In-Home Care FAQs for Fort Myers, Cape Coral & Southwest Florida

Often, a family member notices the signs before the person who needs help does. Missed medications, a fall or near-fall, trouble keeping up with meals or housework, and changes in hygiene are common early signs. For a fuller checklist, see 14 signs it's time to get help.

It's natural to hold on tighter to independence when things start to slip. In-home care doesn't mean giving up independence for safety. A private caregiver can provide the extra support that helps someone stay safe and independent at home longer.

The key word is health. Home health care is skilled care ordered by a doctor and provided by nurses or therapists, such as wound care, treatments, therapy, and education. Medicare often covers it for qualifying patients.

Home care is non-medical, hands-on help with daily life: bathing, dressing, mobility, meals, companionship, and personal care. Medicare generally does not pay for this type of care, which it calls custodial care. This is the support caregivers referred through a Florida nurse registry like Abby Services can offer. Many families use both at the same time, especially after a hospital stay.

It depends on the person. Most people say they would prefer to stay at home, and with the right support and budget, care can be scheduled around almost any level of need.

Facility care may make more sense in two situations. The first is when someone needs skilled nursing every day, which gets expensive when paid privately at home. The second is when someone needs 24-hour supervision the family can't provide or arrange at home, such as a person with Alzheimer's or dementia who is prone to wandering.

It can be, but not always. Labor is the core cost of any care, whether it's provided at home or in a facility.

The difference with in-home care is that you only pay for the help you need. If someone just needs help getting up in the morning and getting to bed at night, two short hourly visits a day may cost far less than a facility. See what in-home care costs in Southwest Florida for current price ranges, or our comparison of in-home care vs. assisted living costs.

This is common. Someone who is afraid of losing their independence may refuse care, or accept it and then find fault with every caregiver.

Two approaches often help. The first is to make it about you: "Dad, you may not think you need this, but I'm losing sleep worrying. I need you to do this for me so I know you're safe." The second is to bring in a professional. Hearing it from a trusted health professional often lands differently than hearing it from family. Scott Strachan, RN, BSN, can sit down with your family and talk through the situation openly.

It depends on what kind of provider you mean:

• Nurse registries and home care agencies. Nurse registries like Abby Services and home health agencies are licensed by Florida's Agency for Health Care Administration (AHCA). Look them up on FloridaHealthFinder, which shows the license along with inspection reports and any legal actions. Here is Abby Services' profile.
• Nurses and CNAs. Registered nurses, LPNs, and certified nursing assistants are licensed or certified by the Florida Department of Health. Check them on the Department of Health's license verification search, which also shows any discipline.
• Home health aides. Florida doesn't issue a state license for home health aides, so there's no public lookup. Ask to see proof of their training instead. A licensed nurse registry verifies it before referring a caregiver.

Licensing matters because licensed providers must follow Florida's safeguards, such as Level 2 background screening, and are inspected by the state. If someone offering care can't show you a license, ask why.

No. Under Florida law, caregivers referred by a nurse registry are independent contractors, not employees of the registry (§400.506(6)(d), Florida Statutes). The same law doesn’t allow a nurse registry to monitor, supervise, manage, or train the caregivers it refers. The caregivers we refer run their own businesses and work directly with the families they serve.

You and your caregiver decide how care is provided day to day. Abby Services is here for referrals, replacements, and administrative support.

Abby Services was founded in 1997 by Tom Strachan, the father of current owner Scott Strachan, RN, BSN. Today, Abby Services is one of Southwest Florida’s longest-running caregiver referral services and continues to serve families throughout Lee, Collier, and Charlotte Counties.

Abby Services refers caregivers throughout Lee, Collier, and Charlotte Counties, including Fort Myers, Cape Coral, North Fort Myers, Lehigh Acres, Estero, Bonita Springs, Sanibel and Fort Myers Beach, Shell Point, Naples, and Babcock Ranch.

Our office is in Fort Myers at 6314 Corporate Court, Suite 160. See all areas we serve.

Abby Services is owned and operated by Scott Strachan, RN, BSN. Scott has experience in nursing, in-home care, and nurse registry administration and remains actively involved in the daily operation of the company.

Complete the Client Intake Form with the information you have about your loved one’s needs, requested schedule, location, and the type of assistance being considered. After submission, you will receive information about pricing, the referral process, and the Client Agreement to review.

Before Abby Services can begin identifying caregivers, the Client Agreement and payment information must be completed. Both can be handled electronically, allowing the referral process to move forward without an office visit. Prefer to talk it through first? Schedule a call with our office.

Yes. Everything can be done from wherever you are: a hospital room, your office, or another state. Start with our Client Intake Form or schedule a call. We'll send everything you need to review, including pricing, how the referral process works, and the Client Agreement, and you can sign electronically from your phone or computer.

You won't be on your own while you do it. A registered nurse is available to answer your questions and talk through your loved one's needs before you sign. That makes it possible to move quickly when a hospital discharge, a fall, or a change in health comes with little warning.

We’ll ask for basic information about the person needing caregiver support, including their location, requested schedule, and the type of assistance they may need. Sharing details about daily routines, pets, mobility, personal care needs, health considerations, expectations, and other preferences can also help us identify caregivers who may be a good fit.

Don’t worry if you don’t have every detail figured out. Abby Services follows a client-directed care philosophy, and our owner, Scott Strachan, RN, BSN, brings extensive nursing and in-home care experience to help families understand their options and make informed decisions about their loved one’s care.

Yes. In-home meetings are available on a limited basis. For most families, though, a scheduled phone meeting works better, and it's usually how we start.

A phone meeting lets everyone who's involved join at once, whether they live down the street or in another state. Adult children, spouses, and other family members can all hear the same information, ask their questions, and help make decisions together, without anyone having to take time off or travel. It's also faster, so the caregiver search can get moving sooner.

During the call, we'll talk through your loved one's needs, routine, schedule, and budget, explain how caregiver referrals work, and answer your questions. If an in-person meeting would still help after that conversation, we can schedule one once your service agreement is complete. Schedule a call with our office.

Yes. We're on call 24/7 for urgent needs, and we'll do our best to help when something comes up suddenly. Still, the more notice we have, the better. Extra time lets more caregivers respond to your opportunity, so we can help you find the best fit, not just the first person who responds. In a perfect world, we recommend at least 24 hours. Emergencies don't happen in a perfect world, so call us at 239-590-0861 as soon as you know a caregiver may be needed, even if plans aren't final.

To get started, request a caregiver online. It takes about a minute. We'll follow up by email or text with pricing, a Client Agreement, and a payment information form, all of which you can complete from your phone or computer. They need to be completed before we can begin sharing your request with caregivers, and they're often the biggest source of delay, so completing them right away makes a real difference.

Timing matters too. Finding a caregiver during the week and during the day is much more straightforward than at night, when caregivers may not be expecting new referral opportunities. Location, the requested schedule, and the type of help needed also affect how quickly a caregiver is available. Our office is open Monday through Friday, 8am to 4pm, and on call after hours.

Yes. We can often make plans very quickly, though timing always depends on the circumstances, such as the schedule, location, and type of help needed. Learn more about hospital and rehab support and after-surgery home care.

Before we can begin looking for a caregiver, the family needs to review and sign the Client Agreement and provide payment information. Both can be done electronically, but they still take time, and a hospital discharge often comes with little notice.

You can do all of this remotely, even from the hospital. Start with our Client Intake Form, review and sign electronically, and call us with any questions along the way. A registered nurse is available to help.

If you can see a discharge coming, get these steps done in advance. A planned surgery, a rehab stay, or a hospitalization that's winding down are all good times to call us. With a little lead time, we aren't limited to whichever caregiver happens to be available that day, and can take the time to find the best caregiver available for your loved one.

It also helps to talk with the hospital's discharge planner early about what help will be needed at home. Medicare's discharge planning checklist is a good guide for that conversation, and our article on planning for a hospital or rehab discharge covers what to arrange at home.

Yes, this is very common. Often, the person receiving caregiver services relies on a trusted family member or other responsible person to help manage and coordinate their care and support. Adult children, spouses, relatives, guardians, and others involved in arranging support may complete the intake form on their behalf.

Once we receive your information, Abby Services will review your request and contact you to discuss your needs, answer questions, and explain the next steps. We’ll also provide the Client Agreement and the information needed to complete payment arrangements.

Once everything is in place, we can begin sharing your request with our network of caregivers whose availability, experience, and preferences may align with your needs.

Yes. Once your documentation is complete, Abby Services can arrange a meet-and-greet visit with the caregiver you've been matched with. It's a paid first visit, so the caregiver is there to help while you see how they work with your loved one in your own home. That tells you more about the fit than an interview usually can.

Most caregivers balance other clients and commitments, so they generally aren't able to set aside time for unpaid interviews, especially for shorter or occasional schedules. For more involved situations, such as live-in or around-the-clock care, we can also set up a phone interview between you and the caregiver before the meet-and-greet visit.

If it isn't the right fit, don't worry. Share your feedback with us, and we'll use it to look for a caregiver who may be a better match. You can request a different caregiver at any time.

Yes. Language is an important part of finding a good match. If your loved one is more comfortable in Spanish or another language, let us know and we'll include it when we share your request with caregivers.

Comfort with English varies from person to person, so we rely on two sources. When caregivers register, they complete a self-assessment of the languages they speak and how comfortably they communicate in English. Client feedback fills in the rest: if communication with a caregiver isn't working well for your family, tell us. We'll note it in the caregiver's profile so future matches are a better fit, and we can look for another caregiver for you.

Many clients also have a preference for a male or female caregiver, especially when help with bathing, toileting, or dressing is involved. That's a matter of personal privacy and comfort, and we'll include your preference in the referral request. Keep in mind that most caregivers are women, so a request for a male caregiver may take longer and depends on who is available.

We match based on needs, language, schedule, and personal fit, never on race, ethnicity, national origin, or religion.

Hiring privately can cost less, and some families do it successfully. The difference is what you take on yourself. Florida's safeguards add some cost, but here's what they include when you work with a licensed nurse registry:

• State-required Level 2 fingerprint background screening through Florida's Care Provider Background Screening Clearinghouse, with notification if a caregiver's eligibility changes.
• Verified credentials, including CNA certification or home health aide training, CPR, and health documentation.
• Backup when you need it. If your caregiver needs a day off, becomes unavailable, or isn't the right fit, we can help you find a fill-in for the short term or a new caregiver for the long term.
• Someone to call. If something doesn't feel right, you have someone outside the household to talk it through with and to help you find other options.
• Invoicing and records that long-term care insurers and the VA often ask for.
• State oversight. Nurse registries are licensed and inspected by Florida's Agency for Health Care Administration.

When you hire on your own, through an online marketplace, an ad, or a neighbor's recommendation, screening and credential checks are up to you. If your caregiver gets sick, needs time off, or the relationship starts to go wrong, there's often no one to call for a fill-in or a second opinion. You may also take on household employer responsibilities, such as payroll taxes. Online caregiver marketplaces generally aren't licensed by Florida's Agency for Health Care Administration, so the screening, credential checks, and state oversight required of licensed nurse registries don't apply to them. Most work like listing services, and a Wall Street Journal investigation found that the largest one relied on families to do most of the vetting, sometimes with tragic results.

Why licensing matters. Florida law requires a license to operate a nurse registry, and it treats unlicensed activity as a serious matter. Under section 408.812, Florida Statutes, performing services that require a license without one constitutes abuse and neglect under Florida's adult protective services law. The same statute requires anyone aware of an unlicensed provider to report it to the Agency for Health Care Administration.

Before using any caregiver referral service, you can look up its license on FloridaHealthFinder. Learn more about how a Florida nurse registry works.

It can be, but it helps to know what you may be giving up. Home care in Florida is a regulated industry for good reason. Nurse registries like Abby Services are licensed and inspected by the Agency for Health Care Administration (AHCA), and caregivers referred through a registry must pass Level 2 fingerprint background screening and have their licenses or certifications verified. Apps, Facebook groups, and classified ads don't have to meet those standards, and caregivers who can't meet them can still find work there.

It's not a problem until it's a problem. In a 10 Tampa Bay investigation, a Palmetto woman who hired a home care company she found on Care.com to care for her dying husband says she lost thousands of dollars, raising questions about how the site vets the people and companies it lists. A 2019 Wall Street Journal investigation also found that some caregivers hired through Care.com had police records or were accused of crimes while caring for clients, and that the site had relied largely on families to do their own vetting (report).

If you hire on your own, ask for proof of a current Level 2 background screening, check any license or certification with the Florida Department of Health, and call references. Or call us at 239-590-0861, and we'll help you connect with screened, credentialed caregivers in your area.

Abby Services primarily refers Certified Nursing Assistants and Home Health Aides who meet Florida’s applicable training, screening, and registration standards.

In private-duty home care, CNAs and HHAs often provide many of the same types of hands-on assistance, including help with bathing, dressing, mobility, personal care, meals, and everyday routines. The primary difference is the credential each caregiver holds: CNAs maintain a Florida certification, while HHAs provide documentation of qualifying home health aide training. Both credentials are recognized in Florida for the hands-on in-home assistance commonly requested by private-duty clients.

Registered nurses are available for referral when a situation calls for one. For most families, though, hourly private-duty nursing isn't the most cost-effective choice. CNA and HHA support usually offers the best value for people who want help staying independent at home.

When a loved one's situation is more complex, many families also work with a nurse care manager, often an RN, who can coordinate care, communicate with doctors, and help the family navigate decisions. Learn how a nurse care manager works with your private caregiver.

Before caregivers may be considered for referrals, Abby Services reviews documentation required by Florida for nurse registry caregivers, including professional credentials or training, background-screening eligibility, health documentation, CPR certification, and other applicable records.

Caregivers are responsible for maintaining their qualifications and keeping required documentation current. Abby Services tracks applicable registration requirements and updates caregiver records to help ensure caregivers remain eligible for referral opportunities. Caregivers interested in referral opportunities can review the requirements to register with Abby Services.

Professional liability insurance is an important consideration when choosing an independent caregiver. Many clients request proof of coverage before engaging a caregiver, and Abby Services encourages caregivers to maintain an active professional liability insurance policy.

Professional liability coverage can provide additional protection for caregivers wherever they provide services—not just when accepting referrals through Abby Services. Abby Services can also provide caregivers with information about insurance resources upon request.

Caregivers referred by Abby Services may assist with a wide range of everyday needs, including personal care, bathing, dressing, mobility assistance, meal preparation, companionship, pet care, transportation, light housekeeping, and other activities of daily living. The specific services provided are determined between you and your caregiver based on your needs and the caregiver’s qualifications, experience, and skills.

Caregivers may also support clients living with Alzheimer's or dementia and give family caregivers a break through respite care.

Yes. Abby Services has helped seasonal residents for years, and many families return to us season after season.

If you worked with a caregiver last season, let us know before you head back. We'll check whether that caregiver is still available and interested in working with you again. If they aren't, we'll use what you liked about your last arrangement to help find another caregiver who may be a good fit.

Reach out a few weeks before you arrive. Southwest Florida's busy season brings more requests for care, and starting early gives you the best choice of caregivers. Care can be as flexible as you need, from a few hours a week to live-in or around-the-clock care.

Yes. Care can be short-term or long-term: one hour, one day, one week, or one year. You decide what works for your family. Visiting family members often arrange help so a parent can enjoy the trip safely, so the family can get out on their own for a while, or so a parent can recover after a hospital stay before traveling home.

Common options include hourly care, respite care to give family caregivers a break, overnight care, and care after surgery or a hospital stay. Caregivers can help at a family member's home, a vacation rental, or a hotel within the areas we serve.

Let us know the dates, location, and type of help your parent needs. Giving as much notice as possible helps us share your request with caregivers who may be available.

Yes. Caregivers referred through Abby Services can help clients wherever they call home, including communities such as Shell Point, assisted living facilities, and rehab facilities, for short or long-term needs. A caregiver can even stay with your loved one in a hospital room.

Many facilities have their own requirements for outside caregivers or visitors, such as sign-in procedures, proof of screening, or house rules. Check with the facility before care begins so those requirements can be shared with the caregiver you choose. We're happy to pass them along.

Yes. If your needs grow, or your caregiver can't cover additional hours, contact Abby Services and we'll share a new referral opportunity with caregivers whose availability fits your request.

Many families build a small team of caregivers so coverage holds up when someone is sick or away, and your loved one still sees familiar faces.

Abby Services offers flexible scheduling options designed to accommodate a variety of client needs. Caregiver availability may vary depending on the length of the requested visit, location, schedule, and type of assistance needed.

Your requested schedule can also affect the cost of services. Finding the right balance between visit length, caregiver availability, and overall value is important. Generally, longer and more consistent schedules attract a larger pool of interested caregivers, while shorter visits may have fewer available options or a higher hourly rate.

Abby Services can help you consider these factors and determine a schedule that makes sense for your needs and budget before sharing your request with interested caregivers.

Yes, and we're glad to try. Just know that short visits cost much more per hour. In Southwest Florida, visits of one to three hours typically run $100 to $150 per visit in total. A one-hour visit is usually about $100, and longer short visits, or visits in Naples or on the islands, run toward the higher end. By comparison, visits of four to six hours typically run about $40 to $45 per hour.

The higher cost comes from two places. Caregivers still have to travel to and from each visit, so most charge considerably more for short visits. Short visits also take as much administrative work to arrange as longer ones, so our registry fee is higher for them too.

Families often wonder what a caregiver would do for four hours. In practice, the time goes quickly: an unhurried bath, getting dressed, a meal together, laundry, light housekeeping, and an errand or some company. Many families find a four-hour visit gets far more done for not much more than a short visit. Longer visits also draw more caregiver interest, since many experienced caregivers prefer longer, consistent visits that fit their schedules.

If a short visit is the right fit, let's talk it through. Think about what you'd be comfortable paying, and we'll have an honest conversation about whether that's likely to work for a caregiver and for our costs. Once we agree on a realistic range, we'll share your request with caregivers who may be interested. If you mainly want peace of mind between visits, a camera or medical alert device may help too. See home cameras for checking on a parent.

Yes. Caregivers referred through Abby Services may be available for overnight, extended-hour, or live-in arrangements. Availability depends on the client’s needs, location, schedule, and the caregivers interested in the opportunity.

Because these arrangements can vary considerably, Abby Services will discuss what you are looking for and help identify the type of schedule that may work best before sharing your request with available caregivers.

Yes. Caregivers are available on weekends and holidays. Availability can be more limited on holidays, busy weekends, and during emergencies or major events, so it helps to plan ahead when you can.

Caregivers set their own rates, and some charge more for holidays or when demand is high. In Florida, caregivers generally expect time and a half on major holidays. You decide whether to offer a holiday rate, and each caregiver decides whether to accept. We'll tell you what we're seeing and pass along a caregiver's rate before care begins, so you know what to expect on your bill, with no surprises. Learn more about what private caregivers cost in Fort Myers and Cape Coral.

Yes. Many caregivers are willing to provide transportation or accompany clients to medical appointments, errands, shopping, social activities, and other outings.

Transportation arrangements should be discussed directly with the caregiver, including whether the client’s or caregiver’s vehicle will be used and any associated expenses. Let Abby Services know if transportation is important so we can share that information with caregivers considering your request.

Abby Services is not a transportation provider and does not provide automobile insurance coverage for transportation arranged between clients and caregivers. Clients and caregivers are encouraged to confirm appropriate insurance coverage with their own insurance providers. As an alternative, clients may choose to use a professional transportation service while having their caregiver accompany them.

Yes. Hospitals and rehab facilities often tell families that a sitter is needed when a patient becomes suddenly confused or agitated and may be at risk of falling or pulling at lines. This kind of sudden confusion, called delirium, has many causes. One we see often is a urinary tract infection, which is usually treatable and short-term but can cause a sharp increase in confusion and agitation in older adults.

Family members can take turns staying with their loved one, or you can arrange for a private caregiver to stay at the bedside. A caregiver can provide companionship and reassurance, help keep your loved one safe, and alert the nursing staff when something is needed, assisting as the facility allows. Medical care remains with the hospital team. Learn more about hospital and rehab support, and read our guide to private sitters at home, in the hospital, or in rehab.

No. Most in-home help doesn't require a doctor's order. That includes companionship, homemaking, and personal care from a certified nursing assistant (CNA) or home health aide (HHA).

Florida law does add one step for CNA and HHA care. Your loved one needs to be under a physician's care, and we notify that physician in writing once care is arranged (§400.506(6)(b), Florida Statutes). That's why we ask for the name and address of your loved one's doctor when you first call. Companion and homemaker services don't require this.

Skilled nursing, such as wound care or injections, is different. It must be ordered by a physician and performed by a registered nurse (RN) or licensed practical nurse (LPN) under a signed medical plan of treatment. Abby Services focuses on non-medical care, so if your loved one needs skilled nursing, give us a call and we'll talk through your options.

If you plan to use long-term care insurance, your policy will likely require a licensed health care practitioner to certify your loved one's needs and prescribe a plan of care. As a registered nurse, Scott Strachan can help you gather the paperwork your insurer needs. Learn how tax-qualified policies work.

Not in the way a nurse can. Under Florida's rules for nurse registry caregivers, CNAs and home health aides cannot administer medications, give injections, or fill or dispense from a pill organizer. With additional training, a nurse's review of the medications, and written consent, they may assist someone who takes their own medications, such as opening a container or steadying a hand.

Managing medications safely takes real clinical training, which is why our owner, Scott Strachan, RN, BSN, generally recommends that caregivers stick to medication reminders. That keeps the decisions with the client, family, and pharmacist rather than the caregiver.

The best person to organize medications is a pharmacist. Many local pharmacies offer pre-sorted packaging by date and time, such as Cypress Pharmacy's medication packaging in Fort Myers. That way a caregiver can remind your loved one and confirm the right packet was opened.

In limited ways. Florida draws a clear line between what a CNA or home health aide may do and what requires a licensed nurse:

• Catheters: caregivers can keep the area clean with soap and water and empty the drainage bag. They cannot insert or change a catheter.
• Ostomies: caregivers can empty and change a colostomy bag. They cannot remove the flange (the wafer around the stoma) or handle the stoma site.
• Injections: no. Injections, including insulin, are a nursing task. Caregivers can assist with using a glucometer to check blood sugar.
• Wound care: caregivers can reinforce a dressing. They cannot change sterile dressings, clean or irrigate wounds, or treat them.

These limits protect your loved one, and they protect the caregiver from being blamed for complications, like an infection, that come from tasks they aren't trained or licensed to do. When skilled care is needed, a home health agency nurse (often covered by Medicare) can handle it alongside your private caregiver. See the Florida rule for the full list.

Yes, in many cases. Safe transfers, such as moving from bed to chair or getting on and off the toilet, are a big part of helping someone with limited mobility stay at home. Devices like Hoyer lifts and sit-to-stand lifts can make difficult transfers safer for both the client and the caregiver when they're used properly.

Equipment alone doesn't guarantee a safe transfer, though. Carpet, tight bathrooms, furniture placement, or the client's ability to help can make a transfer unsafe even with a lift in the home. Whether and how a transfer is done is decided between the client and the caregiver, and a caregiver may decline a transfer they don't believe is safe.

When transfers are getting harder, ask your doctor about a physical or occupational therapy evaluation. A therapist can recommend the right equipment and show the family and caregiver safe techniques for your home. Let Abby Services know about any lift or transfer needs so we can share them with caregivers considering your request.

A caregiver isn't a physical therapist, but they can help your loved one keep up with the exercises a therapist prescribes. It works much like a doctor and a nurse: the doctor prescribes, and the nurse carries out the plan. A physical or occupational therapist designs the home exercise program, and a caregiver can prompt, encourage, and assist so it actually gets done.

For example, if the therapist recommends rotator cuff stretches or range-of-motion exercises three times a day, a caregiver can remind your loved one, help them through the routine the way the therapist showed, and let you know how it's going. Share the therapist's written instructions with your caregiver, and ask the therapist which exercises are safe to do with help. Learn more about rehabilitation at home and caregiver support.

Yes. A private caregiver can help a person living with Alzheimer's or another dementia stay safe and comfortable at home, with help such as keeping an eye on safety, bathing and dressing, meals, medication reminders, a steady daily routine, and companionship. Florida requires caregivers who provide personal care to complete Alzheimer's and dementia training, and the caregivers we refer for dementia care meet that requirement. Learn more about Alzheimer's and dementia caregiver support.

I've seen the difference firsthand. My father, Tom, who founded Abby Services, lived with Parkinson's disease that progressed to Lewy body dementia. A caregiver helped him at home, and just as importantly, helped my mom, who was his primary caregiver.

That second part matters as much as the first. Caring for someone with dementia day after day is exhausting, and the people doing it need breaks too. Respite care, even a few hours a week, gives family caregivers time to rest, see their own doctor, or simply be a spouse or son or daughter again. See how in-home respite care helps family caregivers avoid burnout.

Helpful resources: the Alzheimer's Association's guide to respite care, the National Institute on Aging's Alzheimer's caregiving tips, and, for Lewy body dementia, the Lewy Body Dementia Association, whose Lewy Line is 800-539-9767.

Yes. A private caregiver can help with many of the daily challenges Parkinson's brings, including walking and fall prevention, transfers, bathing, dressing, meals, and getting to appointments. Caregivers can also give medication reminders as directed by your loved one's physician or family. With Parkinson's, timing matters, because a late dose can bring back symptoms. We encourage families to use a pharmacy dispensing service or pre-sorted packs, so medications are organized and ready on schedule.

Families often call our office asking for a nurse. Most don't need one, and wouldn't want to pay for one. Skilled nursing from an RN or LPN often costs $75 to $120 per visit and isn't necessary for daily support. An independent CNA or home health aide can provide the hands-on help that keeps your loved one safe and independent at a cost that works over the long term.

Parkinson's is progressive and affects both body and mind, so most people need more help as time goes on. Care might start with a few hours a week to give a spouse a break and grow to longer visits or around-the-clock care. Some people with Parkinson's also develop Lewy body dementia, which can bring confusion and behavior changes. That's what happened with my father. When his confusion led to combative behavior and he became a danger to himself and others, our family made the difficult decision to move him to an assisted living community focused on dementia care, where he had supervision around the clock.

The best time to call is before a fall or a crisis. Too many families wait for an emergency. Planning early gives your loved one the support to stay safe and independent longer.

Helpful resources: the Lee Health Parkinson Program (formerly the HOPE Parkinson Program, 239-343-9243) offers free movement classes, education, support groups, and support for care partners. My father took part in its exercise classes, and the support it gave him, my mom, and our family was amazing. The Parkinson's Foundation Helpline is 1-800-4PD-INFO (1-800-473-4636). See also exercise and Parkinson's disease: where to find classes in Fort Myers and Cape Coral.

Absolutely. Respite care is one of the most important things a family caregiver can arrange, and it's one of the key benefits of working with Abby Services. A private caregiver can step in so you can rest, work, see your own doctor, travel, or simply have time to yourself.

Respite can be short-term or long-term: a few hours a week, a regular day off, overnight help so you can sleep, or coverage for a week or more while you recover or go out of town. Learn more about respite care through Abby Services and read 5 ways in-home respite care helps family caregivers avoid burnout.

Don't wait until you're exhausted to ask for help. Regular breaks make it easier to keep caring for someone you love. If you're caring for someone with dementia, see Alzheimer's and dementia caregiver support.

Other helpful resources: the Alzheimer's Association's guide to respite care and the ARCH National Respite Network's respite locator. If your loved one is on hospice, Medicare's hospice benefit also includes short-term inpatient respite care.

Yes. Hospice is a wonderful benefit, but it's a visiting service. Hospice nurses, aides, chaplains, and social workers come for scheduled visits and are on call for urgent needs, while the hours in between usually fall to family. A private caregiver can help fill that gap, assisting with personal care between hospice aide visits, staying overnight, preparing meals, and giving family members time to rest or simply be family again.

As a former hospice nurse, I've seen how much a consistent caregiver helps. Hospice teams welcome someone in the home who can notice changes and call the hospice nurse when it matters. The caregiver works alongside hospice, following your family's wishes and the comfort measures the hospice team has shown you.

Hospice doesn't pay for private caregivers, so this is support families arrange alongside hospice care. Learn more about hospice caregiver support, read 3 home hospice tips from a former hospice nurse, or see what Medicare's hospice benefit covers.

In any emergency, the caregiver should do what anyone should do: call 911. Caregivers referred through Abby Services maintain current CPR certification, as Florida requires.

After calling 911, the caregiver should contact the client's emergency contact right away, both to keep the family informed and to get direction. That's why it helps to keep an emergency sheet somewhere easy to find, with family contacts, doctors, medications, allergies, and insurance information.

If your loved one has a Do Not Resuscitate Order, keep it where paramedics will see it. Florida's DNRO form (DH 1896) must be printed on yellow paper, or EMS isn't required to honor it. Please also let Abby Services know when an emergency happens so our records stay current.

If your parent falls and is hurt, can't get up, hits their head, or seems confused, call 911. Even after a fall that seems minor, let their doctor know.

Prevention matters most. According to the CDC, falls are the leading cause of injury death for adults 65 and older, but many falls can be prevented. Some of the simplest safety steps are also the most often overlooked: remove throw rugs, make sure halls, stairs, and bathrooms are well lit, add night-lights and grab bars, and keep walkways clear of cords and clutter. The CDC's Check for Safety home checklist walks through the house room by room.

A private caregiver adds another layer of protection. A caregiver can't guarantee your parent will never fall, but can help manage the risk. Your parent has someone to rely on for the things that have become hard, like bathing, getting in and out of bed, or walking to the bathroom. And having someone there, or knowing someone is coming, means a fall won't go unnoticed for hours. Learn more about personal care and overnight care, and see 14 signs it's time to get help.

Planning ahead is the key, and it's one of the protections of working with a licensed nurse registry. Florida requires every nurse registry to maintain a comprehensive emergency management plan, updated each year, that covers hurricanes and other emergencies.

Each family decides on its own emergency plan. Before storm season, decide where your loved one will stay during a storm: at home, if you believe it's safe, with family or friends, or at an emergency shelter. You and your caregiver can then talk through whether the caregiver is able to help before, during, and after the storm at that location, and the rate and terms for those hours. These arrangements need to be made in advance, because plans are hard to change once a storm is approaching, and caregivers have their own families and homes to prepare too.

If your loved one would need help during an evacuation because of a physical, mental, cognitive, or sensory disability, Florida's Special Needs Registry helps local emergency management plan for them. Register through your county: Lee, Collier, or Charlotte. Abby Services can assist with registration if you'd like help.

Special needs shelters have very limited space. They're generally for people whose medical needs depend on electricity or oxygen, who need care beyond basic first aid but not a hospital, or who have a chronic condition or disability that requires help with daily activities. Everyone else is welcome at a general public shelter.

Know what to expect at a special needs shelter. Florida's Agency for Health Care Administration advises that a special needs shelter should be used as a place of last refuge, and that care there may not be the same as at home. If your loved one has a caregiver, the caregiver is expected to accompany them and stay with them at the shelter. See AHCA's Appendix B: Information for Nurse Registry Patients for what to bring, and our Client Emergency Preparedness Guide, which every new client receives.

For a step-by-step checklist, see our guide to building a hurricane plan for older adults in Lee, Collier and Charlotte Counties.

Match the help to the real need. Very often, families don't need someone there all day. They need to know their loved one is safe, and paying a caregiver to be present just in case isn't cost-effective. A few ways families save:

• Use remote monitoring for the just-in-case hours. Cameras and medical alert devices let family check in and feel comfortable without paying for labor. See our guide to home cameras for checking on a parent. Let your caregiver know about any cameras, and be aware that Florida has strict rules on recording conversations without consent.
• Schedule care around the busiest times, such as the morning routine and bedtime. Short visits cost more per hour, while longer, consistent visits have the lowest hourly rate, so it's worth comparing options on our cost guide.
• Share the load with family, and use respite care for the times family caregivers need a break.
• Add community services, such as meal programs, senior transportation, and adult day programs. The Elder Helpline (866-413-5337) can point you to local options.
• Use benefits you already have, such as long-term care insurance or VA benefits.

Abby Services can help you think through a schedule that fits your needs and budget before sharing your request with caregivers.

Caregivers submit information about the services they provide for administrative payment processing. Clients are responsible for reviewing the information submitted and addressing any discrepancies regarding the hours or services reported.

Abby Services assists with invoicing, recordkeeping, collecting funds, and payment processing on behalf of clients and caregivers. This administrative support helps simplify the payment process while the caregiver’s compensation remains the responsibility of the client.

The easiest way to pay from your checking account is an electronic check, also called ACH. It draws directly from your bank account, just like paying a utility bill online, and it's the most cost-effective payment method, so it's the one we recommend.

Most families pay through CareLink, a separate secure payment service. CareLink's current processing fee is 3% for ACH and 5% for Visa, Mastercard, or Discover (6% for American Express). Credit cards are available if you prefer them, but they cost a little more.

If you'd prefer to pay by paper check, there are two possibilities:

• A prefunded CareLink account. CareLink offers an option to pay by check, where you fund an account in advance and payments are drawn from it. Because of the extra management involved, it comes with additional costs set by CareLink and isn't cost-effective for most families. If you're interested, let us know and we're happy to help make it happen.
• Our escrow payment option. Because escrow requires extra administrative work to receive, hold, and disburse payments, it carries a 20% escrow administration fee and may require a deposit.

Most families find ACH far simpler and less expensive. Call us if you'd like to talk through which option fits your situation best.

Yes. We can send paper copies for you to print, sign, and return. Most families find electronic signatures faster and easier, though, so that's how most documents are completed.

Electronic signing also makes it easier for family members who don't live nearby. An adult child in another state can review, sign, and authorize what's needed from their phone or computer without traveling, and there's no waiting on mail. Before signing on someone's behalf, make sure you have the legal authority to do so, such as a power of attorney.

No. Abby Services does not generally require a deposit before caregiver services begin.

Invoicing is completed weekly, after services have been rendered. Clients receive an invoice for the prior week’s reported services and have an opportunity to review the hours and charges before payment is processed.

A deposit or advance balance may be required in limited circumstances involving certain payment arrangements or third-party reimbursement delays, but this is not the standard billing process.

Usually not for the kind of help most families are looking for. Original Medicare covers home health care: part-time or intermittent skilled nursing and therapy for people who are homebound and have a doctor's order. It can include some home health aide visits, but only while skilled care is also needed.

Medicare does not pay for 24-hour care at home, or for custodial care such as help with bathing, dressing, and meals when that is the only care someone needs. That ongoing, non-medical support is what private caregivers offer, and most families pay for it privately or through long-term care insurance.

A common misunderstanding is that Medicare only helps while someone is getting better. Coverage depends on whether skilled care is needed, not on whether the person is expected to improve. A long-term condition doesn't rule out Medicare home health, but help with daily living on its own isn't covered.

Some do, but the benefit is usually limited. Medicare Advantage plans can now offer in-home support services as an extra benefit. In 2026, about 7% of individual plans and 25% of Special Needs Plans offer it, according to KFF.

Before counting on it, ask the plan how many hours per year are covered, which tasks are included, who qualifies, whether you need approval first, and which providers you can use. Benefits change every year, so check the plan's Evidence of Coverage.

For free, unbiased help comparing plans, contact SHINE, Florida's Medicare counseling program, through the Area Agency on Aging for Southwest Florida's Elder Helpline at 866-413-5337. SHINE counselors don't sell insurance. Medicare Open Enrollment runs October 15 to December 7.

Yes, for people who qualify. Florida's Statewide Medicaid Managed Care Long-Term Care program can cover in-home help, such as personal care, for people who meet both financial and medical eligibility requirements.

There are limits to know about. Unlike regular Medicaid, this program isn't an entitlement, so there is a waitlist, and people are released from it based on need rather than how long they've waited. Approved services also come only through providers in the Medicaid plan's network.

The first step is a phone screening with your local Aging and Disability Resource Center. In Southwest Florida, call the Elder Helpline at 866-413-5337. The same helpline connects you with SHINE, which offers free, unbiased counseling on Medicare and Medicaid. For other local resources, dial 2-1-1.

Yes, as long as the hours don't overlap. Caregiver support arranged through Abby Services is private pay, so Medicaid doesn't cover it. Many families use a private caregiver to add help Medicaid doesn't provide, such as extra hours, evenings, or weekends.

Privately paid hours should be separate from the hours your Medicaid plan authorizes, so the same services aren't being paid for twice. It's a good idea to let your plan's care coordinator know about any private help you arrange.

Yes, for veterans and surviving spouses who qualify, but the details matter. The most common option is Aid and Attendance, a monthly payment added to a VA pension for people who need help with daily activities such as bathing, dressing, and eating. To qualify, the veteran or surviving spouse must first be eligible for a VA pension, which includes service, income, and net worth requirements.

Like many government programs, the application can be confusing. The best free starting point is your County Veteran Service Office:

• Lee County Veteran Services: 239-533-8381
• Collier County Veteran Services: 239-252-8387
• Charlotte County Veteran Services: 941-764-5579

You can also find a VA-accredited representative. Be cautious of anyone who charges a fee to help you file an initial claim.

Aid and Attendance is paid directly to the veteran or surviving spouse, not to a care provider. That means families can use it toward the cost of a private caregiver referred through Abby Services.

The cost of care may also count when the VA reviews income, so good records matter. Abby Services' weekly invoices show the dates, hours, and charges for services reported, which can help families document care expenses for their claim. Your Veteran Service Officer can explain exactly what the VA will need.

Many long-term care insurance policies may reimburse some or all of the cost of qualifying in-home caregiver services. Abby Services has extensive experience helping clients understand confusing policy requirements, navigate the claims process, and receive the maximum benefits available under their coverage.

Abby Services can assist with service records, invoices, and other documentation requested by the insurance company. When invoicing is completed, we can electronically submit the necessary claim information each week, helping make reimbursement as simple and timely as possible.

Clients may also choose to assign their insurance benefits to Abby Services. An additional administrative fee applies to assigned-benefit arrangements because of the added processing requirements, financial responsibility, and potential payment delays. Final eligibility, coverage, and reimbursement decisions remain subject to the client’s policy and insurance company.

Usually longer than families expect, and much of the timing depends on how quickly paperwork is completed. The process starts when the policyholder requests a claims packet from the insurer. Most insurers still mail it, so allow about a week for it to arrive.

From there, three sets of information have to come together: the family's claim forms, the physician's statement (which the insurer requests directly from the doctor), and records from the caregiver or provider. Most policies also have an elimination period of paid care before benefits begin.

In our experience, insurers don't pre-approve claims. You can start care and begin submitting a claim when you believe your loved one qualifies, which is why it helps to work with someone who knows how long-term care insurance works, so a denial doesn't come as a surprise. See our long-term care insurance guide for the full step-by-step process.

Sometimes. Tax rules are tricky, so always talk with your CPA or tax professional before claiming anything.

According to IRS Publication 502, some in-home care can count as a medical expense, including personal care for someone who is chronically ill and receiving care under a plan prescribed by a licensed health care practitioner. Nursing-type services such as bathing and grooming can also count, even when the caregiver isn't a nurse. General household help, like cleaning, usually doesn't qualify.

Even when care qualifies, medical expenses only lower your taxes if you itemize, and only the portion above 7.5% of your adjusted gross income counts. Abby Services' weekly invoices can help you and your tax professional keep accurate records.

The caregivers we refer are self-employed and responsible for their own taxes. You don’t withhold taxes or run payroll through Abby Services. When you pay through CareLink, CareLink issues the year-end 1099 forms to caregivers on your behalf.

Every household’s situation is a little different, so it’s a good idea to check with your tax professional about any obligations that may apply to you. IRS Publication 926 covers household help, and some care costs may be tax-deductible (see “Are in-home caregiver costs tax-deductible?” above).

Most families combine several sources. Common options include:

• Savings and income, such as Social Security, pensions, and retirement accounts.
• Family contributions, with adult children or other relatives sharing the cost. It helps to agree in writing on who pays what.
• Long-term care insurance, which can cover much of the cost once the policy's requirements are met.
• VA benefits, such as Aid and Attendance for eligible veterans and surviving spouses.
• Life insurance, through accelerated benefits, a combination life and long-term care policy, or selling the policy.
• Home equity, through a reverse mortgage, a home equity loan, or selling the home.
• Health savings accounts (HSAs), which can be used for qualified medical expenses, including qualified long-term care services. See IRS Publication 969.

Each option has trade-offs, so talk with a financial advisor, elder law attorney, or tax professional before deciding. The federal government's long-term care planning guide is a good place to compare options.

It can for some homeowners, especially when the goal is to stay at home. A reverse mortgage lets homeowners 62 and older turn part of their home equity into cash without making monthly mortgage payments. The most common type is the FHA-insured Home Equity Conversion Mortgage (HECM), and borrowers must meet with a HUD-approved counselor first.

Know the trade-offs. It's a loan, so the amount owed grows over time. You still have to pay property taxes and homeowner's insurance and keep the home in good repair. The loan generally must be repaid when the last borrower sells, dies, or no longer lives in the home, which can include moving to a nursing home or assisted living for an extended time.

The Consumer Financial Protection Bureau's reverse mortgage guide explains the details. Talk with a HUD-approved counselor and your financial advisor before deciding.

Sometimes. Depending on the policy, options may include:

• Accelerated death benefits, sometimes called living benefits, which pay part of the death benefit early if the insured needs long-term care or has a qualifying illness. Whatever is paid early reduces what beneficiaries receive later.
• Combination life and long-term care policies, which include a long-term care benefit.
• Selling the policy to a third party for cash, often called a life settlement.

Payouts and rules vary widely, and these choices can affect an inheritance, taxes, or eligibility for other benefits. Call your insurer or a licensed insurance professional to find out what your policy allows. The federal government's guide to using life insurance for long-term care explains the options.

Open communication is often the best first step. When appropriate, clients and families are encouraged to discuss concerns directly with the caregiver so expectations can be clarified and minor issues can be addressed promptly.

Abby Services is also available to listen, help document the concern, facilitate communication, and suggest practical options. Depending on the circumstances, this may include helping the family clarify expectations, discussing changes to the arrangement, or referring additional caregivers for consideration.

Concerns involving immediate safety, suspected abuse, neglect, exploitation, or a medical emergency should be reported promptly to the appropriate emergency or protective-services authorities, such as the Florida Abuse Hotline (1-800-962-2873). In an emergency, call 911.

Yes. The client and caregiver may agree to adjust the schedule, services, or other details of their arrangement as needs change.

Abby Services should be informed of changes that affect invoicing, documentation, or the terms of the referral so our records remain accurate. We are also available to help families think through changes, discuss available options, and refer additional caregivers when a different schedule or level of assistance is needed.

No. Many families aren't home during visits, and that's often the reason they arrange care in the first place. You're also always welcome to be home whenever you like, including while the caregiver is there.

You don't need to stand over the caregiver's shoulder. Once you and your caregiver have talked through your loved one's routine, preferences, and needs, the caregiver can provide that support on their own during each visit. Staying in touch, by checking in, sharing updates, and talking through any changes, helps the arrangement keep working well for everyone.

Yes. It's your home, and many families find cameras give them peace of mind and an easy way to check in on a loved one. We encourage it, and our guide to home cameras for checking on a parent covers the options.

Follow Florida law when you set them up:

• Video is generally fine in shared living areas of your home.
• Audio is different. Florida requires everyone's consent to record private conversations, so if your camera records sound, get your caregiver's consent first. See section 934.03, Florida Statutes.
• Respect private spaces. Don't record in places where someone expects privacy, such as a bathroom or a live-in caregiver's bedroom.

It's good practice to tell your caregiver that the home has cameras for your loved one's safety. A simple sign or a note in writing works well, and it keeps the relationship built on trust. If you have questions about your specific setup, check with an attorney.

Clients and caregivers may agree to pause their arrangement when services are temporarily unnecessary, such as during a hospitalization or rehabilitation stay, vacation, or extended family visit.

Please notify Abby Services promptly so that invoicing and referral records can be kept accurate. When assistance is needed again, Abby Services can help determine whether the previous caregiver remains available or provide additional caregiver referrals for consideration.

Either the client or Abby Services may terminate the caregiver referral agreement at any time by providing at least 24 hours’ notice. Any services already provided, scheduled-visit obligations, Registry fees, or other outstanding balances remain payable as applicable.

Ending the agreement with Abby Services does not automatically end the client’s separate relationship with a referred caregiver. Only the client and caregiver may change or terminate their home-care relationship. Clients who continue working with a caregiver referred by Abby Services remain subject to the Registry-fee and buyout provisions of the Client Agreement.