Eating out, Eating Well: How to make smart Choices

In a time when all we do is eat out, it can often be hard to keep a healthy diet. However, you should know that there are many healthy alternatives out there which are readily available. There are a lot of Dining options in New York City. Big portions, too many calories and too much salt can make ordering a challenge. However, small changes in your meal selections could make a BIG difference. Choosing grilled, broiled or baked foods over fried foods or even just choosing water over fruity drinks can help improve your health.

Here are a few tips for you to start making smarter choices:

Downsize! Eat smaller portions.

·         Don’t super size anything. Order the small size whenever you can.

·         Eat only half, and take the other half home for another meal.

·         Share a main course with a friend

·         Let your server know that you are passing on the breadbasket chips.

Eat more Fruits and Vegetables.

·         Choose fruit with your meal instead of chips or pretzels

·         Ask for a side of vegetables or a salad with dressing on the side

Drink water, seltzer or other low-calorie beverages.

·         Skip soda and other sugary beverages, such as sports drinks, “energy” drinks, sweetened tea and lemonade.

·         Compare calories on menu boards. Many coffee and tea drinks are high in calories.

Cut the salt.

·         Ask for sauces and dressings on the side.

·         Choose soy sauce with less sodium.

·         Cut down on cheeses and meats, such as: bacon, ham and salami.

·         Ask for your meal to be prepared without added salt or MSG. You can always salt to taste.

Avoid High Fat foods.

·         Skip the cheese on sandwiches and salads

·         Choose chicken (without skin), fish and lean cut beef and pork.

·         Choose broth-based soup instead of cream based soups.

Maintaining a healthy diet is a very important part of staying in good health. With all this in mind, we want to remind you to be more conscious of what you put in your body. At First Care of New York, we believe everyone’s health is important, which is why we have all our Certified Home Health Aides and Personal Care Aides trained efficiently so that you or your loved ones are getting the right health professionals in your home to provide safe care. If you or someone you know is having difficulty with activities of daily living, please feel free to reach out to us and see how we can help 718-741-5956. Or you can visit our website http://www.1st-care.org/

Beat the Heat!!

Summer is here, and we are experiencing some unusually high temperatures all across the city, First Care of New York wants to remind you, as we did our patients, to make sure you have plenty of fluids at home and try to keep yourself as cool as possible. If you feel you need to go out make sure you have a very cold bottle of ice water handy and take frequent breaks under some shade to allow your body to recover.

One can do many great and fun things as the warm weather approaches. People usually plan outings, visit different places and most people typically take a vacation or some other form of leisure and enjoyable activity. People feel better as the warm weather feels great on our skin and we seem to act like plants by trying to suck up as much sunlight as possible.

However, with the great warmth that approaches one should also plan for some of the burdens that come with the warm weather. We have provided a simple list to keep you safe during this season.

• Drink cool, nonalcoholic, non-caffeinated beverages. (If your doctor generally limits the

amount of fluid you drink or has you on water pills, ask him how much you should drink

when the weather is hot. Also, avoid extremely cold liquids because they can cause

cramps.)

• Rest.

• Take a cool shower, bath, or sponge bath.

• If possible, seek an air-conditioned environment.

• If you don't have air conditioning, consider visiting an air-conditioned shopping mall or

public library to cool off.

• Keep warm areas ventilation if not cooled. Proper ventilation will promote adequate sweat

evaporation to cool the skin.

• Wear lightweight clothing.

• If possible, remain indoors in the heat of the day.\

• Do not engage in strenuous activities.

• Sunblocks and sunscreens with a protection factor of 15 (SPF 15) can be very helpful when

one is exposed to extreme direct sunlight.

The summer is a time for long sunny days to be enjoyed responsibly. If you know someone that might not be able to care for themselves due to a physical or mental disability, but you still want them to be able to enjoy the summer, consider getting them a certified home health aide. At First Care of New York, we have plenty of certified home health aides and personal care aides who can assist them with many activities of daily living. They can help with bathing, dressing, grooming, cooking and cleaning as well as assist them going places and make sure that that are safe and secure during the summer weather. If you would like more information on our services, please feel free to contact us at (718) 364-7251.

National Blood Donor Month

As you may or may not know, January is National Blood donor month. Many people are uncomfortable with the notion of donating blood because they think it may be painful or they are simply afraid of being able to see blood leaving their body. Although, this may be an uncomfortable experience for some of you, one must think of how meaningful it is that you sacrificed your time and efforts to give blood.  You have to be at least 17 years of age to donate blood or have your parents sign a legal consent form. Those of you who are over the age of 75 can continue to donate blood as long as you meet all donor requirements and present a physician's letter allowing you to donate. Something you might want to consider is that you might not be eligible to donate blood. Check out the chart below to learn about what conditions may make you ineligible.

Condition  and Length of time before you can give blood

1. Not feeling well for any reason :Until symptoms are over
2. Cold, sore throat, respiratory infection, flu: Until 3 days after symptoms are over
3.Travel to an area of the world where malaria is a problem: 12 months after return
4.Certain cases of heart disease :Contact us for medical eligibility at 1-800-688-0900
5.Ears, nose or skin piercing: 12 months after procedure unless
6.Tattoos if applied in NJ, no wait: If elsewhere: 12 months after application
7.Blood transfusion: 12 months after receiving blood
8.Full-term pregnancy,abortion or miscarriage: Six weeks after end of pregnancy
9.Surgery, serious injury: When healing is complete and feeling well
10.Syphilis, gonorrhea: 12 months after treatment completed

11.Have had certain forms of cancer Contact us regarding medical eligibility 1-800-688-0900
This chart is from: http://www.nybloodcenter.org/

There are many other permanent reasons as to why you might not qualify to donate; so I suggest you look at

the website listed above to verify whether or not you do.Donating blood is giving the gift of life. Remember that you could give someone the chance to see another day just by sharing some of your blood with them. This safe process; A sterile needle is used only once for each donor and then discarded. It is also good for you to know that in a study conducted by the Red Cross it was determined that the share of people eligible to donate blood in the United Sates was only 38 percent of the population. Your help is needed! Always remember, if you are living on your own, you are not alone. First Care is always here to provide you with the care you need. We provide the proper care for our clients affected by an array of medical issues by utilizing our Certified Home Health Aides or Personal Care Aides to help our clients with their activities of daily living such as: visiting their doctors regularly, assisting with medication reminders and also preparing meals with the dietary necessity to help lower blood pressure and other ailments. If you or a loved one can no longer manage on your own or are having health issues due to medical conditions, do not hesitate to give us a call to find out how we may be able to help. Our number is 718-741-5956.

Fun things to do with your elderly loved ones

Hello bloggers! I know that usually winter is the time for most of us to go into hibernation mode. However life must go on, so why not find some enjoyable things to do during this time of year. It can be just as fun as summer if you set your mind to it. This is especially a good time to reconnect with older family members, since we will be spending a lot of time at home. There is a long list of activities you can do with your family.

Try to engage Elders with Fun or Interesting New Gadgets: Some home bound older people have not had much exposure to recent electronic technology. An iPad, a Blackberry, or some other new object could be of interest to a senior. A digital camera isn't much of a novelty for younger folk, but for an older senior citizen, one can be quite interesting. Take photos of the senior's favorite people, items, or animals. Pictures can be made into a slide show or printed and placed in a binder. Let the senior take pictures too!

Another thing that is very important is to exercise both physically and mentally. If walks are appropriate, a stroll on a nice day is a fun and easy way to pass time with a senior. Even pushing a senior in a wheelchair outside can encourage him or her to point to flowers, pets, and such.

As far as exercising your mind…Things like solving word puzzles and reading have been always been favorites. Take into consideration that the elderly might feel just as uncomfortable as you in the winter. So try to make them feel more comfortable. Another fun thing to do is go through old pictures. Have your elderly loved one share some family history. This is not only beneficial for them because it helps them exercise the memory; it is also good for the younger generation to learn where they come from. For more ideas visit: http://www.buzzle.com/articles/fun-activities-for-the-elderly.html

Always remember, if you are living on your own, you are not alone! First Care is always here to provide you with the care you need. We provide the proper care for our clients affected by an array of medical issues by utilizing our Certified Home Health Aides or Personal Care Aides to help our clients with their activities of daily living such as: visiting their doctors regularly, assisting with medication reminders and also preparing meals with the dietary necessity to help lower blood pressure and other ailments. If you or a loved one can no longer manage on your own or are having health issues due to medical conditions, do not hesitate to give us a call to find out how we may be able to help. Our number is 718-741-5956.

Heroes in the Home - Prestigious award honors First Care of New York caregivers

New York Post, Tuesday November 13, 2012 nypost.com

Heroes in the Home - Prestigious award honors First Care of New York caregivers who have provided service above and beyond their duty

The patient had been a “difficult” case, with one home health care aide after another backing away from the task of tending to him, because it had to be done in shifts — two hours in the morning and two hours in the evening. Home care aides often refuse such assignments because the short hours coupled with the commuting time means little money for the hard work.

That wasn’t an issue for Marjorie Wahl. She agreed to care for the ailing man, who in the end paid Wahl the ultimate compliment. “The patient actually asked for her on his death bed. His last words were, ‘Where’s Marjorie?’ It’s amazing,” says Wahl’s employer, Anthony Riccobono, executive director of First Care of New York, a home health care agency.

Such reverence may be its own reward, but New York home care professionals consider it worthy of award, which is why since 2000, the New York State Association of Health Care Providers has been handing out its Heroes in the Home honors to home care aides who’ve provided exemplary service to their wards.

Marjorie Wahl is one of this year’s recipients, and she understands why. “I think I got the award for being one of the best workers — giving them loving care and understanding,” says the Bronx resident.

The trade association official in charge of the program agrees. “It was established to recognize and honor all the dedicated workers who provide thousands of hours of home care each and every day,” says Claudia Hammar, the association’s senior vice president. The award — which is officially titled the Heroes in the Home Statewide Caregiver Recognition Program — can be given for any type of praiseworthy home care service.

“It could be for doing something heroic, like in the current [post storm] situation in New York. Or agencies might recommend someone who’s been a rock, a consistently reliable caregiver that goes in the home every day whom the clients love,” says Hammar.

One of those rocks is home health care aide Beth Thomas of Brooklyn — another 2012 Heroes in the Home award-winner —who’s been assisting patients of First Care of New York for almost a decade, which is an unusually long tenure for a home care worker.

“Beth Thomas, I can say, has been an employee with us since ‘04. There’s some serious longevity there. She’s just an exemplary employee,” says Riccobono.

Home care is often tough work, which is why aides like Wahl, Thomas and dozens of others across the state are singled out by the program every year.

“You have a lot of patients that are hard to please and most people don’t have the patience to get along with them,” says Riccobono. “Both Beth and Marjorie have the patience and know-how and willingness to work with the patient through their difficult situations to help them move forward.”

The awards are given out by each of the eight chapters of the New York home care association. Member agencies nominate their most hard-working employees, who are officially recognized by the association in October, according to Hammar.

The number of recipients varies by the chapter. In New York City, about 50 home health care aides receive the honors each year. In Hudson Valley and Long Island around 30 workers make the cut, while in western New York the number of winners comes out to about a dozen.

Each chapter decides how to fête the honorees, but generally there’s a breakfast or dinner celebration where the awards are presented, Hammar says. Hammar considers the Heroes in the Home program to be essential recognition, but it may pale in comparison to the appreciation home care workers receive from their patients and families.

“From my own personal experience, I can’t stay home with my parents. We need to have people in the home who care for them,” she says. “To be able to have people that love our parents like we do, who really bring in that level of care — it’s so comforting. You don’t have to worry if they’ve fallen down or if they’re eating properly. And it keeps them independent, which lets them live longer.

“They don’t want to be institutionalized. Our caregivers help them do that. It’s more than just providing food and the necessities of life,” adds Hammar.

Industry professionals say Superstorm Sandy will create a gale of award winners next year.

Riccobono has his eye on one worker who went “above and beyond” for her client during Sandy. “She was with a patient throughout the whole time, and there was no light, no electricity. It was incredible to hear this,” he says. “That’s a prime example of being heroic and going above and beyond. She was just there for her patient.”

Read the latest New York Post Health at Home edition online

or Download latest New York Post Health at Home edition at
http://www.1st-care.org/media/Health_at_Home.pdf

Read more about Heroes in the Home award program at
http://www.nyshcp.org/content.aspx?id=230&linkidentifier=id&itemid=230

Mother Nature Strikes Again!!

Just when we thought the worst was over, Mother Nature strikes again! On top of an already bad situation, things got worse for the East coast; when Mother Nature decided to remind us whose boss by sending a Nor’easter our way. Although, this didn’t cause any more major damage, it did leave its effects. First and foremost it made some of our hurricane sandy survivors suffer through already bad conditions. Many people still do not have power and had to endure through the extremely cold weather without heat.

To add insult to injury, this new storm also caused even further issues with the gas shortage. The day after the storm Mayor Bloomberg and Governor Cuomo put in place a gas rationing system in NYC. This system only allows you to get gas on odd or even numbered days depending on your license plate number. This definitely forces us to be more aware of our surroundings; and realize that the world is changing as we speak. We need to prepare ourselves for more things of this nature. I don’t mean that we should be preparing for impending doom. However, these things are a sign, especially for us New Yorkers, that we are no longer exempt from the wrath of Mother Nature. Last year Hurricane Irene hit us with a little wind and water, so we thought that Sandy would be the same. Boy were we wrong!

I would like to take this moment to remind you that Hurricane Sandy recovery efforts are still going on. We cannot stress this enough! I know sometimes an issue becomes old news very quickly. But put yourselves in someone else’s shoes. If your home had burned down to the ground, flooded or been destroyed in any other form; would you want us to forget you? There’s snow on the ground and its freezing cold, even if you can donate a coat, a blanket or some food. Make a difference! Life is not promised to anyone and who knows, tomorrow you could be the one to wake up and find out that everything you’ve worked for your whole life has been blown away.

With this said I would like to remind you that you are a part of our First Care Family and that we are ready and willing to help you or a family member in need of care at any time. Always remember that First Care of New York provides the proper care for our clients affected by an array of medical issues by utilizing our Certified Home Health Aides or Personal Care Aides to help our clients with their activities of daily living such as: visiting their doctors regularly, assisting with medication reminders and also preparing meals with the dietary necessity to help lower blood pressure and other ailments. If you or a loved one can no longer manage on your own or are having health issues due to medical conditions, do not hesitate to give us a call to find out how we may be able to help. Our number is 718-741-5956.

The Price of Beauty


All of us use something to try to improve our appearance on a regular basis; whether it’s make-up, lotion, perfume or even deodorant. This day in age both men and women have their beauty secrets. What we often don’t realize is that many times these products we use to enhance, shape, or even tone our bodies can have very negative effects on our health. In recent studies dangerous chemicals have been found in products that we use daily. According to “ChemicalSafeSkincare” there are three ingredients, which are especially hazardous. Parabens (preservatives used in many moisturizers and body creams) have been linked to both cancer and to skin irritation. Sodium lauryl sulfate (a foaming agent used in shampoos) can irritate the skin, as can formaldehyde (used in hand soap and shampoo). (Alliance for Natural Health, 2012)

Many organizations have tried to bring awareness to the dangers of these chemicals. For example, the Breast Cancer Fund has provided extensive information on research that suggests that the long term use of many skin care products can be linked to breast cancer. Commercial companies have been asked to find safer alternatives for their products; however, like many business people they claim that they use more health conscious chemicals, but that doesn’t mean that this is necessarily true. To view some of the safety scores on cosmetics visit:

www.cosmeticdatabase.com

I bring this to your attention for two reasons. The first is so that you are more conscious of the products that you use on a daily basis. I’m not saying that lotion gives you cancer. However, I am saying that you should check the ingredients in anything you use because you could really be harming yourself in the long run. The second is because as you all know Halloween is next week and many of you use make up on yourselves and your loved ones to enhance your costumes. I think this is great but just take the time to double check the ingredients on those things.

Of course, always remember that First Care of New York provides the proper care for our clients affected by an array of medical issues by utilizing our Certified Home Health Aides or Personal Care Aides to help our clients with their activities of daily living such as: visiting their doctors regularly, assisting with medication reminders and also preparing meals with the dietary necessity to help lower blood pressure and other ailments. If you or a loved one can no longer manage on your own or are having health issues due to medical conditions, do not hesitate to give us a call to find out how we may be able to help. Our number is 718-741-5956.


For more information on this subject visit:


http://www.pureprevention.org/documents/cosmetics_and_breast_cancer_2007.10.10.pdf

6 Myths About Breast Cancer

As you all may or may not know, October is Breast Cancer Awareness Month. That is why this week I would like to discuss a lot of the myths that have been created about this disease. Sadly, many misinformed people have circulated all types of theories and false information about this particular type of cancer. Like any other type of Cancer, breast cancer is a life changing and terrifying disease. Although women have the most occurrences of this disease, they are not the only ones who can develop it. This brings me the first myth about breast cancer.

Myth #1: Only women get breast cancer. Absolutely false! Overall, women have the most reported cases of breast cancer, but men can get it too. According to the National Breast Cancer Foundation approximately 2,190 men are diagnosed with breast cancer and 410 die every year. Although this may seem like a small percentage, it should not be ignored. Men should learn to self-examine themselves and be more aware of the changes that occur in their bodies.Moving along to myth #2 Underwire bras cause breast cancer. Years ago, someone started a rumor that the underwire found in bras could cause breast cancer. There are many claims that these types of bras compress the lymphatic system of the breast, causing toxins to accumulate and cause breast cancer. This is absolutely false! There is no scientific evidence that connects the tightness or the wiring in a woman’s undergarments to breast cancer.

Myth #3 is closely related to #2 because it involves a product that we use on a daily basis. A vicious rumor has been spread that states that wearing antiperspirant increases your chances of getting breast cancer. It is believed that a chemical found in deodorant, when absorbed by the body, can trigger an effect that would produce cancer. Like the underwire bra there is no scientific information stating that this is the case. So don’t stop using your deodorant just yet! Myth #4 is that only people with a history of breast cancer in their family are at risk of getting breast cancer. “While women who have a family history of breast cancer are in a higher risk group, most women who have breast cancer have no family history. Statistically only about 10% of individuals diagnosed with breast cancer have a family history of this disease” (National Cancer Institute, 2012). This means that we are all still at risk and should be going to our regular checkups.

Moving along to breast cancer myth #5, people believe that breast cancer always comes in the form of a lump. A lump may indicate breast cancer, but women should also be aware of other kinds of changes that may be signs of cancer. These include: swelling, skin irritation or dimpling, breast or nipple pain, the nipple turning inward, redness, scaliness, or a discharge from the nipple other than breast milk. Breast cancer can also spread to underarm lymph nodes and can cause swelling there before a tumor in the breast is large enough to be felt. Luckily, a mammogram can pick up breast cancer that has no outward symptoms at all. So make sure you get checked! Last but not least…Myth #6: Breast cancer is a death sentence. Medicine has advanced so much that being diagnosed with cancer no longer means that you are going to die. There are many treatment options and procedures nowadays, this should give you hope! I know that knowing these things doesn’t make cancer any less terrifying, but I share this information with you in the hopes that you will be more motivated to continue to do more research and pay more attention to your health. To learn more about Breast cancer visit:

http://www.nationalbreastcancer.org/breast-cancer-myths

You are a part of our First Care family and we not only want you to be educated, but we always want you to know that First Care of New York provides the proper care for our clients affected by an array of medical issues. By utilizing our Certified Home Health Aides or Personal Care Aides to help our clients with their activities of daily living such as: visiting their doctors regularly, assisting with medication reminders and also preparing meals with the dietary specifications necessary to help assist with any medical needs. If you or a loved one can no longer manage on your own or are having health issues due to medical conditions, do not hesitate to give us a call to find out how we may be able to help you. Our number is 718-741-5956.

EXCEPTIONAL SERVICE

First Care of New York is proud to have received a report card for 2012 with the recognition of exceptional service, by one of its top contracts “Senior Health Partners”,  a managed care organization.

Cancer

Although this is a topic that many of us are familiar with, I thought it would be good idea to revisit it so that we can all have a clear idea of what this disease is all about. More often than not you hear people saying cancer can spread and it can kill you. However, most of us wonder how it spreads? And how does it literally kill you? According to the American Cancer society, all cancers start because abnormal cells grow out of control. Untreated cancer can cause serious illness and death. As we all know, the body is made up of millions of little cells. These cells are constantly growing, dividing, and dying. At different stages of our lives, this cellular process goes about differently. For example when you are young, the cells divide and multiply at a faster rate to allow you to continue growing. But once we reach adulthood this process slows down and most cell division only occurs to replace damaged or dying cells. Cancer begins when cells in a particular part of the body grow out of control. This type of cell growth is very different from normal cell growth. Instead of dying off, cancer cells continue to grow and form new abnormal cells. These cancerous cells can also grow and invade other tissue cells, which is what makes them even more dangerous. In most cases, these cancer cells will eventually form a tumor.

Cancer cells often metastasize or travel to other parts of the body where they begin to grow and form new tumors. This happens when the cancer cells get into the body’s bloodstream. Over time, the tumors replace normal tissue. Different types of cancer can behave very differently. For instance, bone cancer and skin cancer are very different diseases. They grow at different rates and respond to different treatments. This is why people with cancer need treatment that is aimed at their specific form of cancer. It is also important to remember that not all tumors are cancer. Tumors that are not cancerous are considered benign. Benign tumors can cause problems, but they cannot invade other tissues within the body; meaning that they also cannot spread to other parts of the body. These tumors are almost never life threatening.

Many men and women either know someone, or suffer from cancer themselves. This disease has become very common and this is why it is important to educate yourself about it. The best thing to do is to have an open line of communication with your doctor. Let him or her know if you see or feel something different with your body. Early detection may be the difference between recovery and the need for treatments.

At First Care of New York, we care for many cancer patients and can be there for you and your family, if they have been suffering from cancer and can no longer care for themselves or others. Our highly trained certified home health aides and personal care aides can be there to help them lead the most enriching life possible. You can count on First Care of New York to be available 24 hours a day, 365 days a year, for any and all Live in Care, Personal Care, Home Health and Companionship needs. For your convenience, we may even schedule a nurse to visit you or your loved one’s at home and evaluate the level of care that is needed. This will help clarify some questions you or your loved one may have. First Care is a licensed home care service agency that provides top quality aides to all our clients. If you would like to have more information, please feel free to contact us by phone at 718-741-5956 or on our website at www.1st-care.org.

Although this is a topic that many of us are familiar with, I thought it would be good idea to revisit it so that we can all have a clear idea of what this disease is all about. More often than not you hear people saying cancer can spread and it can kill you. However, most of us wonder how it spreads? And how does it literally kill you? According to the American Cancer society, all cancers start because abnormal cells grow out of control. Untreated cancer can cause serious illness and death. As we all know, the body is made up of millions of little cells. These cells are constantly growing, dividing, and dying. At different stages of our lives, this cellular process goes about differently. For example when you are young, the cells divide and multiply at a faster rate to allow you to continue growing. But once we reach adulthood this process slows down and most cell division only occurs to replace damaged or dying cells. Cancer begins when cells in a particular part of the body grow out of control. This type of cell growth is very different from normal cell growth. Instead of dying off, cancer cells continue to grow and form new abnormal cells. These cancerous cells can also grow and invade other tissue cells, which is what makes them even more dangerous. In most cases, these cancer cells will eventually form a tumor.

Cancer cells often metastasize or travel to other parts of the body where they begin to grow and form new tumors. This happens when the cancer cells get into the body’s bloodstream. Over time, the tumors replace normal tissue. Different types of cancer can behave very differently. For instance, bone cancer and skin cancer are very different diseases. They grow at different rates and respond to different treatments. This is why people with cancer need treatment that is aimed at their specific form of cancer. It is also important to remember that not all tumors are cancer. Tumors that are not cancerous are considered benign. Benign tumors can cause problems, but they cannot invade other tissues within the body; meaning that they also cannot spread to other parts of the body. These tumors are almost never life threatening.

Many men and women either know someone, or suffer from cancer themselves. This disease has become very common and this is why it is important to educate yourself about it. The best thing to do is to have an open line of communication with your doctor. Let him or her know if you see or feel something different with your body. Early detection may be the difference between recovery and the need for treatments.

At First Care of New York, we care for many cancer patients and can be there for you and your family, if they have been suffering from cancer and can no longer care for themselves or others. Our highly trained certified home health aides and personal care aides can be there to help them lead the most enriching life possible. You can count on First Care of New York to be available 24 hours a day, 365 days a year, for any and all Live in Care, Personal Care, Home Health and Companionship needs. For your convenience, we may even schedule a nurse to visit you or your loved one’s at home and evaluate the level of care that is needed. This will help clarify some questions you or your loved one may have. First Care is a licensed home care service agency that provides top quality aides to all our clients. If you would like to have more information, please feel free to contact us by phone at 718-741-5956 or on our website at www.1st-care.org.