This article is reprinted from the News Press, Monday Dec. 8, available online at  http://www.news-press.com/apps/pbcs.dll/article?AID=2008812080309

Twice a week, a home health care aide comes to Robert Hoffman's apartment in Cape Coral and takes care of the mundane tasks of life he's not quite up to these days.

The visits, which he's had for the past eight months, help Hoffman stay independent in his own place. They're also part of a vast and growing industry that aims to keep people from having to go to more expensive nursing homes or assisted-care facilities.

It's a major business, with $57.6 billion spent in 2007 on home health care in 2007. Providers made 33 million visits in Florida alone in 2006 and nationwide, 7.6 million people get care from 83,000 providers because of acute illness, long-term health conditions, permanent disability or terminal illness, according to the National Association for Home Health Care and Hospice.

Robert Thomas is the owner of Fort Myers-based Assisting Hands for Southwest Florida, which provides Hoffman's care. Thomas moved here last year from Des Moines, Iowa, and started the franchise operation after a career in finance.

"I always had a strong desire to have my own business, a strong desire for a feel-good business," he said. "I had the opportunity to finally do it."

Now, he's a home health care provider, one of two categories of entities that provide help keeping people in their own homes. Hospices, originally set up just to take care of terminally ill people at the very end of their lives, have also increasingly been involved in home health care.

There will be plenty of business to go around as the nation's 79 million baby boomers - the huge generation born from 1946 to 1964 - move inexorably into old age, Thomas said. "It's a growth industry."

In Southwest Florida, he said, many customers "came down to Florida for their lifestyle and a big part of that is the house they live in.

"As they age, they can't do everything they want to do, such as golf, but they want to stay in their home. Going up north is an option but they can't bear to sell their homes at the current prices."

Often, Thomas said, he's contacted first by a relative.

"We've talked to a lot of adult children, especially daughters, who live up North. They've noticed their parents' health is failing, they're worried one of them will have a fall. It tends to be kind of a fire drill for families.

"We get a lot of people who ask, 'What do we do? We don't even know the questions.' You calm them down, explain it's affordable compared to all the other alternatives. I think they need to ask first 'Is it safe for their parents to continue living in their home?'"

Samira Beckwith, CEO of the private, nonprofit, Fort Myers-based Hope Hospice, said her agency doesn't deal in basic assistance such as Hoffman gets but that "We do have a number of additional programs in addition to hospice. One reason we developed them was that some people who needed our care did not meet the prognosis that the disease could be (fatal in) six months or less the way the disease progresses, but they did need our skills."

One program, for example, uses Medicaid funding to provide in-home care for the frail elderly.

"We provide intermittent visits by nurses' aides, medical supplies, medicine, to keep them from having to go to the nursing home if they don't want to," Beckwith said.

In another program, elderly people are picked up at their homes and taken to a center in Fort Myers run by Hope Hospice to provide physical therapy, exercise sessions and companionship.

One client at the center is Greg Moreno, who's in his 80s and has been coming five days a week for the past two months.

"I love it," he said, working out on an exercise machine that along with walking laps around the complex is his basic routine for a visit. "I'm happy. Everybody's very kind and try to help you, that's what it's all about."

Others at the center participated in an hour-long exercise session put on by Elena Knight, a personal trainer and Pilates instructor.

She started in June, Knight said, and already "they have more coordination, and it pumps oxygen to the brain so they're more alert."

Thomas said running a home health care agency is rewarding but a demanding job on occasion.

He and all his employees who deal with clients are licensed and have criminal background checks, for example.

"I meet all our clients personally," Thomas said. "Clients or family members can always get ahold of us. We answer the phone 24 hours a day. You don't want to call your caregiver and get an answering service."