Home care assistance—Homemakers, Housekeepers, Personal Care Assistants

Many patients with ME/CFS and FM are sufficiently disabled that they may frequently or periodically need some kind of in-home assistance with the daily tasks of life—such as buying food, preparing meals, laundry, house cleaning, picking up medication, etc. When you are in a bad relapse, even getting out of bed and doing the smallest task is nearly impossible. There are times we all need help. If you don't have a family or friends to help, you may need to obtain the assistance of homemaker, housekeeping or personal care attendant services.

Homemakers assist with shopping, cleaning and meal preparation. They can often be hired, at an hourly rate, through home care agencies and visiting nurses associations.

For those of limited means, payment for such services is sometimes available through public agencies assisting the disabled.

In Massachusetts, the Mass. Rehabilitation Commission's Home Care Assistance Program provides homemaker services free of charge to income-eligible people with disabilities (ages 18–59, with no children in the household.)

Also see the section below on the provision of Home Health Services through Massachusetts Health.

I. Massachusetts Rehabilitation Commission

The Commission is a Massachusetts government agency that provides services to disabled people in Massachusetts.

Homemaking services: HCAP Case Managers determine eligibility, coordinate services and give you resources needed to live independently. Homemaking Services are provided either by an agency or by people you choose. Homemaking Services are defined as direct help with meal preparation, grocery shopping, medication pickup, laundry and light housekeeping (limited to dusting, vacuuming, mopping, kitchen clean-up, bathroom cleaning, bed changes, and trash removal).

Homemaking services are provided only to adults with disabilities between 18 and 59.

You are eligible if you:

• Have a disabling condition which keeps you from doing one or more homemaking tasks.
• Require homemaking help to prevent hospitalization or institutionalization.
• Meet the MRC-HCAP financial guidelines.
• Live alone* or with another adult relative or significant other with a disabling condition.
• Are between the ages of 18 and 59.
• Are not legally blind (The Massachusetts Commission for the Blind also has a program).
• Do not already have services through a comparable benefit such as a PCA.

*Individuals with children under 18 years old may be eligible for services if they meet all other eligibility criteria, however, services are provided only to adults with disabilities.

To apply and get more information, call the Intake Coordinator at 1-800-223-2559, and then dial 3.

Independent Living Centers (ILCs) are private, nonprofit, consumer-controlled organizations providing services and advocacy by and for people with all types of disabilities. Centers for Independent Living help people with disabilities reach their goals through peer counseling, skills training, advocacy, and information and referral. Centers may also provide a range of other services such as housing referrals, communication help, support groups, transportation, health  information and much more.  They also serve as a strong consumer voice on a wide range of national, state and local issues.

For the Independent Living Center nearest you, click here.

For these services contact: Betty Sughrue Sneirson, Adult Supported Living Program Coordinator at 617.204.3722 (telephone) or This email address is being protected from spambots. You need JavaScript enabled to view it. (email).

MRC Assistive Technology Services

Assistive technology is any device that improves a person's ability to live more independently. Many different items are considered assistive technology, including adaptive computer equipment, walkers, hearing aids, memory enhancement aids, print magnifiers, wheelchairs, vehicle modifications and more. Some home modifications and vehicle purchases also are covered.

Adult Supported Living (ASL)

The Adult Supported Living (ASL) Program provides ongoing services for adults to live independently in the community. The program is designed to support people living with severe physical disabilities in combination with a secondary disability. MRC contracts with agencies statewide to provide case coordination.

Services include: Finding accessible housing, the personal care assistant program, household management, transportation, adaptive equipment, accessing educational, vocational assistance, and social & recreational opportunities.

Who is eligible? An adult living with a severe physical disability and a secondary (sensory, cognitive, or emotional) disability which significantly impede the individual’s ability to manage their day-to-day life.

Potential applicants need to have a) Massachusetts residency, b) the ability to handle the emotional stresses of community living with reasonable supports, and c) be their own guardian. Consumers receiving comparable services through another state agency or MRC Community Based Services (Waiver or SHIP) are not eligible.

• There is no financial need criterion
• The program does not include the provision of companionship or supervision. Consumers must possess the cognitive and psychological abilities to make safe decisions on a moment-to-moment basis.

Other MRC Programs for the Disabled:

The Turning 22 (T22) program:

MRC works with special education departments to coordinate services for students who will be graduating and needing supported living services to meet their independent living goals. Students begin meeting with a case coordinator during their last year in school. MRC funds agencies statewide to provide on-going case coordination services to transition and maintain into school, work and living in the community.

Eligibility For T22: Consumers need to be eligible for Chapter 688 transition planning with an independent living goal.

Interested in T22? Please contact: Anna Hermann, Independent Living Programs Supervisor, 617.204.3786 (telephone) or This email address is being protected from spambots. You need JavaScript enabled to view it. (email).

Vocational Rehabilitation Services:

The Vocational Rehabilitation Program helps job seekers with disabilities obtain and maintain a job. Vocational rehabilitation helps people with physical, cognitive, intellectual or mental health conditions manage the modern workplace.

To consider utilizing MRC’s vocational rehabilitation services a person must meet the following eligibility requirements:

• Have a physical, cognitive, intellectual or mental health condition which creates or results in a major obstacle to employment; and
• Require VR services to prepare for, secure, maintain, advance, or regain employment

II. Visiting Nurses Association – Massachusetts (VNA)

Massachusetts VNA will do an in-home assessment of a patient’s needs, sometimes after a hospital stay, and will either arrange for a provider/agency to provide the service or will give the patient a list of appropriate referrals.

The VNA is organized by locality or region—and presumably there is a Mass. VNA administrative office. Here are some of the services provided: When a patient is learning to manage a chronic disease, transitioning home from the hospital, or rehabilitating after an injury or surgery, VNA Care may assist patients to continue the level of care necessary to help restore health, well-being and independence all from the comfort of home.

Home care can be provided for

• Those who suffer from chronic illnesses, including heart failure, diabetes or respiratory disease.
• Someone transitioning home after a hospital stay.
• A patient in need of physical therapy following a joint replacement.
• Adults or children with physical or cognitive disabilities.
• Aging adults who require help with daily living tasks or personal care.

Palliative Care Program

The Palliative Care Program is specially designed to provide support, comfort, and improved quality of life for anyone living with a serious or complex health condition. It is appropriate at any stage of an illness and can be a part of a care plan that includes treatment for a disease.

Additional support including nursing, therapy, and social work is available as needed. All care is provided in coordination with your personal physician and with the support of our own medical director.

Clinicians work with patients to meet their goals and address their concerns, which may include:

• Managing pain, nausea, fatigue, shortness of breath, anxiety, and other distressing symptoms and helping to deal with side effects of therapies.
• Improving ability to continue participating in day-to-day activities.
• Achieving the best possible quality of life — most of our patients find that when their pain and discomfort are relieved, their quality of life is enhanced.
• Offering a support system to help you and your family or caregivers cope.
• Helping with identification of treatment options and care goals.
• Guiding you through a sometimes complex health care system.
• Assisting with advance care planning, financial issues related to illness and caregiving responsibilities, and insurance and financial paperwork.

Palliative Care is oftentimes covered by Medicare and other health insurance plans.

III. Boston Mayor's Health Line

The Mayor’s Health Line (tel.: 617-534-5050) works to ensure Boston residents’ ability to access services and programs that promote health and wellness. The MHL staff is available to help residents with a variety of services including, answering questions about health insurance eligibility, enrolling in health insurance, finding primary care providers, finding social services, locating free clinics and many more.

IV. Mass. Health (Medicaid) Home Health Services

Home Health Care can be provided to lower income persons through the Mass. Health (Medicaid) program.

Also Massachusetts Health can provide Personal Care Assistants (PCAs)—The PCA program is funded by Medicaid and administered by the Independent Living Centers. To be eligible for the program you must need a certain number of hours of personal care assistance (help with food shopping or preparation, personal hygiene, household maintenance, etc.) per week and be Medicaid eligible. To find out more, call your local Independent Living Center at 1-800 462-5105. If you are not eligible for Medicaid, you may be able to obtain personal care assistance through your local Visiting Nurse Association, Senior Care agency, or private personal care assistance agency.

Massachusetts Health also offers Senior Care Options—the program provides home health care and other social services:

Medicare and medical insurance may pay for a variety of types of home health care under various circumstances.

V. Local Senior Care Agencies

Also older disabled persons may be able to obtain homemaking assistance from local senior care agencies. Some health insurance programs may provide payments for these services for a limited period.

VI. Delivery of food and medicine

Some supermarkets will take a shopping order for delivery by phone or computer. In many areas in Massachusetts, Stop and Shop, through Peapod, will take a computer order and deliver your food to your door. Shaw's supermarkets in the Boston area has a delivery service. You can check with your local supermarket or food store to see about possible delivery of an order.

Some pharmacies may have home delivery services. If you are too sick to pick-up your medications, your local taxi company will often pick-up and deliver your medication for a fixed cost.