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Managing Chronic Kidney Disease with Home Care

Managing Chronic Kidney Disease with Home Care: A Complete Guide for Patients and Families

A Complete Guide for Patients and Families

More than 35.5 million Americans—1 in 7 adults—are living with chronic kidney disease. Yet remarkably, 9 out of 10 people with CKD don’t even know they have it. This “silent disease” often progresses without symptoms until significant kidney damage has occurred, making awareness, early detection, and proper management absolutely critical.

For seniors and their families navigating a CKD diagnosis, the path forward can feel overwhelming. Between dietary restrictions, medication schedules, medical appointments, and the fatigue that often accompanies kidney disease, daily life becomes increasingly challenging. That’s where professional home care can make a profound difference—helping patients manage their condition, maintain their independence, and enjoy a better quality of life.

Understanding Chronic Kidney Disease: The Basics

Chronic kidney disease describes the gradual loss of kidney function over time. Your kidneys—two bean-shaped organs located on either side of your spine—perform several essential functions that are vital to your overall health.

What Do Healthy Kidneys Do?

Filter waste and toxins: Each day, your kidneys filter approximately 120-150 quarts of blood, removing waste products that are then eliminated through urine.

Regulate fluid balance: The kidneys maintain proper water and electrolyte balance (sodium, potassium, calcium, phosphorus) in the body.

Control blood pressure: The kidneys produce renin, an enzyme that helps regulate blood pressure by controlling blood vessel constriction.

Stimulate red blood cell production: The kidneys produce erythropoietin (EPO), a hormone that signals your bone marrow to make red blood cells.

Maintain bone health: The kidneys activate vitamin D, which is essential for calcium absorption and bone strength.

Balance acid levels: The kidneys help maintain proper acid-base balance in the blood.

When kidney function declines, these processes become impaired, leading to a cascade of symptoms and health complications.

Chronic Kidney Disease: The Statistics (2024-2025)

Understanding the scope of kidney disease helps illustrate why awareness and management matter so much.

Prevalence in the United States

Statistic Data
Americans with CKD 35.5 million (14% of adults)
Unaware they have CKD 9 in 10 adults with CKD
Adults with diabetes who have CKD 1 in 3
Adults with high blood pressure who have CKD 1 in 5
Americans living with kidney failure (ESKD) 815,000
Americans on dialysis 555,000
People on the kidney transplant waiting list 90,000+
Kidney transplants performed in 2024 28,492

Age and Risk Factors

Age Group CKD Prevalence
Ages 18-44 6%
Ages 45-64 12%
Ages 65 and older 34%

CKD is significantly more common among seniors, with more than one-third of adults over 65 affected. This makes kidney health a particularly important consideration for older adults and their caregivers.

The Financial Burden

  • Medicare spending on CKD patients (excluding ESKD) ages 66+: $77 billion in 2021
  • Annual per-person expenditures for Medicare beneficiaries with CKD: $28,162 (more than double that of those without CKD)
  • Total Medicare spending on ESKD: $52.3 billion in 2021

Racial and Ethnic Disparities

Kidney disease does not affect all populations equally:

  • Black Americans are 4 times more likely to develop kidney failure
  • Hispanic Americans are more than 2 times more likely to develop kidney failure
  • Diabetes causes approximately 45% of new kidney failure cases

The Five Stages of Chronic Kidney Disease

CKD is classified into five stages based on kidney function, measured by the estimated glomerular filtration rate (eGFR). Understanding these stages helps patients and caregivers know what to expect and how to plan for care needs.

Stage 1: Kidney Damage with Normal Function

  • eGFR: 90 or higher
  • Kidney function: 90% or more
  • Symptoms: Usually none
  • Care focus: Identify and treat underlying causes; control blood pressure and blood sugar

Stage 2: Mild Loss of Kidney Function

  • eGFR: 60-89
  • Kidney function: 60-89%
  • Symptoms: Usually none
  • Care focus: Continue managing risk factors; annual monitoring

Stage 3a: Mild to Moderate Loss of Function

  • eGFR: 45-59
  • Kidney function: 45-59%
  • Symptoms: May include fatigue, appetite changes, and urination changes
  • Care focus: Nephrology referral; dietary modifications; medication adjustments

Stage 3b: Moderate to Severe Loss of Function

  • eGFR: 30-44
  • Kidney function: 30-44%
  • Symptoms: Fatigue, shortness of breath, appetite loss, and urination changes
  • Care focus: More frequent monitoring; address complications like anemia and bone disease

Stage 4: Severe Loss of Kidney Function

  • eGFR: 15-29
  • Kidney function: 15-29%
  • Symptoms: Swelling (hands, feet, face), back pain, sleep difficulties, concentration problems, nausea
  • Care focus: Prepare for kidney replacement therapy; discuss dialysis or transplant options

Stage 5: Kidney Failure (End-Stage Kidney Disease)

  • eGFR: Less than 15
  • Kidney function: Less than 15%
  • Symptoms: Severe fatigue, swelling, minimal or no urination, weight loss, nausea, itching
  • Care focus: Dialysis or a kidney transplant is required to survive

Recognizing the Symptoms of Kidney Disease

One of the most challenging aspects of CKD is that early stages often produce no symptoms. By the time symptoms appear, significant kidney damage may have already occurred. This is why regular screening is so crucial for people at risk.

Common Symptoms of Advanced CKD

Fatigue and Weakness: When the kidneys can’t filter waste properly, toxins accumulate in the blood, causing persistent fatigue. Additionally, reduced erythropoietin production leads to anemia, further contributing to fatigue.

Swelling (Edema): Failing kidneys cannot remove excess fluid from the body. This fluid accumulates in the ankles, feet, legs, hands, and face—a condition called edema.

Shortness of Breath: Fluid accumulation in the lungs and anemia reduce oxygen delivery to tissues, both contributing to breathlessness.

Changes in Urination:

  • Urinating more or less frequently than usual
  • Foamy or bubbly urine (indicating protein in urine)
  • Blood in urine
  • Difficulty urinating

Nausea and Vomiting: The buildup of waste products in the blood (uremia) can cause persistent nausea, loss of appetite, and a metallic taste in the mouth.

Sleep Problems: Toxin buildup, discomfort, and restless legs syndrome (common in CKD) can all interfere with sleep.

Itchy Skin: Mineral imbalances and waste buildup can cause persistent, uncomfortable itching.

Muscle Cramps: Electrolyte imbalances, remarkably low calcium, and high phosphorus, can cause painful muscle cramps.

Cognitive Difficulties: Advanced kidney disease can affect concentration, memory, and mental clarity.

What Causes Chronic Kidney Disease?

Understanding the root causes of CKD is essential for prevention and management. In most cases, kidney disease results from other health conditions that strain the kidneys over time.

Leading Causes of Kidney Disease

Diabetes (Type 1 and Type 2): Diabetes is the #1 cause of kidney failure, responsible for approximately 45% of new cases. High blood sugar damages the small blood vessels in the kidneys, impairing their filtering ability. About 1 in 3 people with diabetes have CKD.

High Blood Pressure (Hypertension): Hypertension is the #2 cause of kidney failure. Elevated blood pressure damages blood vessels throughout the body, including in the kidneys. About 1 in 5 people with high blood pressure have CKD.

Glomerulonephritis: Inflammation of the kidney’s filtering units (glomeruli) can damage kidney function over time.

Polycystic Kidney Disease: This inherited condition causes fluid-filled cysts to grow in the kidneys, gradually replacing normal tissue and impairing function.

Other Causes:

  • Prolonged use of certain medications (NSAIDs, some antibiotics)
  • Urinary tract obstructions (kidney stones, enlarged prostate)
  • Recurring kidney infections
  • Autoimmune diseases (lupus)
  • Heart disease
  • Family history of kidney disease

CKD Complications: Why Comprehensive Care Matters

Chronic kidney disease doesn’t affect the kidneys alone. As kidney function declines, multiple organ systems are affected, necessitating comprehensive management.

Cardiovascular Disease

The leading cause of death in people with CKD is heart disease, not kidney failure. The connection between the kidneys and the heart is so strong that researchers refer to it as the “cardiorenal syndrome.” CKD increases the risk of:

  • Heart attack
  • Stroke
  • Heart failure
  • Irregular heartbeat (arrhythmias)

Anemia

As kidney function declines, the kidneys produce less erythropoietin (EPO), leading to reduced red blood cell production. Anemia affects:

  • 14.9% of people with Stage 3, A1 diabetic CKD
  • 57-61% of people with Stage 5, A3 CKD

Anemia causes fatigue, weakness, shortness of breath, and can worsen heart problems.

Bone and Mineral Disorders

Failing kidneys can’t properly balance calcium, phosphorus, and vitamin D, leading to:

  • Weak, brittle bones
  • Increased fracture risk
  • Calcification of blood vessels and soft tissues

Fluid Retention

Impaired fluid regulation can cause swelling and may lead to hypertension and cardiac strain.

Electrolyte Imbalances

Disrupted potassium, sodium, and acid-base balance can cause muscle weakness, heart rhythm problems, and other complications.

Malnutrition

Loss of appetite, dietary restrictions, and metabolic changes can lead to weight loss and muscle wasting.

The 2024 KDIGO Guidelines: Modern CKD Management

The Kidney Disease: Improving Global Outcomes (KDIGO) organization released updated clinical practice guidelines in 2024, reflecting significant advances in CKD care. Key recommendations include:

Risk-Based Approach

Rather than focusing solely on eGFR numbers, the 2024 guidelines emphasize an individualized, risk-based approach to CKD management that considers:

  • Overall kidney failure risk
  • Cardiovascular risk
  • Individual patient factors and preferences
  • Quality of life

New Medication Recommendations

SGLT2 Inhibitors: These medications, initially developed for diabetes, have shown remarkable kidney-protective benefits. The guidelines now recommend SGLT2 inhibitors for many patients with CKD—with or without diabetes—when eGFR is greater than 20.

Statin Therapy: Cholesterol-lowering statins are recommended for adults aged 50 years and older with CKD due to their elevated cardiovascular risk.

Emphasis on Comprehensive Care

The guidelines stress the importance of:

  • Early detection and referral to nephrology
  • Multidisciplinary care teams, including dietitians
  • Patient education and shared decision-making
  • Conservative care is a valid option for some patients

Nutrition and Diet for Kidney Disease

One of the most critical aspects of CKD management is dietary modification. Because the kidneys can no longer efficiently filter waste and regulate electrolytes, what you eat directly impacts how well you feel and how quickly the disease progresses.

Key Dietary Considerations

Sodium (Salt):

  • Recommendation: Less than 2,000 mg per day (approximately 5g of salt)
  • Why: Excess sodium causes fluid retention, raises blood pressure, and strains the heart and kidneys
  • Tips: Avoid processed foods, canned soups, and fast food; use herbs and spices instead of salt

Protein:

  • Recommendation (Stages 3-5, not on dialysis): Approximately 0.8 g/kg body weight per day
  • Why: High protein intake creates more waste for the kidneys to filter and may accelerate kidney damage
  • Exception: Patients on dialysis may need more protein; elderly patients need a careful balance to prevent muscle wasting

Potassium:

  • Recommendation: Individualized based on blood levels
  • Why: Damaged kidneys can’t remove excess potassium, leading to dangerous heart rhythm problems
  • High-potassium foods to limit: Bananas, oranges, potatoes, tomatoes, avocados

Phosphorus:

  • Recommendation: Limit to 800-1,000 mg per day for advanced CKD
  • Why: High phosphorus pulls calcium from bones, causing weakness and cardiovascular calcification
  • High-phosphorus foods to limit: Dairy products, processed foods with phosphate additives, dark colas

Fluids:

  • Recommendation: Varies by stage; may need restriction in advanced CKD
  • Why: Failing kidneys can’t eliminate excess fluid, leading to swelling and breathing problems

The Shift Toward Plant-Based Eating

The 2024 KDIGO guidelines recommend that patients with CKD adopt healthy, diverse diets with greater consumption of plant-based foods and reduced intake of ultraprocessed foods. Research shows that plant-based diets can:

  • Reduce protein load on the kidneys
  • Decrease metabolic acidosis
  • Lower inflammation
  • Provide more bioavailable nutrients
  • Slow CKD progression

How Home Care Can Help Clients with Kidney Disease

Living with chronic kidney disease presents daily challenges that can be overwhelming, especially for seniors managing multiple health conditions. Professional home care provides essential support that helps patients maintain their health, independence, and quality of life.

Preparing Kidney-Friendly Meals

Diet is one of the most critical—and most challenging—aspects of CKD management. Our caregivers can help by:

Meal Planning and Preparation:

  • Preparing delicious, kidney-friendly meals that follow prescribed dietary restrictions
  • Carefully limiting sodium, potassium, phosphorus, and protein as directed by the healthcare team
  • Ensuring adequate caloric intake to prevent malnutrition (a common problem in CKD)
  • Making meals appetizing despite restrictions—especially important when appetite is reduced

Grocery Shopping:

  • Shopping for fresh, low-sodium, kidney-appropriate foods
  • Reading nutrition labels to identify hidden sodium, phosphorus, and potassium
  • Avoiding processed foods with phosphate additives

Hydration Management:

  • Helping track fluid intake when restrictions are in place
  • Providing measured amounts of fluids as prescribed
  • Offering alternatives when the patient feels thirsty but has reached their limit

Medication Management

Patients with CKD often take multiple medications to manage kidney disease and its complications—sometimes 10 or more different pills each day. Our caregivers assist by:

Medication Reminders:

  • Ensuring medications are taken at the correct times
  • Helping organize pills using weekly pill organizers
  • Reminding patients which medications to take with food

Pharmacy Coordination:

  • Picking up prescription refills
  • Communicating with pharmacies about medication questions
  • Keeping track of when refills are needed

Monitoring for Side Effects:

  • Observing for signs of adverse reactions
  • Noting and reporting any concerns to family or healthcare providers

Transportation to Medical Appointments

CKD patients require frequent medical visits—especially as the disease progresses. Stage 4 and 5 patients may see their nephrologist every 1-3 months. Dialysis patients attend treatments 3-4 times per week. Our caregivers provide:

Safe, Reliable Transportation:

  • Driving to nephrology appointments, dialysis treatments, and other medical visits
  • Accompanying patients to ensure they don’t have to navigate healthcare settings alone
  • Waiting during appointments and providing support afterward

Appointment Preparation:

  • Helping patients prepare questions for their doctors
  • Assisting with gathering relevant health information before visits
  • Ensuring that patients bring necessary items (e.g., insurance cards, medication lists)

Physical Activity and Rehabilitation Support

Exercise is essential for patients with CKD—it helps control blood pressure, manage weight, maintain muscle mass, and improve mental health. Our caregivers can:

Encourage Safe Activity:

  • Assist with range-of-motion exercises as recommended by physical therapists
  • Accompany patients on walks
  • Help with light stretching and movement throughout the day
  • Ensure safety during physical activity

Prevent Deconditioning:

  • Combat the tendency toward inactivity that often accompanies fatigue
  • Support participation in appropriate activities that maintain strength and function

Domestic Duties and Home Safety

CKD-related fatigue, weakness, and shortness of breath make household tasks exhausting. Our caregivers help by:

Maintaining a Clean, Safe Home:

  • Cleaning bathrooms, kitchens, and living areas
  • Vacuuming, mopping, and sweeping floors
  • Doing laundry and changing bed linens
  • Organizing and decluttering
  • Removing fall hazards

Creating a Comfortable Environment:

  • Ensuring the home is conducive to rest and recovery
  • Maintaining appropriate temperature and lighting
  • Keeping essential items within easy reach

Personal Care Assistance

As CKD progresses, personal care tasks become increasingly complex. Our caregivers provide dignified, compassionate assistance with:

  • Bathing and showering safely
  • Dressing and grooming
  • Toileting assistance
  • Skin care (especially important given CKD-related itching)
  • Mobility assistance

Emotional Support and Companionship

Living with a chronic disease takes an emotional toll. Depression and anxiety are common among CKD patients. Our caregivers offer:

Meaningful Companionship:

  • Conversation and social interaction
  • Engagement in enjoyable activities
  • Emotional support during difficult times
  • A consistent, caring presence

Reduced Isolation:

  • Helping patients stay connected with family and friends
  • Accompanying patients to social activities when able
  • Providing mental stimulation through games, reading, and activities

Monitoring and Communication

Our caregivers serve as an essential link between patients and their healthcare team by:

Observing Changes:

  • Monitoring for symptoms that may indicate worsening kidney function
  • Noting changes in swelling, urination patterns, or mental status
  • Tracking blood pressure and weight as directed
  • Observing food and fluid intake

Communicating with Families:

  • Keeping family members informed about their loved one’s condition
  • Reporting concerns promptly
  • Documenting care activities and observations

Home Dialysis Support

For patients who progress to kidney failure (Stage 5), dialysis becomes necessary to filter the blood. Many patients can receive dialysis at home—either peritoneal dialysis (PD) or home hemodialysis (HHD)—rather than traveling to a dialysis center three times per week.

Research shows that home dialysis offers several advantages:

  • Improved quality of life compared to in-center hemodialysis
  • Greater independence and flexibility
  • Comparable or better outcomes in many cases
  • Lower overall healthcare costs

Home care can support patients on home dialysis by:

  • Assisting with supplies and equipment organization
  • Helping maintain a clean treatment environment
  • Providing support during and after dialysis sessions
  • Offering companionship during treatment
  • Assisting with other daily tasks so patients can focus on their dialysis routine

The Value of Early Intervention and Consistent Support

Research consistently shows that patients who receive comprehensive, coordinated care—including early nephrology referral and multidisciplinary support—have better outcomes. Value-based kidney care programs have demonstrated:

  • 140% more optimal dialysis starts
  • 50% higher home dialysis rates
  • 41% higher transplant rates compared to national averages

These outcomes underscore the importance of consistent support throughout the CKD trajectory—precisely what professional home care provides.

Take the Next Step: Partner with All Heart Home Care

If you or your loved one is living with chronic kidney disease, you don’t have to navigate this journey alone. Professional home care can make a meaningful difference in managing the condition, maintaining independence, and improving quality of life.

Contact All Heart Home Care at (619) 736-4677 to learn how we can help. We offer free in-home consultations where we can:

  • Assess your specific needs and challenges
  • Develop a customized care plan
  • Explain how our services support kidney disease management
  • Answer your questions about home care

Our caregivers can provide:

  • Kidney-friendly meal preparation
  • Medication reminders and pharmacy coordination
  • Transportation to dialysis and medical appointments
  • Assistance with daily activities
  • Companionship and emotional support
  • Light housekeeping and laundry
  • Personal care assistance as needed

Every person with kidney disease deserves compassionate, knowledgeable support. Let us help you or your loved one live well despite CKD—in the comfort of your home.

All Heart Home Care is a veteran-owned, nurse-led home care agency serving San Diego County for over 11 years. We provide companion care, personal care, 24-hour care, specialized care for chronic conditions, respite care, and post-hospital recovery services—call (619) 736-4677 to learn more.

References

  • National Institute of Diabetes and Digestive and Kidney Diseases. Kidney Disease Statistics for the United States. Updated December 2024.
  • Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, 2023.
  • American Kidney Fund. Quick Kidney Disease Facts and Stats. 2025.
  • Kidney Disease: Improving Global Outcomes (KDIGO). 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.
  • National Kidney Foundation. Nutrition and Kidney Disease, Stages 1-5. 2025.
  • United States Renal Data System. 2023 USRDS Annual Data Report.
  • Yonsei Medical Journal. Management of Elderly Patients with Chronic Kidney Disease. 2024.
  • Clinical Kidney Journal. Integrated home dialysis model. 2024.
  • BMC Nephrology. The way home: interventions to increase home dialysis utilization. 2025.

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About the author

Eric Barth, co-founder and CEO of All Heart Home Care San Diego

Eric Barth

CEO, All Heart Home Care

Eric Barth is the founder and CEO of All Heart Home Care™, an award-winning San Diego agency dedicated to providing compassionate, personalized in-home care for seniors. As the writer behind the All Heart Home Care blog, Eric shares insights and stories drawn from years of hands-on experience leading one of San Diego’s most trusted home care teams.

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Additional FAQ's on Digital Home Care System

Yes. HITRUST CSF Certified security—same gold standard hospitals use. More secure than paper.

Extremely rare (99.9% uptime), but caregivers can work in offline mode if connectivity is temporarily lost. Care continues without interruption. Documentation syncs automatically when connection returns.

Caregivers document throughout their shift in real-time. Notes are typically finalized and visible in Family Room within minutes of the caregiver clocking out.

We can set up Family Room accounts for as many family members as you want—local siblings, children in other states, anyone you authorize. Everyone sees the same information. No limit on number of accounts.

Yes. Family Room includes secure document storage. Upload medical records, insurance cards, POLST forms, medication lists, doctor’s instructions, photos—anything important. All authorized family members can access these documents. No more searching for forms.

We update the digital care plan immediately, and all caregivers receive instant notification of changes. This is one of the biggest advantages over paper—updates reach everyone simultaneously, not gradually over days or weeks.

Absolutely. Family Room is a tool for families who want it, not a replacement for human connection. We’re always reachable by phone at (619) 736-4677. Many families use both—portal for quick updates, phone calls for detailed conversations.

We train every caregiver on the WellSky mobile app before their first shift. The app is intuitive—designed specifically for caregivers, not engineers. If someone can text and use GPS navigation, they can use our caregiver app. And we provide ongoing support.

Yes. The Family Room care calendar shows upcoming shifts with caregiver names and times. You’ll know exactly who’s coming and when. No more surprise caregiver switches.

Use the two-way messaging feature in Family Room. Send your message, and the caregiver receives an instant notification on their mobile app. They’ll see it and can respond or confirm receipt immediately.

Yes. All notes are searchable. Want to see every mention of “appetite” from the past month? Type it in the search bar and find all relevant notes instantly. No more flipping through pages of handwritten entries.

You can access the complete care history from the day Family Room access began. Review notes from last week, last month, or since care started. Historical data helps identify patterns over time.

Family members cannot delete caregiver documentation—that’s protected and maintained by All Heart for record-keeping purposes. You can delete your own uploaded documents, but we can often recover those if needed within a certain timeframe.

With your authorization, we can provide limited Family Room access to healthcare providers. This allows better coordination between home care and medical teams. You control exactly who has access and what they can see.

Family Room works both ways. You can access it through any web browser (Chrome, Safari, Firefox, Edge) on your computer, or download the mobile app for easier access on your phone or tablet. Your choice.

All authorized Family Room users see the same care information—we can’t create different access levels for different family members. However, you (as the primary contact) control who gets Family Room access in the first place. If family dynamics are challenging, you decide who receives login credentials.

The messaging system shows when messages are delivered and read. You’ll see confirmation that the caregiver received and opened your message. For critical information, you can also call our office to ensure the message was received.

Yes. You can print individual shift notes, date ranges, or specific types of documentation (like Change of Condition reports) directly from Family Room. Useful for doctor appointments or insurance purposes.

If your loved one transitions to hospice, hospital, or another care setting, we can maintain your Family Room access for a transition period so you have complete records. After care ends, we provide a final data export if requested, then access is closed according to your wishes and legal requirements.

Yes. Family Room is accessible from anywhere with internet connection. If you’re traveling abroad, you can still check on your loved one’s care. The system works globally.

Family Room doesn’t support selective information sharing—all authorized users see the same care documentation. For private family communications, you’d need to use personal email, phone, or text outside the Family Room system.

Change of Condition reports automatically alert you when caregivers document significant health changes. For custom alerts (like specific behaviors or situations), talk to our office—we may be able to add special flags to your loved one’s care plan that trigger notifications.

We typically set up Family Room access during your initial care planning meeting, before the first caregiver shift. You’ll have login credentials and a brief tutorial on how to use the portal. Most families are viewing their first shift notes within 24 hours of care beginning.

Complete Security & Privacy Information

HITRUST CSF Certification - What This Means

HITRUST CSF (Common Security Framework) is the most rigorous security certification in healthcare. It's harder to achieve than HIPAA compliance alone. This certification requires:

  • Annual independent security audits by certified assessors
  • Continuous monitoring of security controls
  • Documented policies and procedures for data protection
  • Employee security training and background checks
  • Incident response and disaster recovery plans
  • Regular penetration testing to identify vulnerabilities

Why it matters: If it’s secure enough for hospital patient records, it’s secure enough for your loved one’s care information.

Bank-Level Encryption Explained

Data in Storage (At Rest):

  • All information stored on WellSky servers is encrypted using AES-256 encryption
  • This is the same encryption standard used by banks and the U.S. military
  • Even if someone physically accessed the servers, they couldn't read the data without encryption keys

Data in Transmission (In Transit):

  • When you access Family Room from your phone or computer, all data traveling between your device and our servers is encrypted using TLS 1.2 or higher
  • This is the same technology that protects your online banking
  • The "lock" icon in your browser address bar confirms this encryption

What this means: Even if someone intercepted the data (extremely unlikely), they would only see scrambled, unreadable information.

Strict Access Controls

Who Can See What

Family Member Access:

  • You decide exactly which family members get Family Room login credentials
  • Each person has their own unique username and password
  • You can add or remove access at any time
  • Family members can only view information for your loved one—no one else's

Caregiver Access:

  • Caregivers only see care plans for clients they're actively assigned to
  • When a caregiver is no longer working with your loved one, their access to that care plan is immediately revoked
  • Caregivers cannot access billing information or family contact details

Staff Access:

  • All Heart staff access is role-based and monitored
  • Office staff see only the information necessary for their job function
  • Nursing supervisors have broader access for quality oversight
  • All access is logged with timestamps

Audit Trail:

  • Every action is logged: who accessed what information, when, and from where
  • These logs are regularly reviewed for any suspicious activity
  • Logs are maintained for compliance and security purposes

HIPAA Compliance - Federal Protection

The Health Insurance Portability and Accountability Act (HIPAA) establishes federal standards for protecting health information. Our compliance includes:

Privacy Rule Compliance:

  • Your loved one's health information is never shared without authorization
  • You control who has access to information
  • Clear privacy policies explain how information is used

Security Rule Compliance:

  • Administrative safeguards (policies, training, access management)
  • Physical safeguards (secure facilities, workstation security)
  • Technical safeguards (encryption, authentication, audit controls)

Breach Notification:

  • In the extremely unlikely event of a data breach, affected individuals are notified promptly as required by law
  • We maintain insurance and procedures for breach response

Business Associate Agreements:

  • WellSky (our technology provider) has signed formal agreements guaranteeing HIPAA compliance
  • All vendors with potential access to data must meet the same standards

Continuous Backup & Disaster Recovery

Automated Backups:

  • Data is backed up automatically multiple times per day
  • Backups are encrypted and stored in geographically separate secure data centers
  • This protects against hardware failure, natural disasters, or other catastrophic events

Redundancy:

  • Data is stored across multiple servers simultaneously
  • If one server fails, others immediately take over
  • No single point of failure in the system

Disaster Recovery Plan:

  • Formal, tested procedures for recovering from any disaster scenario
  • Regular drills ensure the recovery plan actually works
  • Recovery Time Objective (RTO): System restored within hours, not days
  • Recovery Point Objective (RPO): Minimal data loss (minutes, not hours)

What this guarantees: Your loved one’s care information is never truly lost. Even if an entire data center were destroyed, complete backups exist elsewhere.

99.9% Uptime Guarantee

What “99.9% uptime” means:

  • The system is available and functional 99.9% of the time
  • That translates to less than 9 hours of downtime per year
  • Most families never experience a single outage

Monitoring:

  • System performance monitored 24/7/365
  • Automated alerts notify technical teams of any issues immediately
  • Problems are often resolved before users even notice them

If the system goes down:

  • Caregivers can work in offline mode on their mobile devices
  • Care continues without interruption
  • Documentation is saved locally and syncs automatically when connection returns
  • Your loved one's care never depends on perfect internet connectivity

Multi-Factor Authentication (Optional)

For families who want extra security, we can enable multi-factor authentication (MFA):

  • Requires both password AND a code sent to your phone
  • Even if someone stole your password, they couldn't access your account without your phone
  • Optional but recommended for families with high security concerns

Mobile Device Security

Caregiver Phones:

  • WellSky mobile app requires login credentials
  • Apps lock automatically after inactivity
  • No data is stored permanently on caregiver phones—it's accessed from secure servers
  • If a phone is lost or stolen, we can remotely disable access immediately

Your Devices:

  • Family Room is accessed through secure web browsers or mobile apps
  • You can log out from any device at any time
  • Session timeouts prevent unauthorized access if you forget to log out

Security Incident Response

In the extremely unlikely event of a security concern:

  • Detection: Automated systems and staff monitoring detect potential issues immediately
  • Response: Security team investigates and responds within minutes
  • Containment: Affected systems isolated to prevent spread
  • Resolution: Issue resolved and systems secured
  • Notification: Affected users notified as required by law
  • Review: Incident analyzed to prevent future occurrences

Digital vs. Paper Security Comparison

Security Concern
Paper Binders
WellSky_Color

Who can read it?

Anyone who enters the home

Only authorized users

Can it be lost?

✔︎ — permanently

✕ — backed up continuously

Can it be damaged?

✔︎ — spills, fires, floods

✕ — stored digitally

Is access tracked?

✕

✔︎ Access logged & audited

Encryption protection?

✕

✔︎ — bank-level encryption

Updates reach everyone?

✕ — printing/distribution delays

✔︎ — instant notification

Survives disasters?

✕

✔︎ — redundant backups

HIPAA compliant?

✕ — difficult to prove

✔︎ — certified & audited

Can be accidentally discarded?

✔︎

✕ — requires a password

Verdict: Digital is significantly more secure than paper in every measurable way.

Common Security Questions

"What if I forget my password?"

Secure password reset process via email or phone verification. We verify your identity before resetting access.

"Can hackers access the system?"

Multiple layers of security make unauthorized access extremely difficult. Regular penetration testing simulates attacks to identify and fix vulnerabilities before hackers can exploit them.

"What if my phone is stolen?"

Change your password immediately from any other device. The thief would still need your password to access Family Room.

"Can All Heart staff see my credit card information?"

No. Payment processing is handled by a separate, PCI-compliant payment processor. We never see or store your full credit card number.

"What happens to the data if I stop using All Heart?"

Your data is retained according to legal requirements (typically 7 years for healthcare records), then securely deleted. You can request a copy of your data at any time.

This isn’t just secure—it’s among the most secure systems available in healthcare.

Your information is safer in our digital system than it ever was in a paper binder sitting on a kitchen counter.

Complete Care Plan Contents:

Care Goals & Priorities

  • What matters most to your family (safety, remaining at home, socialization, quality of life)
  • Family's priorities for daily care
  • Long-term care objectives

Emergency Contact Information

  • Primary and secondary emergency contacts
  • Preferred contact methods (call, text, email)
  • Contact priority order

Medical Conditions & Health History

  • Chronic conditions (dementia, Parkinson's, diabetes, heart conditions, etc.)
  • Recent hospitalizations or surgeries
  • Functional limitations (hearing, vision, mobility, speech)
  • Allergies and medication sensitivities
  • DNR status and advance directives

Mental Health & Cognitive Status

  • Dementia staging (if applicable): none, forgetful, mild, moderate, severe
  • Specific symptoms and behavioral patterns
  • Triggers that cause agitation or confusion
  • Calming strategies that work
  • Best times of day for activities
  • Communication preferences and techniques

Medications & Supplements

  • Complete medication list with dosages
  • Administration times and frequency
  • Medication reminder schedules
  • Who manages medications in the household
  • Special instructions (with food, before bed, etc.)

Mobility & Transfers

  • Mobility equipment used (walker, wheelchair, cane, gait belt)
  • Fall risk assessment
  • Transfer assistance needs
  • Use of dominant arm/hand (left or right)
  • Weight-bearing limitations

Personal Care Routines

  • Bathing preferences and frequency (shower, bath, sponge bath)
  • Grooming and hygiene assistance levels
  • Dressing assistance needs (independent, light assist, total assist)
  • Dental care and denture management
  • Skin care requirements

Meal Preparation & Dietary Needs

  • Favorite foods and meal preferences
  • Food allergies and restrictions
  • Special diets (diabetic, low-sodium, pureed, etc.)
  • Meal times (breakfast, lunch, dinner, snacks)
  • Appetite patterns and hydration goals
  • Swallowing difficulties or feeding assistance

Daily Routines & Schedules

  • Morning routine (wake time, preferences)
  • Afternoon activities and needs
  • Evening routine (dinner time, bedtime)
  • Sleep patterns and nighttime assistance
  • Napping schedule

Activities & Engagement

  • Favorite hobbies and interests
  • Activities at home (reading, games, music, crafts)
  • Activities away from home (parks, outings, restaurants)
  • Social preferences and visitor information
  • Brain health and cognitive activities

Home Environment Details

  • Gate codes and access instructions
  • Lockbox location and code
  • Parking information for caregivers
  • Pet care instructions (feeding, walking, behavior notes)
  • Safety equipment locations (grab bars, shower bench, raised toilet seat, bed rails)
  • Camera locations (if applicable - California law requires disclosure)

Transportation & Driving

  • Does client drive?
  • Caregiver transportation needs (errands, appointments)
  • Vehicle information (client's car vs. caregiver's car)
  • Parking permit requirements

Additional Important Information

  • Cultural or religious considerations
  • Language preferences
  • Communication style preferences
  • Special instructions or family notes

This comprehensive information ensures every caregiver provides consistent, personalized care from day one.

Tracking health changes that matter.

The Change of Condition form documents significant shifts in your loved one’s health—new symptoms, changes in mobility, behavioral differences, or improvements in their condition. This isn’t about minor day-to-day variations; it’s about meaningful changes that physicians, families, and caregivers need to know about.

Why have a separate form for this?

Instead of searching through weeks of caregiver narratives to find when symptoms started or conditions changed, this form puts all significant health changes in one easy-to-reference place. When doctors ask “when did the difficulty walking begin?” or family members want to understand the progression of a condition, you’ll have clear, dated documentation right at your fingertips.

What gets documented:

Each entry includes:

  • Date the change was observed
  • Description of the change in condition (symptoms, behaviors, mobility changes, cognitive shifts, or improvements)
  • Caregiver instructions based on the change (new monitoring requirements, adjusted assistance levels, safety precautions, or care plan modifications)
  • Authorization source (Client, Family, Doctor, or Agency)
  • Expiration date for temporary instructions (or marked as "Indefinitely" for ongoing changes)
  • Caregiver acknowledgments confirming they've read and understood the new instructions

Why this form matters:

Early detection changes outcomes. When caregivers notice something different—increased confusion, difficulty walking, loss of appetite, or even positive improvements like better mobility—documenting it immediately allows for faster responses.

Your family stays informed about meaningful health changes. Physicians receive accurate updates during appointments instead of relying on memory. Incoming caregivers know exactly what’s changed and what new precautions or assistance your loved one needs.

One form. Complete health timeline. Better care.

Whether tracking a temporary change after a fall or documenting the progression of a chronic condition, the Change of Condition form creates a clear health timeline. This helps everyone—doctors, family members, and our San Diego caregiver team—understand how your loved one’s needs are evolving and respond appropriately.

Proactive monitoring isn’t just good practice. It’s essential senior care.

How the Caregiver Narrative works.

Each caregiver documents their shift using a simple timeline format that captures the essential details of your loved one’s day. This structured approach ensures consistency across all caregivers and makes information easy to find.

What we document in every narrative:

  • Daily health observations and changes in condition
  • Meals, snacks, and hydration intake
  • Mobility assistance and transfer support
  • Activities completed, mood, and engagement levels
  • Social interaction, conversation topics, and preferences
  • Safety concerns or environmental changes noticed
  • Medication reminders provided (when applicable)
  • General well-being updates and family notes

Narrative Format:

Each entry follows this structure:

  • Start Date | Start Time | Caregiver Name
  • Timeline Narrative (chronological notes throughout the shift documenting activities, meals, observations, assistance provided, and any notable moments)
  • End Date | End Time | Caregiver Name

Why this format works:

This timeline approach provides clear, chronological documentation that’s easy for incoming caregivers to read and understand. Instead of wondering what happened during the previous shift, they can see exactly what your loved one ate, how they felt, what activities they enjoyed, and any health changes observed.

One record. Every shift. Complete continuity.

Whether care is short-term, long-term, or evolving, the Caregiver Narrative ensures nothing gets missed and nothing gets repeated. Your family can review the journal at any time during visits, or we can share photos of recent narratives with long-distance family members who want to stay connected and informed.

Complete transparency and peace of mind, right when you need it.

Your loved one's complete care roadmap, now available digitally.

The All Heart Customized Care Plan is completed during your initial assessment and tailored to your loved one’s specific needs, preferences, mobility level, and safety requirements.

Now fully digital and accessible on every caregiver’s phone.

We’ve gone paperless. Your care plan is accessible through our digital platform—caregivers reference it anytime, anywhere. Updates happen in real-time, so when something changes, every caregiver sees it immediately.

What's included:

Care goals, emergency contacts, medical conditions, mental health & cognitive status, medications & supplements, mobility & transfers, personal care routines, meal prep & dietary needs, daily routines, activities & engagement, and home environment details.

One plan. Every caregiver. Consistent care.

This digital approach ensures every San Diego caregiver has the same accurate, up-to-date information from day one—promoting safety, continuity, and person-centered care.

See how we organize care information. This form becomes your loved one’s digital care roadmap.