The In-Home Service program is designed to:
  • -Assist the elderly to maintain and/or improve living conditions.
  • -Maximize independence in everyday living.
  • -Minimize the need for institutional care.
  • -Safeguard against potential abuse or neglect.
  • -Aid in non-medical personal care.
  • -Aid in care of the home.

The assistance and care occurs in the home of the individual client. The following describes in some detail the services provided:



Butler County In-Home Services, LLC’s sole purpose is to meet the growing needs of our rural, underdeveloped area to serve the elderly, disabled and infirm with the quality of care they deserve. We will deliver these services with the utmost dignity and care, realizing that our clients are potentially the most vulnerable of Missouri's citizens.

Basic Personal Care services are maintenance services provided to a client in the individual's residence to assist with the activities of daily living. Basic personal care services shall include, at a minimum, the following activities:
1. Plan and prepare meals, including special diet menus; clean up after meals.
2. Assist with eating or feeding helpless clients.
3. Make beds and/or change sheets with the client in or out of the bed, as required.
4. Give bed baths and assist with other baths.
5. Brush, comb, and shampoo hair.
6. Brush teeth/clean dentures.
7. Shave with an electric or safety razor, as appropriate; an electric razor must be used for the diabetic or client with contraindicating conditions.
8. Cut and clean fingernails and toenails (except clients with contraindicating conditions).
9. Help dress/undress the client when necessary.
10. Assist the client to and from toilet when client is at least partially weight bearing, give and remove bedpan/urinal.
11. Assist the client with self-administered medications (open bottles, get water).
12. Apply non-prescription topical ointments/lotions at the client's direction.
13. Give assistance to and from the bed to a wheelchair, walker or chair when a client is at least partially weight bearing.
14. Assist with ambulating when the client can at least partially bear own weight.
15. Instruct the client in ways to become self-sufficient in personal care.

Homemaker/Chore services are general household activities provided by a trained homemaker when the client is unable to manage the home and care for him/herself or others in the home, or when the individual (other than the client) who is regularly responsible for these activities is temporarily absent. Homemaker/Chore services are activities directed toward home management and assistance with activities of daily living on a regular basis for a client who has multiplicity of needs and requires assistance in order to remain in the home, and shall include, at a minimum, the following activities:
1. Plan and prepare meals, including special diet menus; clean up after meals.
2. Wash dishes, pots, pans, and utensils.
3. Clean counters, cupboards, and appliances, including oven and refrigerator.
4. Clean bathroom fixtures.
5. Make beds and change sheets.
6. Sweep, vacuum and scrub floors.
7. Tidy and dust the home.
8. Launder clothes and linens.
9. Iron and mend clothes.
10. Wash inside windows and clean venetian blinds, within reach without climbing.
11. Bag trash inside the home and put it out for pick-up.
12. Shop for essential items (e.g., groceries, cleaning supplies, etc.).
13. Perform essential errands (e.g., obtain food stamps, pick up medication, etc.).
14. Read and write essential correspondence for blind, illiterate, or physically impaired clients.
15. Instruct clients in ways to become self-sufficient in performing household tasks.
16. Wash walls and woodwork.
17. Spray for insects within the home with over-the-counter supplies.
18. Provide rodent control within the home (for example, setting traps, and putting out over-the-counter supplies).
19. Wash and/or change curtains within reach.

Respite care services are maintenance and supervisory services provided to a client in the individual's residence to provide temporary relief to the usual caregiver(s). Respite care services shall include, at a minimum, the following activities:
Supervision - The respite care worker will provide personal oversight of the client for the duration of the service period. Personal oversight includes making a reasonable effort to assure the safety of the client and to assist the client in meeting his/her own essential human needs. Sleeping is permitted when the client is asleep, provided there is no indication that the condition of the client would pose a risk if the client awoke while the worker was sleeping. The worker must be in close proximity to the client during a sleeping period.
Companionship - The worker will provide companionship during the client's waking hours and attempt to make the client as comfortable as possible.
The respite care worker and the client mutually determine the range of activities the respite care worker provides. *Refer to activities allowed in personal care and Homemaker/Chore services.


Advanced Respite Care shall consist of maintenance and supervisory care provided to clients of the Department of Health & Senior Services who have specialized needs. The purpose is to provide temporary relief for the family or a personal caregiver. Advanced Respite clients may include any of the following:
1. Clients who are essentially bedfast, turning and positioning, and/or assistance with elimination (urinal or bed pan).
2. Clients who have behavior disorders, particularly Alzheimer’s disease.
3. Clients who have special monitoring or assistance needs due to swallowing problems caused by conditions such as Parkinson’s and stroke.
4. Clients requiring prompting for self-administered medication.
*Refer to the activities in advanced personal care and basic personal care.


Advanced Personal Care services are maintenance services provided to a client in the individual's residence to assist with the activities of daily living when such assistance requires devices and procedures related to altered body functions. Advanced personal care services shall include, at a minimum, the following activities:
1. Routine personal care of persons with ostomies, external indwelling and suprapubic catheters including changing bags and soap and water hygiene.
2. Remove external catheters, inspect skin and reapply catheter.
3. Administer prescribed bowel programs, including use of suppositories and sphincter stimulation, and enemas (pre-packed only) with clients without contraindicating rectal or intestinal conditions.
4. Apply medicated (prescription) lotions, ointments or dry, non-sterile dressings to unbroken skin including Stage I decubitus.
5. Use of lift for transfers.
6. Manual assistance with oral medications set up by a registered nurse (not PRN medications).
7. Passive range of motion (non-resistive flexion of joint within normal range) delivered in accordance with an order from a registered nurse, unless contraindicated (will cause more damage) by underlying joint pathology.
8. Apply non-sterile dressings to superficial skin breaks or abrasions as directed by a registered nurse.
9. Infection control procedure.


Registered Nurse visits are skilled nursing services of a maintenance or preventive nature provided to clients with stable chronic conditions. Nurse visits are provided at the client's residence and are prior-authorized by the Department of Health & Senior Services case manager. Such services are not intended primarily as treatment for an acute health condition. Registered Nurse visit services may be provided by a licensed practical nurse under the direction of a registered nurse. R.N. visits shall include, at a minimum, the following activities:
1. Skin monitoring and care, including care of chronic Stage II decubiti.
2. Pre-fill insulin syringes.
3. Set up and administer prescribed medications.
4. Nail care for the diabetic client or client with circulatory or neurological deficiency.
5. General health assessments.

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