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‘Alternative Senior Care was a godsend’

With the health of both parents failing, they provided much-needed help

“Guided by faith we are called to provide compassionate care and peace of mind to all who desire to live at home.”

Alternative Senior Care includes (front left to right), Janet Thieschafer, Mike Karasch, Cindy Karasch, Paula Bromenshenkel; Back (L to R) Barb Wanquist, Janeen Mitchell and Metta Kincade. Contributed photo

Alternative Senior Care includes (front left to right), Janet Thieschafer, Mike Karasch, Cindy Karasch, Paula Bromenshenkel; Back (L to R) Barb Wanquist, Janeen Mitchell and Metta Kincade. Contributed photo

This is the mission statement of Alternative Senior Care, a home care company with a team of 75 personal assistants and eight office staff dedicated to helping seniors stay in their own home as long as they can. The personal assistants provide housekeeping, laundry, meal preparation, medication management, companionship, transportation, personal care and nursing care in five counties, and can provide a little help, or a lot, depending on the needs of the family.

“We will be there anytime, 24 hours a day, seven days a week,” said Mike Karasch, who along with his wife Cindy own and operate Alternative Senior Care. “We can be there for an hour or two all the way up to 24-7 and anything in between.”

Alternative Senior Care, based in Sauk Centre, was launched by Cindy in 2005. Her husband, Mike, joined her in 2009. During the last 11 years, there have been hundreds of families helped through Alternative Senior Care. Each family has a different situation and are in need of unique services. Each has their own story. Here is one of those stories:

Bill and Josie Heegaard, of Alexandria, were born just a few days apart. They met in high school and got married in college while Bill was finishing medical school at the University of Minnesota. They raised four children in Alexandria and were caring members of the community. Bill was a small town physician who loved his family practice work, and Josie was always volunteering. She taught swimming at Central High School and loved to work with children with special needs. Together they raised four children and 10 grandchildren. This year, first Josie (88) and then five months later Bill (89) passed away after a yearlong slippery slide from health and independence. Their last year was filled with all the wonder and complexity that comes at the end of a long happy life.

“My parents were both in good health most of their lives. They were vibrant, active people at 88 years of age,” said Roger Heegaard. “They were celebrating a long life knowing that they were the lucky ones for having made it through so many years together with a person they loved.

Then everything changed.

In August 2015, Bill suffered what was first diagnosed as a stroke but later ended up being a brain infection called encephalitis. He was flown by LifeLink from Alexandria to Hennepin County Medical Center.

“From that day on, it was a very hard year,” said Roger.

Bill was hospitalized for three months, intubated for weeks, followed by a slow and delicate recovery of his damaged faculties. Josie and their daughter, Jenny, moved to Minneapolis and lived with Roger.

Because it was a brain injury and he was slowly recovering his actions were erratic and unpredictable. “Someone was in his room, on guard around the clock,” he said. Bill’s health struggles were taking a toll on Josie, who was hospitalized three times during this time from pure exhaustion.

Jenny, Roger and their two other siblings suddenly became caregivers, and living a daily rollercoaster of daily ups and downs as they hoped for a recovery. “Recovery and rehab did happen, and happily, both my mom and dad were able to come home in late November 2015. My sister was living with them and giving them day-to-day care. December was a good month. Both were glad to be home and were enjoying life again.”

Then Bill relapsed, fell again and suffered another blow to his head. He was in a coma in the ICU at Douglas County Hospital.

“We were told he was brain dead,” said Roger. “We were driving up to give him a last goodbye. When he was lying there, he started to stroke the hand of one of the grandchildren. Doctors had given him a zero percent chance, but he survived again.”

Bill recovered, but began suffering from hallucinations. The family was still struggling.

“There was so much care going on for both parents, and we were all exhausted. My mom was just plain worn out,” said Roger.

Finally Bill returned home in February, but then Josie started to decline.

“We realized we needed far more care,” he said.

Bill and Josie Heegaard, of Alexandria, remained active well into their 80s. The two were cared for by Alternative Senior Care in their final months and were able to stay in their home right up until they passed away earlier this year. Photo contributed by the Heegaard family

Bill and Josie Heegaard, of Alexandria, remained active well into their 80s. The two were cared for by Alternative Senior Care in their final months and were able to stay in their home right up until they passed away earlier this year. Photo contributed by the Heegaard family

The siblings wanted to give their parents what they wanted — the opportunity to live and die at home. Two hospital beds were brought in and set up side by side in their Alexandria home. Jenny was working full time providing care to her parents.

“We started looking at the care services and a trusted friend, Laura Fiedler, suggested we meet with Cindy at Alternative Senior Care. We liked her immediately, and it was clear we needed help, and their service fit our situation,” he said. “At the same time we also contacted Knute Nelson Hospice.”

Alternative Senior Care started to help fill in the cracks in the Heegaard’s care.

“We got to know all the caregivers,” said Roger. “Both dad and mom loved them, and over time, they became sort of like family.”

But, as expected over the following weeks, Bill and Josie declined further

“In late March we thought both were going to die side by side,” said Roger. “They celebrated their 66th anniversary on March 18 this year, and mom passed away on March 29. My dad had not been up and out of his bed for a month. The day mom died, he said he needed to get up and go to the bathroom, like he had been waiting for her to go.” In August, Bill also passed away.

After the funerals, the Heegaard children and grandchildren were able to rest and reflect on the last year. They were thankful that Alternative Senior Care was there to help them through the most difficult days they had ever been through.

“The care they provided was compassionate,” said Roger. “It was just a very meaningful time to have them there.”

The family started by asking Alternative Senior Care to help for a couple of hours a day. That number increased quickly to 24 hours a day.

“When our situation changed and we needed more care, they were there for us,” said Roger.

Roger said Alternative Senior Care was a great fit for their family and undoubtedly would be a good fit for many faced with a similar situation.

The lessons learned are “Every one has their own journey,” said Roger. “It is very hard to foresee what will happen in the future, but people should be exploring care options earlier if they can.” Roger said they had conversations with their parents when they were healthy, including living wills. “We discussed what they wanted. We knew they wanted to stay at home, but we never could have imagined the perfect storm of needing to care for them both going at the same time.”

“The caregivers were incredible people,” said Roger. “We couldn’t have done it without them. Both died with dignity, and they died how they wanted to. They were both strong in their faith, which helps, and they were both ready.”

Alternative Senior Care is available in Douglas, Pope, Todd, Morrison and Stearns counties. Included in their team of personal assistants is a registered nurse, who can help patients with health issues, such as diabetes and medication management.

“It is our desire to pull up alongside family caregivers and help them along their journey,” said Mike. “That is what we do.”

“We have 11 years of experience in the business, and we also both have parents in their 80s, so we have that experience as well,” said Cindy. “We try to help any way we can.”

Finding the right personal assistants has been key to Alternative Senior Care’s success since day one.

“It comes down to compassion. The number one trait for a personal assistant is compassion,” said Mike, “We are also looking for reliability, dependability, honesty and integrity. And we won’t hire anyone that we wouldn’t send to our own parents.”

“The rest of the skills we can train, but they need those core skills and values to start,” said Cindy.

In addition to their regular training, they also offer “champion level training,” that goes deeper into a specific area of care. This advanced training was made possible thanks to a grant from the Minnesota Department of Human Services.

“We have champion level training for hospice, dementia and mental health,” said Mike. “We never assign personal assistants to clients. They are always able to choose. And it is particularly true in hospice care.”

Alternative Senior Care is not a hospice agency, but they work with certified hospice agencies like Knute Nelson and Recover Health to provide care beyond the care they are providing.

“We are sort of a hybrid home health care agency. We supplement the care and provide longer-term care when needed,” said Mike. “Medicare will only pay for a short amount of time, and we are able to continue after that time has expired.”

Like Roger, Mike and Cindy also believe it is important for parents and children to communicate their wants and needs as they age.

“People are independent, and they feel like they are losing their independence if they ask for help,” said Cindy. “We are looking to extend that independence. We all have a hard time asking for help; it’s human nature. “When they move into a nursing home-type facility, that is when they lose their independence,” said Mike. “We can extend that independence by helping them stay in their home longer.”

Staying home with care is most always more cost effective than moving. Although most clients are private pay, they also work with long-term care insurance companies, the VA and those with low income/assets who qualify for services through the waivered programs.

To learn more about Alternative Senior Care or to schedule a free assessment, call toll free 866-352-3350, email, or stop by their office at 418 10th Street South in Sauk Centre. More information can also be found by going to

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