Senior care coordination, also called care management or aging life care, is professional help organizing an older adult’s care when it has become too complicated for the family to manage alone. A care manager, usually a nurse or social worker, assesses the situation, builds a plan, coordinates doctors, facilities, and in-home help, and advocates for the senior when things go wrong. Most families do not need one. It is worth considering when there are multiple doctors and diagnoses, a crisis or hospital discharge, family members who disagree or live far away, or a big decision such as moving to assisted living. In Southwest Florida, many families start with free help, such as a physician’s office, a hospital case manager, or the Elder Helpline, and hire a private care manager when the situation calls for more.
What a senior care coordinator or care manager does
- Assessment: an in-home review of health, safety, medications, finances, support, and what the senior wants.
- A care plan: clear recommendations for what is needed now and what to plan for next.
- Coordination: scheduling and following up with physicians, specialists, pharmacies, home health, hospice, and private caregivers.
- Advocacy: attending appointments and care conferences, pushing for answers at a hospital or facility, and making sure the senior’s wishes are heard.
- Crisis help: a fall, a hospital admission, or a sudden decline, especially when family is out of state.
- Placement guidance: helping compare assisted living, memory care, and skilled nursing options when staying home is no longer workable.
- Family communication: a neutral professional voice when siblings disagree, and regular updates for family who live far away.
When is care coordination worth it?
With a little help from a private caregiver, many seniors stay independent at home without a care manager. Consider adding one when:
- Your loved one sees several doctors, takes many medications, and nobody has the full picture.
- There has been a hospital stay, rehab stay, or repeated trips to the ER.
- Dementia is progressing and decisions are getting harder.
- The main family caregiver lives out of state, works full time, or is burning out.
- Family members disagree about what should happen next.
- You are deciding between staying home with more help and moving to a facility.
- There are concerns about money being mismanaged or someone taking advantage.
Free and low-cost care coordination in Southwest Florida
Before hiring privately, check what is already available:
- The senior’s physician’s office. Many primary care practices offer care coordination, and Medicare covers chronic care management services for patients with two or more chronic conditions. Ask the office whether they offer it. For doctors who come to the home, see our guide to house call and concierge physicians.
- Hospital and rehab case managers. Before any discharge, ask to meet with the case manager or discharge planner about home care, equipment, and follow-up. See our hospital and rehab support.
- The Elder Helpline, 866-413-5337. Run by the Area Agency on Aging for Southwest Florida, it is the starting point for Medicaid long-term care screening, SHINE Medicare counseling, and caregiver programs.
- 211. For food, transportation, utility, and other community help, see our guide to Lee County United Way 211.
- Veterans benefits. The VA offers caregiver support and the Aid and Attendance pension, which can help pay for care at home.
- Hospice. If your loved one qualifies, the hospice team includes a nurse and social worker who coordinate much of this. See hospice caregiver support.
How to find and choose a private care manager
Florida does not issue a separate license for care managers, so the background of the person matters. Look for:
- A professional license, such as a registered nurse (RN) or licensed clinical social worker (LCSW), which you can verify through the Florida Department of Health license lookup.
- Professional credentials or membership, such as Care Manager Certified (CMC) through the National Academy of Certified Care Managers, or membership in the Aging Life Care Association, which has a searchable directory and a Florida chapter.
- Local experience with Lee, Collier, or Charlotte County hospitals, physicians, and facilities.
- Clear fees in writing. Private care management is usually billed hourly, often with a separate initial assessment fee. Medicare generally does not pay for private care management; some long-term care insurance policies may.
- How they handle referrals. Ask whether they receive anything from facilities or providers they recommend.
For legal and financial questions, such as guardianship, powers of attorney, or Medicaid planning, a Florida elder law attorney is the right professional, and many work closely with care managers. When you contact any care manager, attorney, or program, let them know Abby Services referred you.
Local nurse, local advocate: how Abby Services fits in
A care plan is only as good as the help that shows up to carry it out. Care managers across Southwest Florida often recommend private caregivers for exactly that, and many of our families have both: a care manager who organizes the big picture and a caregiver who is there every day.
Abby Services is a nurse-owned, state-licensed nurse registry in Fort Myers. Our RN, Scott Strachan, has worked with Southwest Florida seniors and families since 1997 and is available to talk through your situation, including whether a care manager makes sense for you. We match families across Lee, Collier, and Charlotte Counties with screened, credentialed private caregivers who are independently employed and directed by the client, from companion care a few hours a week to live-in and 24-hour care, including Alzheimer’s and dementia support. See how a Florida nurse registry works and the cost of in-home care.
Call 239-590-0861 or tell us what you need online. If the family caregiver is running on empty, our guide to respite care and caregiver burnout can help.
Frequently asked questions
What is senior care coordination?
Senior care coordination, or care management, is professional help assessing an older adult’s needs, creating a care plan, and coordinating doctors, services, facilities, and in-home care. Care managers are usually nurses or social workers and also advocate for the senior with providers and facilities.
Does Medicare pay for a care manager?
Medicare generally does not pay for a private care manager. It does cover chronic care management services billed by a physician’s office for patients with two or more chronic conditions, and hospital and hospice teams include case managers. Some long-term care insurance policies may cover private care management.
When should a family hire a care manager?
Consider a care manager when there are multiple doctors and medications, a recent hospitalization, progressing dementia, family who live far away or disagree, or a decision about moving to assisted living or memory care.
How do I find a care manager in Fort Myers or Naples?
Search the Aging Life Care Association directory, ask your loved one’s physician or hospital case manager for names, or call the Elder Helpline at 866-413-5337. Look for a licensed RN or social worker with local experience and ask for fees in writing.
What is the difference between a care manager and a caregiver?
A care manager plans, coordinates, and advocates, usually a few hours a month. A caregiver provides the hands-on help every day, such as companionship, meals, bathing, and getting to appointments. Many families use both.
Sources
- Aging Life Care Association
- Area Agency on Aging for Southwest Florida
- CMS — Chronic Care Management Services
In Home Assistance For Seniors: Making The Bed
So you need in home assistance for seniors? Making the bed is an important task.
It is national make your bed day. Yes, we get it, not something everyone gets excited about. However, did you know that we spend about a third of our lives in bed? This is especially obvious for patients who may be bed bound or have limited ability to make their bed. That’s why in home assistance for seniors is so important.
It doesn’t seem like much. Making your bed is something that many of us take for granted on a daily basis. It is only when you are unable to independently complete this once simple task that the importance becomes obvious. That is why finding a service that can refer reliable caregivers who can assist with in home assistance for seniors is imperative.
Abby Services has been helping local Fort Myers residents maintain their independence by helping to find reliable, safe caregivers. With an Abby private in-home caregiver you or your loved one can receive the help and support desired to remain independent and in your home. Your private caregiver can help make the bed and so much more.
In-home assistance plays a vital role in supporting individuals who may require help with various daily tasks, and among these tasks, the act of making your bed holds particular importance. While it may appear as a simple chore, the act of making your bed can have a profound impact on your overall well-being and the environment of your living space.
First and foremost, making your bed sets a positive tone for the rest of the day. It creates a sense of accomplishment and order right from the beginning, which can have a positive ripple effect on your mindset and productivity throughout the day. By completing this small task in the morning, you start your day with a sense of achievement and a proactive mindset. It provides a psychological boost, enhancing your motivation to tackle other tasks and challenges that lie ahead.
Furthermore, making your bed contributes to the overall aesthetics of your bedroom and living space. A neatly arranged bed not only creates a visually pleasing environment but also helps to establish a sense of calm and organization. Coming back to a well-made bed at the end of a long day can be incredibly comforting and can contribute to a peaceful and restful sleep. It signals to your brain that it’s time for relaxation, allowing you to unwind and recharge for the next day.
In the context of in-home assistance, caregivers understand the importance of supporting individuals in maintaining a tidy living space. They recognize that bedmaking goes beyond mere aesthetics and can significantly impact their clients’ physical and mental well-being. In-home assistants can provide the necessary support and guidance to ensure that their clients’ beds are properly made, taking into account any specific requirements or preferences.
For individuals who may have physical limitations or health issues, in-home assistance with bedmaking becomes even more crucial. Caregivers can help individuals with mobility challenges or chronic conditions that make bedmaking difficult. By assisting with this task, they promote independence and improve the overall quality of life for their clients.
In conclusion, in-home assistance plays a pivotal role in supporting individuals with their daily tasks, and bedmaking stands out as an essential activity. Beyond its aesthetic value, making your bed sets a positive tone for the day, contributes to a sense of accomplishment, and promotes good sleep hygiene. In-home caregivers recognize the significance of bedmaking and provide invaluable support to ensure their clients can enjoy a comfortable and organized living environment.
To find out how we can assist you can today 239-590-0861!
You need in-home care when someone can no longer manage daily life safely on their own. The clearest signs are a fall or close call, unexplained weight loss or bruising, declining hygiene or housekeeping, missed medications, dents in the car, unpaid bills, and withdrawal from friends and activities. One sign alone may not mean much. Several together mean it is time to get help. The good news: recognizing it early usually means a few hours of support per week, not a move out of the home.
As we age, there are times we need more support than we can provide ourselves, and conditions like Alzheimer’s, dementia, Parkinson’s, and decreased mobility can significantly affect someone’s ability to remain safely independent. In the past, the only option for many was a nursing home. Today, in-home care lets you remain at home and in control of your living environment, with services available on a schedule you choose and manage.
As a Registered Nurse who has worked with Southwest Florida families since 1997, here are the 14 signs I tell families to watch for.
1. Missed Meetings, Appointments, and Obligations
What you might notice: Missed doctor visits, forgotten lunches with friends, birthdays that slip by, or a calendar that hasn’t been touched in weeks.
Why it matters: Missed obligations are often one of the first visible signs of memory loss. Sometimes they signal something else, like embarrassment about difficulty walking, hearing or driving.
It rarely happens all at once
Alzheimer’s is progressive. It develops slowly, often over many years. People are remarkably good at compensating: keeping lists, leaning on a spouse, quietly avoiding situations that expose the gaps. Then they reach a point where they can no longer compensate, and to the family it seems to happen all of a sudden, when it has really been building for years. Missed appointments are often one of the first visible cracks.
Scott Strachan, RN, BSN
How a caregiver can help: A caregiver can keep the calendar, offer reminders, and get your loved one to appointments and social activities, so small slips don’t turn into missed care.
2. Difficulty Standing on Their Own
What you might notice: Pushing off furniture to get up, several tries to rise from a chair, holding onto walls, or avoiding getting up at all.
Why it matters: It’s easy to blame arthritis or stiff joints, but trouble standing is one of the strongest predictors of a fall. A parent who can’t get up alone could be stuck on the floor for hours.
What a fall can really mean
I saw this firsthand working in the ICU at Lee Health. When older adults fall, the injuries can be significant, and some never fully recover. A little help with standing, walking and getting to the bathroom can prevent the fall that changes everything.
I also served on the board of the Lee County Injury Prevention Coalition, which led local efforts to prevent falls in the home through its Step WiseLee program. Today, the coalition and the Lee Health Trauma Center continue that work through Step Smart, a community fall-prevention initiative.
Scott Strachan, RN, BSN
How a caregiver can help: A caregiver can help with standing, walking, bathing and getting to the bathroom safely, the moments when most falls happen at home.
3. Unexplained Bruising or Wounds
What you might notice: Bruises, scrapes or skin tears your loved one can’t explain, or brushes off as nothing.
Why it matters: Unexplained injuries usually mean falls or near-falls that no one is reporting. According to the CDC, more than one in four adults over 65 falls each year, and one fall often leads to another. Falls send older adults to the emergency room about 4.5 million times a year and are the most common cause of traumatic brain injury in older adults.
How a caregiver can help: A caregiver can help with the activities that lead to falls, notice new injuries early, and let the family know so the cause can be addressed.
4. A Neglected Home or Self-Neglect
What you might notice: “Dad used to be so meticulous.” Trash piling up, expired food in the refrigerator, laundry undone, or a parent who has stopped showering or shaving.
Why it matters: Rotten food can mean your parent isn’t eating. Poor hygiene raises the risk of infection and skin breakdown, and both can point to memory changes or trouble moving around.
How a caregiver can help: A caregiver can help with bathing and personal care, light housekeeping, laundry and keeping the kitchen safe, so your loved one can stay comfortable at home.
5. Forgetfulness
What you might notice: Repeating the same questions or stories, the stove left on, doors left unlocked, or important things forgotten that never used to be.
Why it matters: Everyone forgets now and then. Forgetting things that affect safety is different, and it can be an early symptom of Alzheimer’s or another dementia.
How a caregiver can help: A caregiver can be a steady presence in the home, help with daily routines, and keep an eye on safety. Ask about caregivers experienced with memory care.
6. Confusion
What you might notice: Getting lost on a familiar drive, mixing up days or times, struggling with familiar tasks, or becoming frustrated or angry more easily.
Why it matters: Confusion is not the same as forgetfulness. It affects judgment and decision-making, and it can come on suddenly with an infection or medication change, so mention it to their doctor right away.
How a caregiver can help: A calm, familiar caregiver can help with daily routines, reduce stressful situations, and support your loved one through the day.
7. Incontinence
What you might notice: Accidents, soiled clothing or bedding, a lingering odor, or a loved one who has started avoiding outings.
Why it matters: Incontinence is often hidden out of embarrassment. It can lead to skin problems, infections and falls from rushing to the bathroom, and it is one of the biggest reasons people pull away socially.
How a caregiver can help: A caregiver can help set up a regular bathroom routine, with reminders and help getting there in time, which prevents many accidents before they happen. When accidents do occur, a caregiver can help with toileting, hygiene and laundry discreetly and respectfully, protecting your loved one’s dignity.
8. Difficulty Managing Finances
What you might notice: Unopened mail piling up, late notices, bounced checks, unusual withdrawals, new “friends” or callers asking for money, or sudden interest in sweepstakes and investments.
Why it matters: Memory changes often show up in finances first, and older adults are frequent targets of scams and financial exploitation.
What helps: Set up bank alerts and a trusted contact on their accounts, consider a durable power of attorney while your parent can still sign one, and review statements together regularly. A caregiver doesn’t manage money, but a regular visitor in the home is often the first to notice changes in mail, calls or visitors, and can let the family know.
9. Social Isolation
What you might notice: Fewer phone calls, skipped clubs or church, a parent who rarely leaves the house, or who says there’s “no point” in going out.
Why it matters: Isolation is linked to depression, cognitive decline and poorer health. It often builds quietly after a spouse dies or driving stops.
How a caregiver can help: Companion care gives your loved one regular conversation and company, plus rides to the activities and people that matter to them.
10. Weight Changes
What you might notice: Clothes fitting differently, an empty or overstocked refrigerator, the same few foods over and over, or meals that go uneaten.
Why it matters: Unexplained weight loss or gain can mean trouble shopping and cooking, forgetting meals, or eating for comfort. Poor nutrition weakens muscles and raises fall risk.
How a caregiver can help: A caregiver can help plan, shop for and prepare healthy meals, share mealtimes, and package extras for later.
11. Auto Accidents or Vehicle Damage
What you might notice: New dents and scrapes, close calls, getting lost while driving, or a parent who suddenly avoids driving at night.
Why it matters: Unsafe driving puts your loved one and everyone else on the road at risk. Because losing the car feels like losing independence, many seniors hide driving trouble. In Florida, you can report a driver for a medical review, anonymously if you choose, which is often the kindest approach. Our guide to senior transportation services covers local alternatives.
We saw this firsthand working with the Lee County Sheriff’s Office through the CarFit program, which helps older drivers check how well their vehicle fits them, from seat and mirror position to how easily they reach the pedals. Small adjustments can make driving safer, and a check like this can also open an honest conversation about when it may be time to stop driving.
Scott Strachan, RN, BSN
How a caregiver can help: A caregiver can drive your loved one to appointments, errands and social activities, so giving up the keys doesn’t mean giving up their life.
12. Difficulty Managing Medications
What you might notice: Full bottles that should be empty, pills on the floor, doubled or missed doses, or confusion about what each pill is for.
Why it matters: According to Georgetown University’s Health Policy Institute, most older adults fill between 9 and 13 prescriptions each year. Missed or doubled doses are among the most dangerous signs on this list.
How a caregiver can help: A caregiver can provide medication reminders at the right times and let the family know when doses are missed or refused.
13. Depression
What you might notice: Persistent sadness, loss of interest in hobbies, sleeping much more or less, or comments about being a burden.
Why it matters: Depression is common after loss, illness or isolation, but it is not a normal part of aging, and it can make other health problems worse. Encourage a conversation with their doctor.
How a caregiver can help: A caregiver can offer companionship, encourage activity and routine, and help your loved one get out and stay connected. A caregiver is also another set of eyes and ears, keeping the family informed about your loved one’s mood, needs, and any signs that more support may be needed.
14. Wandering
What you might notice: Leaving home at odd hours, getting lost on a familiar walk, or trying to go “home” while already at home.
Why it matters: Wandering is one of the most dangerous symptoms of Alzheimer’s and dementia. A person who wanders can be lost or injured within minutes.
How a caregiver can help: Caregivers experienced in dementia care can keep watch, offer structure and gently redirect. Overnight or 24-hour care may be the safest choice once wandering starts.
The Sign Families Miss: Their Own Exhaustion
Sometimes the clearest sign is not in your parent’s home, it is in the mirror. If a spouse or adult child is providing daily care and running on empty, that is a need for in-home care too. A caregiver covering even a few respite visits a week protects the family caregiver’s health and keeps the whole arrangement sustainable. We cover this in our guide to recognizing and managing caregiver burnout.
What to Do Next
Choosing to hire an in-home caregiver for an aging parent is difficult, and recognizing when it is time to call for extra help is the important first step. Many families wait until a serious accident or hospitalization forces the decision. A proactive approach helps avoid serious injury, the expense of an extended hospital stay, and a prolonged rehab stay. If your loved one is already facing a discharge, arranging hospital and rehab discharge support for the transition is one of the most effective ways to prevent a readmission.
The National Institute on Aging notes that most older adults prefer to age in place, and in-home care exists to make that possible. Most families start small: a caregiver a few mornings a week for bathing, meals, errands, and companion and personal support care. Your caregiver can assist with activities of daily living including bathing, dressing, ambulation, hygiene, and toileting, plus light housekeeping, laundry, meal preparation, and pet care. You set the schedule, you decide what the caregiver helps with, and you stay in control of the care. As needs change, hours can be adjusted at any time, from occasional visits through 24-hour care.
Recognize some of these signs?
If you are seeing these signs in Fort Myers, Cape Coral, or anywhere in Lee, Collier, or Charlotte Counties, Abby Services can talk through your situation and help you understand your options. We have been helping Southwest Florida families find caregivers since 1997.
Have questions about care at home?
Talk it through with a registered nurse.
Frequently Asked Questions
How many signs mean it’s time for in-home care?
There is no magic number, but a pattern matters more than any single sign. One missed appointment is life. Missed appointments plus weight loss plus a near fall is a pattern that deserves action. When in doubt, start with a few hours a week and adjust.
Does needing help at home mean assisted living is next?
No. Most people who start in-home care remain at home. Care scales with need, from a few hours a week to around-the-clock support, and starting early often prevents the crisis that forces a facility decision.
How do I bring this up without upsetting my parent?
Lead with independence, not decline. Framing help as a way to stay in their own home, on their own schedule, is usually received far better than framing it as something being taken away. Starting with light support like housekeeping or meals also feels less intrusive than personal care.
How quickly can a caregiver start?
Timing depends on your location, schedule, and caregiver availability. Contact Abby Services as early as possible, especially before a planned surgery or discharge, and complete the client agreement promptly to keep things moving.
Sources
- CDC: Older Adult Fall Prevention
- Georgetown University Health Policy Institute: Prescription Drugs
- National Institute on Aging: Aging in Place
If getting to a doctor’s office has become the hard part, you have two kinds of options in Lee County: house-call practices that come to you, and concierge practices that give you a closer relationship with one physician, faster access, and longer visits, usually for an annual fee. This guide lists the local practices in each group, explains what Medicare will and won’t pay for, and shows how a private in-home caregiver fits alongside a private physician.
Abby Services is a nurse-owned, state-licensed nurse registry in Fort Myers. We are not affiliated with any practice listed here and do not coordinate medical care. We share these as community resources because families ask us about them every week. Please confirm current services, coverage area, and fees directly with each practice, and let them know Abby Services referred you.
What is a mobile physician or house-call doctor?
A mobile physician, house-call doctor, or home-based primary care provider is a physician or nurse practitioner who sees patients in their own homes instead of an office. In Florida, most house-call programs focus on people who are homebound or have limited mobility: someone who uses a walker or wheelchair, cannot drive for health reasons, has a memory disorder, is bedridden, or was recently discharged from the hospital. The visit itself looks like a normal primary-care appointment (exam, medication review, orders for labs or home health), just at your kitchen table.
A concierge physician is different. Concierge, or “direct,” practices limit how many patients they take so each patient gets same-day or next-day appointments, unhurried visits, and a direct line to the doctor. Some make house calls when needed; most expect you to come to the office. You pay a membership fee for the access, and the practice may or may not also bill Medicare.
House-call and home-based primary care in Fort Myers and Cape Coral
These are the practices we could confirm actually come to the home.
Lee Health House Calls (Home-bound Senior Care)
Lee Health’s House Calls program, run through Lee Physician Group, brings primary care into the home for homebound and limited-mobility patients throughout Lee County. Care is provided by advanced registered nurse practitioners. The program accepts most insurance plans, including Medicare and Medicaid, and was accepting new patients at the time of writing. This is the first call for most families we talk with, because it bills Medicare like any other visit.
- Phone: 239-343-8250
- Office: 12600 Creekside Lane, Suite 6, Fort Myers, FL 33919
- Website: leehealth.org – Homebound Senior Care
Private Physicians of Southwest Florida
A concierge practice founded in 1997 by Gary M. Price, MD, the first practice of its kind in Florida. Membership covers care wherever you need it (office, hospital, or home), and the practice describes itself as “even making house calls when needed.” Offices in Fort Myers, Bonita Springs, Sanibel, and Clewiston. Because this is a membership model, ask how Medicare billing works before you join.
- Phone: 239-415-1111
- Fort Myers office: 9722 Commerce Center Court, Fort Myers, FL 33908
- Website: privatephysiciansofswfl.com
Does Medicare cover house calls?
Yes, with conditions. Original Medicare Part B covers a physician or nurse practitioner home visit the same way it covers an office visit, as long as the visit is medically necessary and the provider participates in Medicare. You do not have to be certified “homebound” for a house call the way you do for Medicare home health services; the provider simply has to document why a home visit was appropriate. Lee Health House Calls works this way.
What Medicare never covers is a membership or retainer fee. A concierge practice that still bills Medicare will charge you the annual fee on top of your normal Medicare cost-sharing. A practice that has opted out of Medicare cannot bill Medicare for anything its physicians do, so you pay the full cost of every visit yourself, though Medicare still covers labs, imaging, specialists, and hospital care the practice orders elsewhere. Ask every practice one question before joining: “Do you bill Medicare, or have you opted out?”
Concierge and private-physician practices in Fort Myers
These practices offer a closer doctor relationship and faster access. They are office-based unless noted, so they suit people who can still get to an appointment but want more time and attention when they get there. Fees change; confirm current pricing with the practice.
MDVIP-affiliated practices
MDVIP is a national concierge network. Affiliated doctors keep a small panel, include an annual comprehensive wellness exam, and continue to bill Medicare and insurance for visits, so the membership fee is the only thing you pay out of pocket beyond your normal coverage. MDVIP fees are typically in the range of $1,800 to $2,200 per year; each practice sets its own. Three MDVIP physicians practice in Fort Myers:
- Britto Chinnappan, MD (internal medicine): 9671 Gladiolus Drive, Suite 107, Fort Myers. 239-418-1118
- Sherry Farag, MD (family medicine): 15750 New Hampshire Court, Unit D, Fort Myers. 239-395-2434
- Shannon Greer, DO (family medicine): 12631 World Plaza Lane, Building 54, Fort Myers. 239-267-3377
Directory: mdvip.com – Fort Myers physicians
Daniel Bendetowicz, MD
An independent concierge internist in Fort Myers using a hybrid model: the practice bills insurance for covered services, and the membership fee covers what insurance does not. Offers a standard membership, a premium tier, and a six-month “snowbird” plan for seasonal residents, which is rare locally and worth knowing about if you winter here.
- Phone: 239-985-1050
- Website: drdanielbendetowicz.com
IMLWP (Internal Medicine, Lipid & Wellness Practice)
A membership-based internal medicine practice in south Fort Myers whose physicians stay involved across settings, including advocating for patients during stays at Lee County hospitals. Two things to know before calling: IMLWP has opted out of Medicare, so Medicare cannot be billed for anything its physicians do, and patients 65 and older are required to join the Premier tier, published at $5,280 per year plus a one-time $150 fee. Younger patients have a lower Core tier. This is a good fit for families who want one doctor closely involved at every step and are prepared to pay for it directly.
- Phone: 239-362-3005
- Office: 6160 Winkler Road, Fort Myers, FL 33919
- Website: imlwp.com
Private Physicians of Southwest Florida
Listed above under house calls; it is also the longest-running concierge practice in the area. 239-415-1111.
How to choose
Three questions sort most families out quickly:
- Can you get to an office? If not, start with Lee Health House Calls or ask Private Physicians about home visits. A concierge office practice does not solve a transportation problem.
- Does Medicare billing matter to you? If yes, choose a practice that participates (Lee Health, MDVIP, Bendetowicz) and budget for the membership fee. If you are comfortable paying directly, an opted-out practice like IMLWP is an option.
- Do you want one doctor across office, hospital, and home? That continuity is the main thing concierge and private-physician practices sell. If a loved one is in and out of the hospital, it can be worth the fee.
Local nurse, local physician: pairing a private caregiver with a private doctor
A private physician handles the medical side. A private caregiver handles everything around it, which is most of the day: bathing, meals, medication reminders, getting to the appointment, and the eyes in the home between visits. Families who use a house-call or concierge doctor tend to get the most out of it when there is a dependable caregiver at home who can tell the doctor what has actually been happening, follow the plan the doctor sets, and call when something changes.
That is where a local nurse registry fits. Abby Services has been matching Southwest Florida families with screened, credentialed private caregivers since 1997, and our office is run by a Fort Myers RN. The caregivers we refer are independently employed and directed by you, so the arrangement stays as flexible as the medical care: a few hours a week for appointments and errands, or daily support for someone who is truly homebound. Tell the practice you are working with a private caregiver, and tell us who your physician is; both sides do better work when they know the other is there.
Caregivers referred through Abby Services can help with:
- Bathing, dressing, and personal hygiene
- Meal preparation and light housekeeping
- Medication reminders
- Mobility, transfers, and monitoring for safety
- Getting to and from appointments, and sitting in on them if you want a second set of ears
- Reporting changes to family and, with your permission, to the physician’s office
Every situation is different. Tell us what kind of help you are looking for and who your doctor is, and our office will work to match you with caregivers whose experience and availability fit. If a caregiver is not the right fit, you are always free to request another. And when you call one of the practices above, let them know Abby Services referred you.
Not sure if in-home care is right? Ask your doctor.
Your physician, whether office-based or visiting, can help you decide whether in-home support makes sense. It is often the right move when someone has trouble with one or more activities of daily living (ADLs), such as bathing, dressing, or moving safely around the home. If you have questions, call Abby Services at 239-590-0861 or tell us what you need online.
Frequently asked questions
What is a mobile physician?
A mobile physician, also called a house-call doctor or home-based primary care provider, is a physician or nurse practitioner who sees patients in their homes rather than an office. Visits cover the same ground as a regular primary-care appointment. In Lee County, the main program is Lee Health House Calls.
Who qualifies for a house-call doctor?
Most house-call programs serve people who are homebound or have limited mobility: those who use a walker or wheelchair, cannot drive for health reasons, have a memory disorder, are bedridden, or were recently discharged from the hospital. Each practice sets its own criteria, so call and describe your situation.
Does Medicare cover house calls in Florida?
Medicare Part B covers medically necessary home visits from a participating physician or nurse practitioner, billed like an office visit. Medicare never covers concierge membership or retainer fees, and a practice that has opted out of Medicare cannot bill Medicare for any of its own services.
What does concierge medicine cost in Fort Myers?
Published local fees range from roughly $1,100 per year for younger patients at IMLWP to $5,280 per year for its 65-and-older tier. MDVIP practices typically charge in the range of $1,800 to $2,200 per year and continue to bill Medicare for visits. Always confirm current fees with the practice.
Can a private caregiver work with my house-call or concierge doctor?
Yes. A private caregiver referred through Abby Services can help you get to appointments, be present for home visits, follow the care plan the doctor sets, and report changes to family and, with your permission, to the practice. Tell both sides about each other so they can coordinate.
Do you need Veteran in home care now? Abby Services of Fort Myers and Cape Coral can help.
Yes, many families seek veteran in home care. However much of the information available is confusing and unclear. That is why we are excited for the following announcement about veteran in home care.
Abby Services has partnered with Vet Assist to help families manage veteran in home care.
Through a partnership with the VetAssist Program, Abby Services is excited to offer our fantastic In-Home Caregiver Services to veterans participating in the Aide and Attendance Program throughout Fort Myers, Cape Coral, and Lee County.
The VetAssist Program will:
- Help you determine if you qualify for the VA Aid & Attendance Pension Benefit.
- Assist you to identify and obtain documents needed for the application.
- Help you complete and submit the application to the VA.
- Provide your home care right away.
- Furnish an interest-free loan so you can pay for your home care while the VA processes your application.
- Monitor your application’s progress and assist with responses to VA requests for additional information until your pension is approved.
Even after you receive your pension, the VetAssist® Program keeps working for you to help manage veteran in home care.
- Monitor your home care, to assure that you get the services you need, on a schedule that works for you.
- Keep track of your medical expenses and help you stay in compliance with the VA, so you retain the maximum allowable pension amount.
- Assist you to file any additional paperwork with the VA.
- They’re always a phone call away if you have questions or concerns.
Getting the veteran in home care you need
Veterans Home Care can provide you with assistance including:
- Help with bathing
- Help with dressing
- Medication reminders
- Transportation
- Meal preparation
- Transferring to and from bed
- Personal care
- Respite care
- Light housekeeping
- Laundry
- Companionship
- Additional services – including help to access other community resources to improve your quality of life.
About the Veterans Aid & Attendance Pension benefit that helps pay for veteran in home care
In 1952 Congress passed Title 38 of the United States Code, creating what we now call the Department of Veterans Affairs (VA), and authorizing benefits for veterans. One of these benefits is the Non-Service Connected Pension, with “Aid & Attendance.” (Veterans Aid & Attendance Pension benefit.)
Even though the pension has been around for 60 years, very few people know about it or understand how it works. Veterans Home Care has 14 years’ experience successfully helping veteran families apply for and receive the pension. Let us help you, too.
Eligibility
Do You Have the “3-Ms”?
- Military: Are you a veteran or the surviving spouse of a veteran who served at least 90 days on active duty, at least one day during wartime*, with an honorable discharge? (Persian Gulf War veterans must have two years of active duty.)
- Medical: Do you have a non-service-connected medical condition causing you to need assistance with activities of daily living?
- Money: Do you have limited income and assets? (Your home and car are exempt.)
Did you serve during one of the *VA Defined War Periods
- World War II: Dec 7, 1941-Dec. 31, 1946
- Korean Conflict: June 27, 1950-Jan. 31, 1955
- Vietnam Era: Aug. 5, 1964-May 7, 1975 For veterans who served Feb. 28, 1961-Aug 5, 1964, must have served “in the country” (Vietnam).
- Persian Gulf War: Aug 2, 1990- date to be prescribed by Presidential proclamation or law. Must have served active duty for 2 years.
Click here for an online referral form.
Making sure an older loved one eats well is one of the most common worries families in Fort Myers and Cape Coral bring to us. Good nutrition keeps seniors stronger, steadier on their feet, and more independent, but shopping and cooking get harder with age. The good news is there are several kinds of help, and they work well together: Lee County’s Meals on Wheels program, private meal-delivery services, and in-home caregivers who shop, cook, and make sure meals actually get eaten. Here’s how each one works.
Lee County Meals on Wheels
Lee County Meals on Wheels, run locally by Community Cooperative (CCMI), delivers nutritious home-delivered meals along with a friendly, safety, and security check to eligible homebound neighbors who can’t shop or cook for themselves. Recipients include seniors as well as disabled or chronically ill adults, and meals may be short-term, while recovering from an illness or surgery, or long-term, to help someone remain safe and independent at home. The program supports over a thousand elderly and homebound residents in the greater Fort Myers area.
Meals on Wheels brings more than food. Volunteers provide daily companionship and a wellness check, and the program has added services over the years, including food and care products for recipients’ pets, and a home-safety and fall-prevention initiative developed through a partnership with the Home Depot Foundation. For many families, that daily friendly visit is as valuable as the meal itself.
Because eligibility rules, application steps, and contact information can change, the best place to confirm current details or apply is Community Cooperative directly. You can find the Lee County Meals on Wheels program and its application through Community Cooperative or the national Meals on Wheels America locator.
How to contact or apply for Lee County Meals on Wheels
Meals on Wheels in Lee County is run by Community Cooperative in Fort Myers. To ask about eligibility, request meals for a loved one, or apply:
- Meals on Wheels line: 239-337-1055 (main office 239-332-7687)
- Email: [email protected]
- Apply online or by mail: communitycooperative.com/what-we-do/meals-on-wheels has the online application and a printable form (mail to Community Cooperative, Attn: Meals on Wheels, P.O. Box 2143, Fort Myers, FL 33902)
- Office: 3429 Dr. Martin Luther King Jr. Blvd., Fort Myers, FL 33916
Family members, physicians, discharge planners, and caregivers can all start the referral. If you are calling for a parent, have their address, a rough picture of their health and mobility, and any dietary restrictions ready. Monthly menus are posted on the program page in English and Spanish. When you call, let them know Abby Services sent you.
Private Senior Meal-Delivery Services
Meals on Wheels is a wonderful program, but not everyone qualifies, and some families want more choice over menus, dietary needs, or delivery frequency. A range of private meal-delivery services can fill that gap, from national prepared-meal companies that ship frozen, senior-friendly meals, to local restaurants and grocery delivery. Options worth considering include:
- Prepared senior-meal services that deliver ready-to-heat meals designed for older adults, often with heart-healthy, diabetic-friendly, or low-sodium menus.
- Grocery delivery for families or caregivers who prefer to cook fresh but want to skip the trip to the store.
- Restaurant delivery for variety and occasional treats, keeping in mind these aren’t tailored to dietary needs.
When choosing a service, look at dietary options, portion sizes, ease of heating, and whether the packaging is easy for older hands to open. The best choice depends on the person’s health needs, budget, and how much they can do for themselves.
How an In-Home Caregiver Helps With Meals
Delivered meals solve the food-supply problem, but they don’t solve everything. Many seniors have plenty of food in the house and still don’t eat well, because opening, heating, and sitting down to a meal has become difficult, or because eating alone is lonely. This is where an in-home caregiver makes a real difference.
A caregiver referred through Abby Services may assist with the whole picture around mealtime: planning meals, grocery shopping, preparing fresh food to the person’s tastes and dietary needs, and providing the company that makes a meal something to look forward to. A caregiver can also notice the early warning signs families miss, such as unexplained weight loss, spoiled food in the refrigerator, or skipped meals, which often signal that more support is needed.
Meal preparation pairs naturally with the other daily help a caregiver provides, such as light housekeeping, medication reminders, and companionship, so a few hours of caregiver support can cover far more than food alone.
Need help making sure a loved one eats well at home?
Putting It Together
These options aren’t either-or. Many Southwest Florida families combine them: Meals on Wheels or a delivery service for some meals, and an in-home caregiver for shopping, fresh cooking, and companionship the rest of the time. If you’d like help thinking through what fits your loved one’s needs, Abby Services has been helping Lee County families find caregivers since 1997.
Have questions about care at home?
Talk it through with a registered nurse.
Frequently Asked Questions
Who qualifies for Meals on Wheels in Lee County?
Lee County Meals on Wheels, run by Community Cooperative, generally serves homebound seniors and disabled or chronically ill adults who can’t shop or cook for themselves, short-term or long-term. Because eligibility and application details change, confirm current requirements directly with Community Cooperative.
What if my loved one doesn’t qualify for Meals on Wheels?
Private senior meal-delivery services and grocery delivery are good alternatives, and an in-home caregiver can shop for and prepare fresh meals tailored to your loved one’s tastes and dietary needs. Many families combine a delivery option with caregiver support.
Can an Abby Services caregiver cook and shop for meals?
Yes. Caregivers referred through Abby Services may assist with meal planning, grocery shopping, meal preparation, and companionship at mealtime, along with other daily support like light housekeeping and medication reminders. You direct what the caregiver helps with.
How do I apply for Meals on Wheels in Fort Myers or Cape Coral?
Call Community Cooperative’s Meals on Wheels line at 239-337-1055, email [email protected], or use the online application at communitycooperative.com. Family members, doctors, and caregivers can make the referral on someone’s behalf.
Sources
- Community Cooperative (CCMI) — Lee County Meals on Wheels
- Meals on Wheels America — Find Meals and Services
Rehabilitation at home means getting physical therapy (PT), occupational therapy (OT), or speech therapy in your own home instead of at a clinic or rehab facility. For most older adults in Southwest Florida, it happens one of two ways: through a Medicare-certified home health agency, which costs nothing for covered services but requires being homebound, or through outpatient therapy, at a clinic or with a therapist who comes to the home, billed under Medicare Part B with a 20% coinsurance. Either way, therapy visits are short, usually 30 to 60 minutes a few times a week. The meals, safe walking, bathroom trips, and home exercises in between are up to the patient and family, and that is where a private caregiver helps recovery stick.
Coverage details below were checked in September 2026 against Medicare.gov. Medicare Advantage plans follow similar rules but often require prior authorization and in-network providers, so call your plan first.
What rehabilitation at home includes
- Physical therapy: strength, balance, walking, transfers, and pain after a fall, surgery, or hospital stay.
- Occupational therapy: getting back to daily tasks such as bathing, dressing, and cooking, plus home safety changes and equipment like shower chairs and grab bars.
- Speech-language therapy: speech, understanding, memory, and swallowing, often after a stroke or with Parkinson’s disease.
Common reasons older adults need rehab at home include joint replacement, a hip fracture or fall, stroke, heart surgery or heart failure, pneumonia or a long hospital stay, and Parkinson’s disease.
How Medicare home health therapy works
Medicare Part A or Part B covers therapy at home through a home health agency when all of these are true:
- You are homebound. Leaving home takes considerable effort or help, such as a walker, wheelchair, or another person, and isn’t recommended because of your condition. You can still go to medical appointments, religious services, adult day care, and occasional short outings like a haircut.
- You need skilled care part time. Intermittent skilled nursing, PT, or speech therapy, or continuing OT.
- A provider sees you face to face and certifies that you need home health care.
- A plan of care is set up and reviewed by your provider, and the services come from a Medicare-certified home health agency.
What it costs and covers:
- You pay nothing for covered home health visits. Medical equipment such as a walker is covered separately, usually at 20% after the Part B deductible.
- A hospital stay is not required first, although most referrals come at hospital or rehab discharge.
- Therapy is covered to improve, maintain, or slow decline. You do not have to be “getting better” for it to continue if skilled therapy is still needed.
- A home health aide may help with bathing for short visits, but only while you are also getting skilled care.
What it does not cover: 24-hour care, meals, housekeeping, or personal care when that is the only help needed. Once you are no longer homebound or no longer need skilled care, the home health episode ends, and many patients move to outpatient therapy.
How outpatient therapy is different
Outpatient therapy is for people who can get out of the house, or who have finished home health and still need therapy. It is covered under Medicare Part B.
- Where: a hospital-based clinic or private practice. Lee Health alone runs more than a dozen outpatient rehabilitation locations across Fort Myers, Cape Coral, Bonita Springs, Estero, and Lehigh Acres, including stroke, balance, and hand therapy. Some private-practice therapists also treat Medicare patients in the home under Part B, without the homebound requirement.
- Cost: after the Part B deductible ($283 in 2026), you pay 20% of the Medicare-approved amount per visit. A Medigap supplement often covers that.
- No hard cap: in 2026, once therapy costs pass $2,480 for PT and speech combined, or $2,480 for OT, the therapist confirms it is still medically necessary and coverage continues.
- Getting there: outpatient therapy often means two or three trips a week, which is hard for someone who can’t drive yet after surgery or a stroke. See our senior transportation guide.
Home health vs. outpatient therapy at a glance
- Must be homebound: home health, yes; outpatient, no.
- Your cost under Original Medicare: home health, $0 for covered visits; outpatient, 20% after the Part B deductible.
- Where: home health, always at home; outpatient, a clinic, or at home with some private practices.
- Typical timing: home health right after discharge; outpatient once you can get out, or when home health ends.
- Aide help with bathing: home health, short visits while skilled care continues; outpatient, none.
For recovery that needs more than either can offer, such as several hours of therapy a day, a doctor may recommend an inpatient rehabilitation hospital or short-term skilled nursing facility first. Our hospital and rehab discharge support page covers planning that transition.
Where a private caregiver fits between therapy visits
Therapists build the plan; recovery happens in the other 160-plus hours of the week. Patients still need to eat, bathe, move safely, take medications on time, and practice their exercises, often while tired, sore, or unsteady. For someone who lives alone, or with a spouse who has limits of their own, that is where setbacks and falls happen.
A private caregiver, working at the client’s direction, can:
- Encourage and give standby help with the home exercises the therapist prescribed
- Provide standby or hands-on help with walking, transfers, toileting, and bathing and dressing while strength returns
- Prepare meals that support healing and keep up with laundry and housekeeping
- Give medication reminders and tell the family, or the home health nurse, when something seems off
- Drive to outpatient therapy and follow-up appointments, where the caregiver’s auto insurance allows it
- Stay awake overnight in the first nights home, when bathroom trips carry the most fall risk
To be clear about roles, a private caregiver is not a therapist or a nurse and does not provide skilled therapy. The caregiver reinforces the plan your licensed therapists created. Ask the therapist to show the caregiver the exercises and any transfer techniques so everyone does them the same way.
Common rehab situations we help with
- After joint replacement or other surgery: see after-surgery home care.
- After a hospital or rehab stay: see hospital and rehab support.
- Stroke recovery, which often continues for months: see stroke recovery support.
- Parkinson’s disease: see exercise and Parkinson’s disease and Parkinson’s caregiver support.
Support that scales down as you recover
Private care during rehab is flexible. A family might start with live-in or 24-hour care for the first week home, drop to hourly care a few mornings a week as strength returns, and stop once independence is back. You set the schedule and stay in control the whole way.
Who pays for what
- Medicare covers skilled home health or outpatient therapy when the rules above are met. It does not pay for a private caregiver for personal care, meals, or supervision.
- Long-term care insurance often pays for in-home help once the policy’s benefit triggers are met.
- Veterans may qualify for the VA Aid and Attendance pension.
- Private pay is most common for short recoveries. See the cost of in-home care in Fort Myers.
Local nurse, local recovery: planning rehab at home in Southwest Florida
The best time to plan care at home is before discharge. Ask the hospital case manager which home health agency is being referred, whether your loved one will qualify as homebound, and when outpatient therapy is expected to start. Then line up the help in between.
Abby Services is a nurse-owned, state-licensed nurse registry in Fort Myers. Since 1997 we have matched families in Fort Myers, Cape Coral, and across Lee, Collier, and Charlotte Counties with screened, credentialed private caregivers who are independently employed and directed by the client. Many have years of experience supporting patients through therapy after surgery, stroke, and hospital stays. See how a Florida nurse registry works. Call 239-590-0861 or tell us what you need online, ideally a few days before discharge, and when you talk with the home health agency or therapy clinic, let them know Abby Services referred you.
Frequently asked questions
Does Medicare cover physical therapy at home?
Yes, when you are homebound, need part-time skilled care, have been seen face to face by a provider, and receive services from a Medicare-certified home health agency under a plan of care. You pay nothing for covered home health visits. If you are not homebound, Medicare Part B covers outpatient therapy, including from some therapists who come to the home, at 20% coinsurance after the deductible.
What does homebound mean for Medicare home health?
Leaving home takes considerable effort or help, such as a walker, wheelchair, or another person, and isn’t recommended because of your condition. You can still attend medical appointments, religious services, adult day care, and occasional short outings and remain homebound.
What is the difference between home health therapy and outpatient therapy?
Home health therapy comes to your home through a Medicare-certified agency, requires being homebound, and costs nothing for covered visits. Outpatient therapy is usually at a clinic, does not require being homebound, and costs 20% of the Medicare-approved amount after the Part B deductible.
Is there a limit on Medicare physical therapy visits?
No hard cap. In 2026, once outpatient therapy costs pass $2,480 for PT and speech combined, or $2,480 for OT, the therapist must confirm therapy is still medically necessary, and coverage continues. Home health therapy continues as long as you qualify.
Does Medicare pay for a caregiver during rehab at home?
Not typically. Medicare covers skilled therapy and nursing, and brief home health aide visits during skilled care, but not ongoing personal care, meals, or supervision. Families usually pay for a private caregiver through long-term care insurance, VA benefits, or private pay.
Can a caregiver help with therapy exercises?
A private caregiver can encourage, remind, and give standby help with the home exercises a licensed therapist prescribed, but does not provide skilled therapy. Ask the therapist to show the caregiver the exercises and safe transfer techniques.
Sources
- Medicare.gov — Home Health Services
- Medicare.gov — Medicare Coverage of Therapy Services (fact sheet)
- Lee Health — Outpatient Rehabilitation
If you are caring for a parent or spouse and running on empty, you are not alone, and you don’t have to choose between your loved one and your own health. Nearly 1 in 4 American adults is now a family caregiver, and nearly 1 in 4 caregivers provides 40 or more hours of care a week, according to AARP’s 2025 Caregiving in the U.S. report. In-home respite care gives you a real break: a private caregiver comes to your loved one’s home for a few hours, a few days, or longer, so you can rest, work, travel or simply catch up, while your loved one stays safe in familiar surroundings.
Ready for a real break?
Family Caregiving Is a Second Job, and It Takes a Toll
Caregivers have the perfect name. They are always giving of their own time and energy for the benefit of a loved one. According to AARP and the National Alliance for Caregiving, tens of millions of Americans care for an older, disabled, or chronically ill family member, many of them putting in the hours of a part-time or full-time job on top of everything else.
Family caregivers are often responsible for bathing, feeding, and dressing a loved one. Caring for someone you love can be deeply rewarding, but it is also exhausting, and caregivers report poor eating habits, missed doctor appointments, and depression at higher rates than the general population. Burnout affects family caregivers physically, emotionally, and mentally. If you are seeing it in yourself, the signs below will help you recognize it early.
Offering care for a loved one is admirable, but you do not have to do it alone. Here are five ways in-home respite care helps.
Signs of Caregiver Burnout
Caregiver burnout is what happens when the demands of caring for someone outrun your ability to recover from them. It builds slowly, and most caregivers only recognize it in hindsight. Watch for these signs in yourself:
- You are exhausted even after a full night’s sleep, or you have stopped sleeping well at all.
- You feel irritable or resentful toward the person you care for, then guilty for feeling that way.
- You have dropped the things you used to enjoy and rarely see friends.
- Your own health is slipping: skipped appointments, more colds, changes in weight or appetite.
- You feel hopeless, that nothing you do is enough, or that there is no end in sight.
- You are leaning on alcohol or sleep aids to get through the day or night.
Two or three of these together are a signal to act, not to push harder. Our caregiver burnout self-assessment walks through these signs in more detail and helps you gauge where you stand. Burnout puts the person receiving care at risk too: a depleted caregiver misses medications, cuts corners on safety, and eventually cannot continue. Respite care is how you prevent that.
1. Respite Care Shares the Daily Workload
Just as the name implies, respite care provides rest, a genuine break from daily responsibilities. In-home respite is a partnership: a caregiver shares the load so the burden is not yours alone. A respite caregiver can help with household chores as well as personal care and daily living assistance, giving you a much-needed break while your loved one stays in the safety and comfort of their own home.
2. You Get Quality Time Back
Maybe the responsibilities of caregiving are getting in the way of actually enjoying your loved one’s company. With a respite caregiver handling the daily jobs, you can focus on talking, playing cards, and taking walks instead of washing dishes, taking out the garbage, and doing laundry. Respite care lets you step out of the caregiver role and back into being a spouse, a daughter, or a son.
3. Trained Help for the Hard Parts
You try to do everything possible for your loved one, but some tasks are physically difficult, clinically tricky, or simply uncomfortable for family to perform, bathing and toileting chief among them. Caregivers referred through Abby Services are screened and credentialed, and many have experience with exactly these situations. If there are tasks you dread, respite care can be the answer.
4. Peace of Mind While You’re Away
In-home respite care can be there when you cannot be. Whether you are at work, out of town, or finally taking a vacation, a caregiver in the home watches for risks and provides personalized, compassionate attention. You benefit from knowing your loved one is safe and supported in their own home, even when you are not around.
5. A Natural Path to Ongoing Care
The needs you face today will not be the same tomorrow. Respite care is often how families discover what regular in-home care would look like: your loved one gets comfortable with a caregiver, you see how the arrangement works, and if care needs grow, the transition to a regular schedule is simple. Arrangements scale from occasional visits and hourly caregiver schedules all the way to live-in and around-the-clock care. You set the schedule, you can adjust it anytime, and you stay in control of the care.
Respite Care in Fort Myers, Cape Coral, and Southwest Florida
If you are a family caregiver in Lee, Collier, or Charlotte County running on empty, taking a break is not a luxury and it is not giving up. It is how you keep caregiving sustainable. The ARCH National Respite Network puts it simply: respite protects the health of the caregiver, and the caregiver’s health protects everyone who depends on them.
Abby Services has been helping Southwest Florida families find caregivers since 1997, including short-notice and temporary respite arrangements. Contact us as early as you can, especially ahead of a planned trip, so there is time to find the right fit.
Have questions about care at home?
Talk it through with a registered nurse.
Frequently Asked Questions
How long can respite care last?
Anywhere from a single visit to several weeks. Families use respite for an afternoon off, a weekend away, a vacation, or recovery from their own illness or surgery. The client and caregiver determine the schedule and terms of the arrangement.
Will my loved one accept a stranger in the house?
This worry is common and usually short-lived. Starting with short visits focused on light tasks and companionship lets your loved one build trust gradually. If the personality fit is not right, you can request a different caregiver at any time.
Is respite care only for emergencies?
No, and it works best when it is not. Regularly scheduled respite, even a few hours a week, prevents burnout instead of just responding to it. Emergency and short-notice arrangements may be possible depending on caregiver availability, but planning ahead gives you the best options.
What are the signs of caregiver burnout?
Persistent exhaustion, irritability or resentment followed by guilt, withdrawing from friends and activities, declining health, hopelessness, and relying on alcohol or sleep aids. Two or three of these together mean it is time to get help, not to push harder.
Sources
- AARP and National Alliance for Caregiving: Caregiving in the U.S.
- ARCH National Respite Network and Resource Center
Abby Services in-home caregivers of Fort Myers and Cape Coral is doing their part to end elder abuse.
Lee Elder Abuse Prevention Partnership or LEAPP is a coalition of local businesses and services dedicated to preventing elder abuse.
Update: LEAPP no longer exists.
While it was an excellent partnership and program LEAPP no longer exists. Those suspecting Elder Abuse are encouraged to contact
The Department of Children and Families Abuse Hotline at 1-800-96-ABUSE To report abuse, neglect, or exploitation, please call toll-free 1-800-962-2873. The Abuse Hotline investigates allegations of physical, sexual, and mental abuse, neglect, and exploitation of vulnerable persons.
Elder Abuse can be a silent problem.
According to the National Council On Aging, up to five million older Americans are abused every year, and the annual loss by victims of financial abuse is estimated to be at least $36.5 billion.
Elder abuse can include physical abuse, emotional abuse, sexual abuse, exploitation, neglect, and abandonment. Perpetrators include children, other family members, and spouses—as well as staff at nursing homes, assisted living, and other facilities.
Abby Services works to prevent elder abuse.
For at least the past 5 years Abby Services has supported and has been involved with LEAPP. L
EAPP stands for the Lee Elder Abuse Prevention Partnership. LEAPP is a coalition among Lee County, Florida human service providers and agencies.
The goal of LEAPP is, “To promote a Lee County community where older adults live safe, value and dignified lives.” and their mission is “to create community partnerships that effectively promote awareness of elder abuse, neglect, and exploitation.”
LEAPP Member Agencies include:
Alvin A. Dubin Alzheimer’s Resource Center
Abby Services In-Home Care
Able Health Care Services
Abuse Counseling & Treatment (ACT)
Adult Protective Services – Florida Department of Children & Families
Agency for Health Care Administration – State of Florida
Arden Courts – Ft. Myers
Area Agency on Aging for Southwest Florida
American Elder Care
Bonita Fire & Rescue
Cape Coral Police Department
City of Ft. Myers – Mayor Henderson’s Office
Coastal Behavioral Health
Comfort Keepers
Community Cooperative Ministries (CCMI)
Congressman Connie Mack’s Office
Cypress Cove
Direct Access Home Health
Dolores Bertolini – Caregiver and Retiree
Dr. Piper Center
Elder Law Office of Norma Hand Brill
Florida Gulf Coast University School of Nursing
Florida Gulf Coast University School of Social Work
Florida Rural Legal Services
Ft. Myers Police Department
Good Wheels
Gulf Coast Village
Heartland Health Care Center
Helen Fallert – Retired Social Worker
Hope HealthCare Services
Iona-McGregor Fire District
JBH Behavioral Health
Lee County Health Department
Lee County Department of Human Services
Lee County Housing Authority
Lee County Library System
Lee County Public Safety
Lee County Sheriff’s Office
Lee Memorial Health System
Long Term Care Ombudsman – Southwest Florida
Lynda Leonard-Boyce – Professional Guardian
Mederi Care Tenders
Millennium House
National Association of Social Workers (NASW) – Southwest Florida Chapter
National Alliance Mental Illness (NAMI)
Neuropsychiatric Research Center of Southwest Florida
Office of Financial Regulations – State of Florida
Osterhout, McKinney & Prather Elder Law Attorneys
Parkinson’s Action Network
Prudential Financial
Redi-Care
Right at Home
Sanibel Fire & Rescue
Sanibel FISH
Schlager, Schlager & Levin
Senior Behavioral Health at Lee Memorial
Senior Friendship Centers
Senior Home Companions
Sherri Graham – Professional Guardian
Signature Healthcare
Southwest Florida Community Foundation
St. Michael and All Angels Episcopal Church
State Attorney’s Office
Superior Residences at HealthPark
The Honorable Archie B. Hayward, Jr. – Lee County Judge
United Way of Lee, Hendry & Glades
United Way 211
University of Florida Lee County Extension Service
Visually Impaired Person (VIP)
Through Abby Services’ involvement with LEAPP, we are able to help ensure our local seniors remain safe in their homes and can help support those seniors and their families who are at risk for abuse.
Abby Services was a lead supporter of the LEAPP Shred-a-thon.
Recently Abby Services supported the LEAPP shred-a-thon. The Shred-a-thon is an annual event around tax season which provides an opportunity for local residents including seniors to securely destroy sensitive documents. All donated proceeds go to help support LEAPP initiatives through a local partnership with The United Way.
By shredding sensitive documents Abby Services In-Home Care helps to reduce the risk of fraud, and financial abuse. Abby Services In-Home Care is proud to support LEAPP and all local initiatives in LEE County, Fort Myers, and Cape Coral who support our seniors and help keep them safe and in their home, regardless if they require in-home care or do not require in-home care.
For more information on how Abby Services In-Home Care and LEAPP protect our local seniors please visit www.leeelderabuse.org
Long-Term Care Insurance can be challenging to navigate.
Abby Services helps seniors navigate confusing long-term care insurance policies to be sure they get all of the in-home care benefits they are entitled to.
Abby Services has helped Fort Myers and Cape Coral seniors navigate confusing long-term care insurance policies since 1997!
With many clients we see, their long-term care insurance policies were purchased years ago. Clients may not remember clearly what policy details are or may incorrectly remember information about their long-term care insurance policy.
It’s no wonder clients can be unclear about coverage benefits or requirements to access their policy. Often the language in long-term care insurance policies can be challenging and confusing to understand.
That is why when a client has a question about their long-term care insurance policy, or benefits, they should schedule a complimentary appointment with one of our owners and RN Scott Strachan.
Although these meetings can take about an hour, it is important to thoroughly review a long-term care policy, and fully explain its benefits and how they are accessed.
What is a tax-qualified long-term care insurance policy?
Most long-term care insurance policies sold today are “tax-qualified.” The term comes from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which added Section 7702B to the Internal Revenue Code. Policies issued on or after January 1, 1997 that meet its standards are treated much like health insurance for tax purposes. Policies issued before 1997 that met state requirements at the time were generally grandfathered in as tax-qualified.
A tax-qualified policy typically offers two tax advantages:
- Benefits are generally not counted as taxable income. Policies that pay a set daily amount are subject to an annual per-day limit set by the IRS.
- Premiums can count toward the medical expense deduction, up to age-based limits (IRS Publication 502).
In exchange, the policy uses federal standards to decide when benefits begin. A licensed health care practitioner, such as a physician or registered nurse, must certify within the past 12 months that the person either:
- needs substantial help with at least 2 of 6 activities of daily living (bathing, dressing, eating, toileting, transferring, and continence) for at least 90 days, or
- needs substantial supervision because of a severe cognitive impairment, such as Alzheimer’s disease or another dementia.
Care must also follow a plan of care prescribed by a licensed health care practitioner. Your policy’s elimination period and other terms still apply, and policies that aren’t tax-qualified may use different rules, so check yours. For questions about deductions, talk with your tax professional.
As a registered nurse, Scott Strachan can help families gather the assessments, plan of care, and other paperwork insurers typically require. Learn more about our long-term care insurance support.
Understanding your long-term care insurance policy.
It is important to understand what you are entitled to under your Long Term Care Policy. More important than understanding your Long Term Care Benefits is how to actually access those benefits.
Even when you are armed with accurate information, and thoroughly understand your policy, some insurers have been known to act inappropriately. Here is an article I found with a quick google search:
Florida nurse registry claims insurer improperly denying benefits on long-term care policies
USA February 4, 2011
A class-action lawsuit filed by a Florida nurse registry claims that Transamerica Life Insurance Company’s (Transamerica) long-term care insurance policies improperly deny coverage by requiring a level of certification for home health aides that exceeds state requirements and that Florida law does not allow Transamerica to deny coverage meeting those state requirements.
According to a complaint filed in the District Court for the Southern District of Florida on January 21, 2011, American Nursing Resources Inc. (American Nursing) arranges home health care services for clients, regularly receives insurance-benefit assignments from its clients, and bills insurance companies directly for its services.
American Nursing alleges that its home health aides have provided services to Howard Boteler since October 31, 2009. Mr. Boteler assigned American Nursing his benefits under a long-term care policy issued by a predecessor of Transamerica. American Nursing alleges that when it attempted to collect benefits under the policy,
Transamerica denied its claim on the basis that the services were not provided by a “Home Health Aide” as defined in the policy. According to the complaint, the policy provided for reimbursement for the services of a “Home Health Aide” if the aide was: (1) eligible for reimbursement under Medicare; (2) employed by a state-licensed or accredited home health care agency; or (3) employed by a provider of home health care services accredited by the National League of Nursing, American Public Health Association, or the Joint Commission on Accreditation of Hospitals.
American Nursing alleges that, by its definition of “Home Health Aide,” Transamerica effectively requires a nurse registry such as American Nursing to either: arrange for the provision of basic services by nurses or other individuals with a level of certification greater than that of a home health aide; become eligible for reimbursement under Medicare; or be licensed as a “Home Health Care Agency.”
American Nursing alleges that this violates Florida statutes governing long-term care insurance, which provide that a long-term care policy cannot: require services to be performed by an individual with a higher level of certification than the services require; require services to be provided by a licensed home health agency when they can be provided by a nurse registry, or require that services be required by Medicare-certified agencies or providers. See FLA. STAT. ANN. § 627.94071.
The complaint alleges that “Defendant cannot define ‘Home Health Aide’ and implement its policy in a manner which violates Florida law by excluding or discriminating against nurse registries as covered home health service providers for basic services. … To do so, violates the Florida Statutes and Rules which by law are incorporated into Defendant’s Policy and give rise to an action for breach of the Policy.”
American Nursing seeks, for itself and on behalf of similarly situated providers, damages for breach of contract and an injunction preventing further denial of benefits on these grounds.
American Nursing has defined the class narrowly to include only Florida licensed nurse registries which, from January 1, 2006, through January 21, 2011, were assignees under a Transamerica long-term care policy and had a claim for benefits for home health-care services provided in Florida denied on the basis that the services were not provided by a “Home Health Aide” under the policy.
The class is also defined to include any Florida-licensed nurse registries currently named as assignees under such a policy. The case is American Nursing Resources, Inc., v. Transamerica Life Insurance Company, No. 0:11-cv-60146 (S.D. Fla.)
Are issues with long-term care insurance common?
Unexpected issues with long-term care insurance are more common than many think.
The situation described in the article above has occurred with a State Farm Long Term Care Insurance Policy a client of Abby Services has. As long-term care insurance experts, we are helping them to work through the insurer’s confusion and hopefully, State Farm will do the right thing.
What do you mean “hopefully the long term care insurance provider will do the right thing”?
Doing the “right thing” would be allowing a claimant to easily and appropriately access the long-term care insurance policy they have paid for as required by law. The specific law the article references is listed below.
Florida Statute 627.94071 which covers life insurance for seniors contracts and rates:
627.94071 Minimum standards for home health care benefits.—A long-term care insurance policy, certificate, or rider that contains a home health care benefit must meet or exceed the minimum standards specified in this section. The policy, certificate, or rider may not exclude benefits by any of the following means:
(1) Providing that home health care cannot be covered unless the insured or claimant would, without the home health care, require skilled care in a skilled nursing facility.(2) Requiring that the insured or claimant first or simultaneously receive nursing or therapeutic services in a home setting or community setting before home health care services are covered.(3) Limiting eligible services to services provided by registered nurses or licensed practical nurses.(4) Requiring that a nurse or therapist provide services covered by the policy that can be provided by a home health aide or by another licensed or certified home care worker acting within the scope of his or her license or certification.(5) Requiring that a licensed home health agency provide services covered by the policy that can be provided by a nurse registry licensed under chapter 400.(6) Excluding coverage for personal care services provided by a home health aide.(7) Requiring that the provision of home health care services be at a level of certification of licensure greater than that required by the eligible service.(8) Requiring that the insured/claimant have an acute condition before home health care services are covered.(9) Limiting benefits to services provided by Medicare-certified agencies or providers.(10) Excluding coverage for adult day care services.
Do you have a long-term care insurance complaint?
If you are confused about your policy or believe you are being inappropriately denied long-term care insurance benefits you are entitled to you should review the Florida Department of Financial Services website. They are the entity best suited to help resolve most long-term care insurance issues. Sometimes, despite attempts to educate insurance providers on regulations in our state, (regulations that they should already be familiar with) you need an attorney familiar with specific state laws, to help fight for the benefits you are entitled to. Below is an attorney you may want to consider. Stephen DunnPhone: (410) 321-8368Email: [email protected]: https://www.sdunnlawoffices.com/