit operator will need to know why the rider is unable to ride buses on existing fixed routes throughout Whatcom County.

Signing up for paratransit can be a fairly easy process, and WTA does a nice job providing this service in our community.

Shared transportation is not always a good fit

Sometimes, however, public transportation does not line up with the needs of a rider.

For example, paratransit services generally mirror the times and locations of fixed routes, so riders may not be able to use the service on their schedule or at the time they need if they’re in an unserved part of the county or if it’s early or late in the day. Those living in rural areas of Whatcom County may find it a challenge to use paratransit services on certain days of the week.

Another item to note is that paratransit trips are shared with other riders. Transit operators schedule their daily service routes to include picking up and dropping off people along a certain route. They work to include the time it takes to load passengers who use mobility devices and the time it takes to wait through unforeseen traffic.

For a 1 p.m. appointment, for example, the bus may need to pick the rider up at 11:30 a.m. or noon to account for other stops along the route. That’s totally understandable; that’s how public transportation works.

Due to bus rides that may be 45 minutes or longer, using public transportation can be difficult for older adults with a variety of health conditions, such as joint stiffness and bladder issues.

An alternative for paratransit in Whatcom County

For those looking for an alternative to paratransit, caregivers from Take My Hand At-Home Care can be hired to provide personal transportation that gets older adults and disabled individuals from door to door — inside a doctor’s office and inside their home (settled in, even) — on a schedule that works for them.

Hiring a caregiver to provide private transportation is an efficient, worry-free way to be transported to many places, such as social outings, family events and medical appointments.

Licensed caregiver companions can even sit in on doctor’s appointments and relay info to family members who could not be present. They can ask questions on behalf of the patient and advocate on their behalf. This is a great option for adult children who are trying to help their parent while residing in another city or state.

The benefits of hiring private transportation

No long periods of waiting. No concern about being too early or late for appointments. No worrying about making it through a long bus ride without access to a restroom. No wondering about managing mobility challenges into the home. The benefits are many!

If you have loved ones living in Lynden, Bellingham, Ferndale or somewhere else in Whatcom County, and if they would benefit from personal transportation and help from a part-time caregiver – maybe because they’re recovering from surgery, or maybe because they’re older and need assistance getting around – please connect them with Take My Hand At-Home Care.

The value of a little help at home

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An elderly woman looks at a large collection of flowers under a green and white tent.
At-home care can free us up to do the things we love, like browse the gorgeous flowers at the farmers’ market.

As we age, it can be common for us to start to scale back our activities.

After all, many of the things we’re used to doing — whether the activities we do for fun or the stuff of daily life — can become more difficult as our bodies and minds start to slow down.

Driving is harder, doing laundry is harder, gardening is harder, walking from point A to point B is harder, finding the motivation to exercise is harder, shopping is harder…

None of these things is impossible, of course — they’re all just a bit more difficult than they have been. Under these circumstances, our worlds can get smaller and less active.

That’s where a little at-home assistance really can be a great service. A little help around the house can be an enormous relief; having a caregiver companion stop by two to three times per week can really help seniors LIVE their lives.

Learn more: How Take My Hand helps Lynden senior Bernadette Millar live a full life.

In essence, having a little help around the home can actually increase a elderly individual’s independence.

That’s an important point to note, because one concern we hear occasionally here at Take My Hand At-Home Care is that caregivers can be limiting for an elderly person’s lifestyle. In fact, the eldery sometimes think that when their family recommends a caregiver, the goal is to take away their independence.

In truth, your family is not trying to take your independence away, they are trying to help you LIVE and enjoy what you have. If your loved ones are resistant to care, here are a few tips to help continue the conversation.

Learn more: How to tell whether your mom or dad is ready for at-home care.

A part-time caregiver at home can help you pursue your passions. A caregiver can help give you time, energy and drive to pursue health long into the future. In-home support can be an activity companion, working with you on fun activities that help maintain brain health. And with the holidays coming up soon, don’t overlook the many ways a caregiver can help with the Thanksgiving and Christmas prep and festivities.

To learn more about how Take My Hand At-Home Care can provide help for you or an elderly loved one, just give us a call or send a message online. Our experienced care providers are standing by to help!

‘We all need others in our lives’

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[ Editor’s note: Originally published in the Lynden Tribune ]

Bernadette Millar, center, gets everyday help and also socializing with Heidi Sorensen and Sue Sorensen. Photo by Laura Place/Lynden Tribune.

For Lynden senior Bernadette Millar, meeting with her caretaker Heidi Sorensen each week not only helps her with her everyday tasks, but provides a sense of companionship. Sometimes the two go shopping together, or Heidi helps Bernadette with her bills and appointments.

Bernadette has been meeting regularly with Heidi for three years now, after being connected to the in-home care service of Take My Hand of Lynden following a visit from her son and daughter-in-law. Those relatives made the initial connection to Take My Hand, and owner Sue Sorensen (Heidi’s mother-in-law) reached out to Bernadette directly.

“I didn’t call her — she called me,” Bernadette recalled. “It came right at the right time.”

Bernadette stopped being able to drive herself around a few years ago after a bad fall that resulted in nerve damage. She said the loss of the ability to drive a vehicle was devastating, but now being able to go to the places she needs to go and get out of her condo every once in a while with Heidi gives her something to look forward to.

The care service offers assistance to seniors with various tasks based on their needs, such as taking medication, scheduling appointments and going on errands. Or, as in Bernadette’s case, the client and caretaker will just go and enjoy coffee together.

“We do everything, from companionship to end-of-life care,” Sue Sorensen said.

For Bernadette, it’s a gift to be able to get out of the house with Heidi and know all of her appointments and bills are organized. Just as important, Sue points out, is having someone to laugh with. Sitting in Woods Coffee at Bender Plaza on a Friday outing, Bernadette and Heidi laugh together about Bernadette’s favorite saying, “Can’t be bothered.”

“I thought it was ‘think positively’?” Heidi asks.

“I’m always positive!” Bernadette says back, smiling.

This companionship from a caretaker can help to combat some of the isolation and loneliness experienced by many senior citizens, making it one of the most important aspects of the service offered by Take My Hand, Sue Sorensen said. Even just going on outings a couple of times a week gives clients something to look forward to.

“It’s a big deal for them, to get out of the house,” Sorensen said of the clients who are assisted by Take My Hand. “We all want to be independent, but we all need others in our lives.”

Take My Hand At-Home Care can be reached at 360-543-5777 and online at takemyhandathome.com.

So, your parents have refused help. Now what?

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As our parents and other elderly loved ones age, it’s common for us to increase in concern for their well-being. Perhaps we’re nervous about their ability to drive safely, or we’re careful to ensure that they attend all necessary appointments with their doctor.

Our concern is one of the biggest reasons we begin suggesting that our parents start thinking of assistance — we want to be sure they get needed at-home help with daily tasks, or we want them to live in a place where their needs are attended to on a regular basis.

But what can we do if they refuse help? It’s true that many of our elderly loved ones reject the idea of care, wanting to remain independent, to save on the cost of assistance, or for some other reason.

Here are a few tips that may help when you have “the talk” with your loved ones about care:

Listen and try to see things from their perspective. Aging can be scary. Having to rely on others can be frightening. Your loved one might be anxious about feeling helpless or guilty about being a burden to others. Take time to listen to their concerns and try to empathize with how they feel.

Patiently discuss what help around the home might look like. It may help to look at specific aspects of life with your loved one and discuss how things might be improved with good assistance. The elderly often don’t realize that they’re ready for assistance until they’re able to understand how at-home care can help them accomplish important daily or weekly tasks.

Gently suggest that your loved one might appreciate help doing the weekly shopping, picking up prescriptions, cleaning the house or getting out of the house for a walk now and then. People can reject having decisions made for them. Discuss the many options available to your parents — from occasional care in the comfort of home to full-time care in an assisted living center — and try to let them decide for themselves where in that range they might be.

Regarding at-home care, it’s good to remember that it can be adjusted to the needs of the individual, so it can be as involved (or not) as necessary. Say a loved one doesn’t want assistance because he or she feels it will be too restricting. At-home care can actually increase a person’s freedom by freeing them up to do what they love, and/or assist them in it.

Learn more: Is your mom or dad ready for care?

Share your concerns and discuss various healthcare options. Here is where you can share specific areas of concern that you have for your loved one. Often, hearing about this concern from a beloved child or friend can have a big impact. If you’ve been the primary caregiver but no longer have the time or energy you used to, mention that you would like to bring in other caregivers to help out.

This could be a good way to ease into the conversation about other types of care down the road, too. If you’re able to chat casually about future healthcare decisions before they’re imminent, you’ll all be much more ready to have that talk when it does come.

Learn more: The benefits of at-home care

Get advice from an outside expert. In our in-home consultations, we try to understand what’s best for each client, even if it means that caregivers from Take My Hand won’t be involved. If you’d like to learn more, please reach out. We would be happy to help explain the best next steps to your reluctant loved one.

Differences between communal living and at-home care

Nearly 9 in 10 elderly people want to live at home for as long as possible, according to the AARP. Why? There are many reasons why a person might choose to age in place rather than move to an assisted living center or other communal living arrangement: cost, independence and the level of personal care needed all have a role in the decision-making process. One of the most  obvious … [Read More...]

ABOUT US

Sue Sorensen became involved with Whatcom County eldercare and aging-in-place services in 2009. She launched Take My Hand At-Home Care in January 2012 … Read More...

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Fax: 360-255-7564
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