Call (314) 809-6655

Blog

  • Body weight in later life is more complicated than it looks

    Weight management tends to drop down the list of priorities in elder care, crowded out by more immediate conditions. There is a reasonable case that it deserves more attention than it gets — and a equally important case that the goal is not simply “less.”

    What one study found

    Researchers at Loma Linda University’s Adventist Health Sciences Center studied more than 6,000 men over the age of 75 and reported that a body mass index above roughly 22 was associated with shorter life expectancy — by a margin of several years at the higher end. The results were published in the Journal of the American Geriatrics Society.

    CDC data has put obesity among US adults aged 65 and over at more than one third. Excess weight is an established risk factor for heart disease, stroke, several cancers and type 2 diabetes — all already common in this age group.

    A BMI threshold of 22 is strikingly low — well below the conventional 25 cut-off for overweight — and it comes from a single cohort of older men in a population with distinctive diet and lifestyle patterns. Treat it as one finding, not as a target to aim at.

    The other half of the picture

    The original draft of this article ended by recommending weight control programs for older adults. That is where it needed a correction, because in geriatric medicine the more common and more dangerous problem runs the other way.

    • Unintentional weight loss in an older adult is a red flag. It is associated with cancer, depression, dementia, swallowing problems, dental pain, medication side effects and simple inability to shop or cook — and it independently predicts mortality.
    • Sarcopenia — age-related muscle loss — is a major driver of frailty and falls. Weight lost through dieting in an older adult is disproportionately muscle, which is exactly the tissue they cannot afford to lose.
    • Being modestly overweight in later life is not the same risk it is at 40. Some reserve is protective during illness and hospitalization.

    The reasonable position is that deliberate weight loss in an older adult is a clinical decision, made with their clinician, usually paired with protein intake and resistance exercise to protect muscle — and never a project a family member or attendant takes on independently.

    What this means for day-to-day care. If you notice clothes getting loose, a wedding ring turning freely, meals left unfinished, or food going out of date in the fridge, report it. Those are often the earliest visible signs of a serious problem, and the person who prepares the meals and does the laundry is the one most likely to see them first. Do not put someone you care for on a diet — that is not a personal care task and it can do real harm.

    Sources

    This article is general information, not medical advice. It describes published research; it is not a recommendation for you or the person you care for. Never start, stop or change a prescribed medication because of something you read here — talk to the prescribing clinician first. Communicare Elite provides non-medical personal care through Missouri’s Consumer Directed Services program and does not provide medical advice or treatment.

  • Coffee and older adults: what the research suggests

    Coffee is among the most consumed drinks in the world, and one of the first things people are told to give up as they age. Some of that advice is well founded — caffeine genuinely disrupts sleep, worsens reflux, and can aggravate some heart rhythm problems. But the blanket version of it may be doing more harm than good.

    Caffeine and muscle

    Research presented to the Society for Experimental Biology found that caffeine improved muscle power output, including in older muscle. That matters more than it sounds: age-related loss of muscle strength is one of the main drivers of falls and of losing independence, and the ability to exercise depends on muscles being able to perform in the first place.

    The effect was modest, and it does not turn coffee into a treatment. But it argues against the assumption that caffeine has nothing to offer an older body.

    Caffeine and the brain — with a large caveat

    Researchers at the Florida Alzheimer’s Disease Research Center found that caffeine given to mice reduced levels of proteins associated with Alzheimer’s disease in both blood and brain, and reversed memory impairment in mice bred to develop Alzheimer’s-like symptoms.

    These were mice. A great many things cure Alzheimer’s disease in mice and nothing in people. This is a hypothesis-generating result, not a reason to drink more coffee, and the original draft of this article presented it with more confidence than it deserves.

    Broader observational research in humans has generally found moderate coffee consumption to be neutral or modestly favourable for overall mortality — but as always, people who drink coffee differ from people who do not in many other ways.

    When coffee genuinely is a problem

    • It interferes with sleep, and poor sleep in older adults contributes to falls and confusion. Late-afternoon coffee is worth questioning even if morning coffee is not.
    • It is a diuretic and can worsen urinary urgency — which, for someone with mobility problems, means more risky trips to the bathroom.
    • It can aggravate reflux and some arrhythmias.
    • It interacts with certain medications.

    What this means for day-to-day care. Small pleasures are not trivial in home care. For a lot of older people the morning cup is a fixed point of the day and part of what makes home feel like home. Unless their clinician has told them to stop, there is usually no reason for an attendant to discourage it — and swapping to decaf after lunch solves most of the sleep problem without taking the ritual away.

    Sources

    This article is general information, not medical advice. It describes published research; it is not a recommendation for you or the person you care for. Never start, stop or change a prescribed medication because of something you read here — talk to the prescribing clinician first. Communicare Elite provides non-medical personal care through Missouri’s Consumer Directed Services program and does not provide medical advice or treatment.

  • Cholesterol in older adults: what the debate is actually about

    Read this first. Statins and other cholesterol-lowering medicines are prescribed to prevent heart attacks and strokes, and large randomized trials show they do. Do not stop, reduce or skip a cholesterol medication because of anything on this page. If you have questions about whether yours is still right for you, that is a conversation to have with the clinician who prescribed it.

    An earlier version of this article presented one side of a contested question as settled fact, and told readers that statin benefits were “grossly exaggerated.” That was not a fair summary of the evidence, and it has been rewritten.

    What the review reported

    In 2016 a group led by Uffe Ravnskov published a systematic review in BMJ Open covering 19 cohort studies — about 68,000 older people in total. The authors reported that in most of the cohorts they examined, high LDL cholesterol was not associated with higher all-cause mortality, and in a number of cohorts the association ran the other way: higher LDL, lower mortality.

    Why it was criticized

    Heavily, and by mainstream bodies. The main objections:

    • Method. The Oxford Centre for Evidence-Based Medicine and others argued the review relied on aggregated published summaries rather than individual participant data, an approach prone to bias, and that its selection and analysis were not robust.
    • It contradicts trial evidence. Observational associations between cholesterol level and death are not the same thing as testing what happens when you lower it. Randomized trials of cholesterol-lowering therapy consistently show reduced heart attacks and strokes, including in older participants.
    • Reverse causation is a known trap here. Serious illness — cancer, frailty, advanced heart failure — lowers cholesterol. In an elderly cohort, low LDL can be a marker of being ill rather than a cause of dying, which can manufacture an apparent inverse association.

    What is genuinely unsettled

    There is a real and legitimate clinical question underneath the controversy, and it is narrower than the headlines: how much benefit does starting a statin for primary prevention give someone in their late 80s with a limited life expectancy and a long list of other medications? Guidelines are genuinely more cautious there, and deprescribing near the end of life is an accepted part of good geriatric practice.

    That is a very different proposition from stopping a statin in someone who has already had a heart attack. “Is this still the right medication for me?” is a good question to bring to a clinician. “I read online that cholesterol does not matter” is not a plan.

    What this means for day-to-day care. Personal care attendants do not advise on medication and should not be drawn into it. If the person you care for raises doubts about their prescriptions, the right response is to encourage them to raise it with their clinician or their family — not to agree, disagree, or look it up for them. What is worth reporting is practical: pills going untaken, confusion about doses, or new side effects like muscle pain.

    Sources

    This article is general information, not medical advice. It describes published research; it is not a recommendation for you or the person you care for. Never start, stop or change a prescribed medication because of something you read here — talk to the prescribing clinician first. Communicare Elite provides non-medical personal care through Missouri’s Consumer Directed Services program and does not provide medical advice or treatment.

  • Diet soda and waist circumference in older adults

    Obesity is a genuine problem in later life, and older adults face a particular version of it: mobility limits make exercise harder, dental and swallowing problems narrow food choices, and fixed incomes narrow them further. Low- and zero-calorie products look like an obvious solution, and diet soda is the most popular of them.

    What the study found

    The San Antonio Longitudinal Study of Aging followed 749 older adults over several years, recording diet soda consumption and measuring waist circumference. The results were published in the Journal of the American Geriatrics Society.

    Diet soda drinkers showed substantially greater increases in waist circumference than non-drinkers — roughly three times the expansion over the study period. Waist circumference matters independently of overall weight: abdominal fat is more strongly linked to cardiovascular disease, type 2 diabetes and sleep apnea than fat elsewhere on the body.

    What it does not establish

    This is observational, and the obvious alternative explanation is hard to rule out: people who are already gaining weight, or who already have a diagnosis like diabetes, are precisely the people who switch to diet soda. The drink may be a marker of the problem rather than a cause of it.

    Proposed mechanisms exist — effects on gut bacteria, on appetite regulation, on the learned relationship between sweetness and calories — but none is settled. What can be said fairly is that swapping to diet soda has not been shown to deliver the benefit people expect from it.

    The broader point about “diet” foods

    Diet soda is a specific case of a general pattern. Products marketed on the absence of one ingredient — sugar-free, fat-free, low-carb — tend to be judged healthy on that basis alone, and the substitution often turns out to deliver less than expected. For older adults the stakes are slightly different from the usual weight-loss framing: the risk is not only excess but displacement, where low-nutrition products crowd out food carrying the protein, fibre and micronutrients an ageing body needs more of, not less.

    Someone eating too little protein while drinking three diet sodas a day has a nutrition problem that no amount of calorie counting will identify.

    What this means for day-to-day care. Two practical notes. First, plain water is genuinely underrated: dehydration in older adults contributes to confusion, constipation, urinary infections and falls, and many people simply drink too little because getting to the bathroom is difficult. Making fluids easy to reach helps more than switching brands. Second, this is the person’s own home and their own choice — an attendant’s job is to support what they want, not to police their groceries.

    Sources

    This article is general information, not medical advice. It describes published research; it is not a recommendation for you or the person you care for. Never start, stop or change a prescribed medication because of something you read here — talk to the prescribing clinician first. Communicare Elite provides non-medical personal care through Missouri’s Consumer Directed Services program and does not provide medical advice or treatment.

  • Blood pressure medication in older adults: the case for monitoring

    Read this first. High blood pressure is a serious condition and treating it prevents strokes and heart attacks. Nothing on this page is a reason to stop or reduce a blood pressure medication. Stopping antihypertensive medication without medical supervision can be dangerous. The point of this article is that treatment needs ongoing review — which is a reason to talk to a clinician, not to act alone.

    Hypertension is one of the most common conditions in older adults; research has put the prevalence among Western populations over 60 at around 60 percent. It is so routine that the diagnosis, once made, often stops being questioned — and so does the prescription.

    What the study found

    A study published in Age and Ageing analyzed more than 11,000 patients over the age of 70 and found that a substantial number — over 1,200 of them — were taking antihypertensive medication while measuring hypotensive, meaning their blood pressure was below the normal range rather than above it.

    The researchers linked persistent low blood pressure in this group to increased mortality and hospital admission.

    Why this happens

    It is rarely anyone’s mistake in particular. It is what happens when a correct decision is never revisited. Blood pressure genuinely falls with age, with weight loss, with illness, and with reduced activity. A dose that was right at 68 can be too much at 78, and nobody notices unless somebody measures.

    The consequences of overshooting are not abstract in an older person: dizziness on standing, falls, fainting, confusion, and hospital admissions that follow from those.

    What the researchers recommended

    Not stopping treatment — monitoring it. Consistent follow-up after starting or changing an antihypertensive, and awareness that hypotension is a real risk in a frail population, not just hypertension.

    Why this matters more in home care than in a clinic

    Blood pressure is measured in a clinic, sitting down, after a rest. The problems caused by it being too low happen somewhere else entirely — standing up from a low chair, getting out of bed at 3 a.m., turning quickly in a bathroom. A reading taken in the right conditions can look perfectly acceptable while the person is nearly fainting at home every morning.

    This is called orthostatic hypotension — a drop in blood pressure on standing — and it is both common and under-detected in older adults. It is also one of the most direct causes of the falls that end independent living. The information that closes the gap between the clinic reading and the reality is behavioural, and it comes from whoever is in the house.

    What this means for day-to-day care. This is one of the clearest examples of why the person who is there every day matters. Dizziness when standing up, unsteadiness after getting out of bed, new confusion, near-faints, or a pattern of falls in the morning are all worth reporting to the family and the person’s clinician. A personal care attendant does not administer medication or make clinical judgments — but noticing and reporting a pattern is exactly the kind of information that gets a dose reviewed.

    Sources

    This article is general information, not medical advice. It describes published research; it is not a recommendation for you or the person you care for. Never start, stop or change a prescribed medication because of something you read here — talk to the prescribing clinician first. Communicare Elite provides non-medical personal care through Missouri’s Consumer Directed Services program and does not provide medical advice or treatment.

  • Diet, activity and survival: what a study of older women found

    This one is worth reading carefully, because the headline version of it that circulates online — including in the first draft of this article — misstates what was found.

    The study

    Researchers analyzed 713 women aged 70 to 79 in the Women’s Health and Aging Studies in Baltimore, and published the results in the Journal of the American Geriatrics Society. Rather than rely on people’s accounts of what they ate, the researchers measured serum carotenoids — the plant pigments that end up in the blood after eating fruit and vegetables, and a far more reliable marker than a food questionnaire. Physical activity was measured separately. Over five years of follow-up, 82 participants died.

    What it actually found

    • Higher total carotenoids were associated with better survival.
    • Women in the highest third of total carotenoids were more likely to survive than those in the lowest third.
    • Physical activity was independently associated with better survival.
    • The women who were both most physically active and had the highest fruit and vegetable intake were around eight times more likely to survive the five-year follow-up than women lowest in both.

    That last figure is the one that gets misquoted. The eightfold difference is the combined effect of diet and activity at the extremes of both. Attributing it to vegetables alone — as the original draft of this article did — overstates what the study showed.

    What to take from it

    The researchers described both factors as modifiable, and that is the practical point. This is observational research, so it cannot prove that changing your diet at 75 changes your survival. But the two things it points at — eating actual plants and moving your body — are low-risk, cheap, and supported by a great deal of other evidence.

    It is also a useful corrective to a common assumption in elder care: that nutrition stops mattering past a certain age. In this cohort it was still measurable in the blood, and still tracked with who was alive five years later.

    What this means for day-to-day care. Meal preparation and grocery shopping are both commonly authorized tasks in a Consumer Directed Services care plan, which puts an attendant in a genuinely influential position. Practical things that help: buy frozen vegetables (as nutritious as fresh, no spoilage pressure, no chopping), prepare food that can actually be chewed and swallowed comfortably, and cook things the person actually likes — nutritionally perfect food that goes uneaten helps nobody. Report unexplained weight loss or loss of appetite; in older adults that is a warning sign, not a diet success.

    Sources

    This article is general information, not medical advice. It describes published research; it is not a recommendation for you or the person you care for. Never start, stop or change a prescribed medication because of something you read here — talk to the prescribing clinician first. Communicare Elite provides non-medical personal care through Missouri’s Consumer Directed Services program and does not provide medical advice or treatment.

  • Sauna use and dementia risk: what the Finnish study showed

    Dementia is not one disease. It is a group of symptoms — decline in memory, reasoning and the ability to manage daily life — produced by several different underlying conditions, of which Alzheimer’s disease and vascular dementia are the most common. Tens of millions of people live with it worldwide and the number is expected to keep climbing.

    Which is why an unlikely finding out of Finland got so much attention.

    What the study found

    The Kuopio Ischaemic Heart Disease Risk Factor Study followed 2,315 men aged 42 to 60 for around 20 years. Men who reported taking a sauna four to seven times a week were about 66 percent less likely to be diagnosed with dementia than men who used a sauna once a week, and about 65 percent less likely to be diagnosed with Alzheimer’s disease. The results were published in Age and Ageing.

    There was a dose-response pattern — more frequent sauna use, lower risk — which is one of the things that makes an association more credible. The analysis adjusted for age, blood pressure, alcohol, smoking, cholesterol and other conditions.

    Note the cohort: middle-aged Finnish men. An earlier version of this article implied the study was of older adults. It was not. These men were 42 to 60 at enrolment, in a country where regular sauna bathing is a lifelong cultural norm. Whether starting saunas at 80 does anything is simply not what was tested.

    What it does not show

    This is observational. Men who sauna four to seven times a week are different from men who sauna once a week in ways that are hard to fully adjust for — they are likely healthier, more social, more physically able, and more embedded in community life. Any of those could be doing the work.

    The researchers’ own hypothesis is cardiovascular: sauna bathing raises heart rate and lowers blood pressure in ways resembling moderate exercise, and vascular health is strongly tied to brain health. That is plausible and unproven.

    Heat is not risk-free for older or frail adults. Saunas and hot baths can cause dangerous drops in blood pressure, dizziness, fainting and dehydration, and they interact badly with several common cardiac and blood pressure medications. Anyone with heart disease, low blood pressure, or a history of fainting should ask their clinician before using one — and nobody unsteady on their feet should be in a hot room alone.

    What this means for day-to-day care. The transferable finding here is not “buy a sauna.” It is that cardiovascular health and brain health are tied together, and that social, physical routine appears to matter. Helping someone keep a regular routine, stay warm, stay hydrated and stay connected to other people is well within a personal care attendant’s role and is supported by far more evidence than any single intervention.

    Sources

    This article is general information, not medical advice. It describes published research; it is not a recommendation for you or the person you care for. Never start, stop or change a prescribed medication because of something you read here — talk to the prescribing clinician first. Communicare Elite provides non-medical personal care through Missouri’s Consumer Directed Services program and does not provide medical advice or treatment.

  • Does oral health have anything to do with heart health?

    Oral health tends to be filed under appearance and comfort, and in home care it is one of the first things to slip. Someone who cannot grip a toothbrush, or who is exhausted by the end of the evening routine, stops brushing properly long before anyone notices.

    The association

    A small study from the Copenhagen Gerontological Oral Health Research Center examined 125 healthy people over the age of 80 and reported that those with three or more root caries were more likely to show cardiac arrhythmias. Other, larger bodies of research have repeatedly found that people with periodontal disease have more cardiovascular disease.

    125 people is a small study, and it is old. Treat the specific number as a hint that prompted further research, not as an established fact about your own heart.

    What the American Heart Association actually says

    This is the important part, and the original version of this article got the emphasis wrong. The AHA’s position is that while gum disease and heart disease are associated, there is no conclusive evidence that treating gum disease prevents heart disease or that one causes the other.

    The likeliest explanation is shared risk factors. Smoking, diabetes, poor diet, age and inflammation all damage gums and arteries at the same time. Someone whose mouth is in poor condition is often someone whose cardiovascular risk is high for reasons that have nothing to do with their teeth.

    That makes oral health a useful signal rather than a lever. Visible decline in someone’s mouth is a reasonable prompt to ask what else is going on — not a reason to promise that flossing will protect their heart.

    Why mouths get neglected in home care

    Understanding the mechanics helps more than exhortation. Oral care fails for specific, fixable reasons: arthritis makes gripping a toothbrush painful; a tremor makes the fine movement hard; someone with cognitive decline forgets or resists; dentures are awkward to clean and easy to leave in; and by the end of an evening routine both the person and their attendant are tired.

    The practical workarounds are unglamorous and effective — a wide-handled or electric toothbrush, doing oral care earlier in the evening rather than last, seating rather than standing at the sink, and a consistent place for dentures so they are not lost or stepped on. Dry mouth, a very common side effect of many medications older adults take, accelerates decay considerably and is worth mentioning to a clinician or dentist.

    What this means for day-to-day care. Oral hygiene — brushing, denture care, mouth rinsing — is a standard personal care task and is commonly included in a Consumer Directed Services care plan. It is also one of the most neglected, because it is fiddly and easy to skip. Pain when eating, bleeding gums, a denture that no longer fits, or sudden avoidance of certain foods are all worth reporting. An older person who quietly stops eating properly because their mouth hurts can lose a dangerous amount of weight before anyone connects the two.

    Sources

    This article is general information, not medical advice. It describes published research; it is not a recommendation for you or the person you care for. Never start, stop or change a prescribed medication because of something you read here — talk to the prescribing clinician first. Communicare Elite provides non-medical personal care through Missouri’s Consumer Directed Services program and does not provide medical advice or treatment.

  • Is there a link between vitamin D and cognitive decline?

    Vitamin D deficiency is common. Analysis of National Health and Nutrition Examination Survey data has put the prevalence of deficiency in US adults at around 41 percent, with substantially higher rates among people with darker skin and those who get little sun exposure — which includes a great many homebound older adults.

    Vitamin D’s role in bone and muscle is well established. The open question is whether it does anything for the brain.

    What the study found

    Researchers analyzed data from the Health, Aging and Body Composition (Health ABC) study — 2,777 adults aged 70 to 79 — over four years, and published the results in the Journal of the American Geriatrics Society. Lower blood levels of 25-hydroxyvitamin D were associated with poorer cognitive performance over the follow-up period.

    Why “associated with” is doing a lot of work

    The researchers were explicit that no causal factor was identified. That caveat is not boilerplate. There are at least three ways this association could arise without vitamin D affecting the brain at all:

    • Reverse causation. People in early cognitive decline go outside less, eat less well, and are less likely to take supplements — all of which lower vitamin D. The decline could be causing the low vitamin D rather than the other way round.
    • Confounding. Low vitamin D tracks with frailty, illness, poverty and immobility, each of which independently predicts cognitive decline.
    • It could be real. Vitamin D receptors do exist in the brain, so a genuine mechanism is plausible.

    Distinguishing these requires randomized trials of supplementation, and those have so far not shown that giving vitamin D protects cognition. As with falls, the observational signal has not translated into a supplement that works.

    What this means for day-to-day care. Do not start a supplement on your own initiative for someone you care for — that is a medication decision and it belongs to them and their clinician. What is squarely within a personal care attendant’s role is the ordinary stuff that shows up in the same research: getting someone outside when weather and safety allow, helping prepare real meals rather than whatever is easiest, and mentioning to the family when you notice a change in memory or confusion. Attendants often spot cognitive change before anyone else, because they are there every day.

    Sources

    This article is general information, not medical advice. It describes published research; it is not a recommendation for you or the person you care for. Never start, stop or change a prescribed medication because of something you read here — talk to the prescribing clinician first. Communicare Elite provides non-medical personal care through Missouri’s Consumer Directed Services program and does not provide medical advice or treatment.

  • Vitamin D and falls: what the guidance actually says now

    About one in four adults aged 65 and over falls each year, and a first fall roughly doubles the odds of another. So when early research suggested something as simple and cheap as vitamin D might reduce falls, it got a lot of attention — including in the first draft of this article.

    The evidence has since moved, and this article has been rewritten to reflect that. If you have read older articles recommending vitamin D to prevent falls — including on this site before 2026 — the current US guidance disagrees with them.

    What the early research suggested

    A small study from Wake Forest Baptist Medical Center followed 68 homebound older adults over five months. Half received monthly high-dose vitamin D; half received a placebo. Participants who reached sufficient blood vitamin D levels reported fewer falls. The researchers themselves were careful to say that a study of 68 people needed replication in a much larger group before anyone acted on it.

    What happened when it was tested properly

    It was replicated, at scale, and it did not hold up. The U.S. Preventive Services Task Force recommends against vitamin D supplementation to prevent falls in community-dwelling adults aged 65 and older — a position it first issued in 2018 and carried into its 2024 update on falls prevention. Its 2024 draft recommendation on vitamin D and calcium likewise concluded, with moderate certainty, that supplementation has no net benefit for primary fracture prevention in community-dwelling adults over 60.

    Some trials of very high intermittent doses found more falls, not fewer. “Natural” and “harmless” are not the same thing, and more of a vitamin is not reliably better.

    What is actually recommended for falls

    The same USPSTF review that rejected vitamin D did recommend exercise interventions for community-dwelling adults 65 and older at increased risk of falls, and suggested a selective, individualized approach to multifactorial interventions. In other words: the thing that works is movement, strength and balance work — not a supplement.

    None of this means vitamin D is useless. It has established roles in bone and muscle function, and people with a diagnosed deficiency are treated for it. The point is narrower: taking it specifically to avoid falling is not supported.

    What this means for day-to-day care. The highest-value things you can do about falls are physical and environmental, not pharmaceutical — clear walking routes, remove loose rugs and cords, light the path to the bathroom, keep frequently used items within reach, and make sure footwear actually fits. If the person you care for is on multiple medications, dizziness on standing is worth reporting to their clinician; it is a common and fixable fall risk.

    Sources

    This article is general information, not medical advice. It describes published research; it is not a recommendation for you or the person you care for. Never start, stop or change a prescribed medication because of something you read here — talk to the prescribing clinician first. Communicare Elite provides non-medical personal care through Missouri’s Consumer Directed Services program and does not provide medical advice or treatment.

Communicare Elite

4477 Woodson Rd, Suite 106, St. Louis, MO 63134

Phone: (314) 809-6655
Text: (314) 886-5902
Fax: (314) 481-3037
Email: info@communicareelite.com

Monday–Friday, 9:00 AM–5:00 PM Central. An enrolled MO HealthNet Consumer Directed Services vendor.

If you need care

If you want to work

Accountability

Emergencies: call 911. Mental health crisis: call or text 988. Adult abuse, neglect or exploitation: Missouri hotline 1-800-392-0210.

Communicare Elite is a trade name of Communicare Elite, LLC. Consumer Directed Services is a MO HealthNet program administered by the Missouri Department of Health and Senior Services; eligibility and authorized hours are determined by the state, not by Communicare Elite. We serve Missouri only.

© Communicare Elite, LLC. All rights reserved.