Home Care for the Vulnerable (Part Three)

Over and over we hear that it is best to age in place. Or if you have a medical condition that requires support from others it is again best to have the help come into your home.

While in theory it sounds like a perfect solution in practise it does not work, unless you have a large bank account.

Both my parents and my in-laws accessed home care at various points. My parents only qualified for it after my mom was released from the hospital with a cracked pelvis. The Home Care worker came in twice a week to help her bath. My mom liked to bathe every other day so on those days she would do it by herself. I tried to make the 30 minute drive out to help because I didn’t want her to fall.

Later on when I was worn out from grocery shopping every few days for them, we hired a lady to come and help out. It cost $25 per hour and she came for three hours once a week. I still supplemented picking up medication and groceries……

If they had a medical appointment, my brother or I would drive them. At their particular age taking a taxi wasn’t in their plans. My in-laws also refused to take taxis so my husband or I would drive them to and from appointments.

We also hired a cleaning lady so that was another cost. Another person was hired for foot care and they purchased meals on wheels.

My in-laws qualified for bathing twice a week, so we hired a cleaning lady and they had meals on wheels. They refused to hire a foot care person.

In our experience Home Care people were often different. How could any sort of trust be gained when different people arrived to do this intimate care?

One my friend’s mothers refused to let a ‘stranger’ in her house. She had mild dementia and was afraid to allow this Home Care Worker she hadn’t seen before come in. Makes sense to me.

When my friend phoned to see why her mother wasn’t bathed she was told her mother refused. While I understand the Home Care Worker could not force herself in, it highlights an issue with Home Care.

Home Care staff were also always rushed as there were time limits set for each ‘service’ they offered. When dealing with people who are vulnerable, as in elderly or medically fragile, trying to rush them only adds to the confusion and stress.

A good friend has a sister who is confined to a wheel chair and requires daily home support, even though she lives in an assisted living facility.

The sister qualifies for three showers each week and is allowed one hour per shower. Because she is incontinent this is not really enough. She copes.

She needs exercises so Home Hare provided a physiotherapist twice a week. As soon as the pandemic started this was stopped. Her sister had to hire a private physiotherapist and can only afford her once a week. This in not helping her to maintain her independence.

The sister has limited use of her hands and Home Care comes in once a week for two hours to assist with laundry, homemaking and cleaning. Even in a small apartment there is no way everything gets done. During the pandemic this limited help was gone. It fell to my friend and later on, to the sister was able to hire a lady to help out. Again this was a financial burden.

As far as meals go, within the assisted living place where the sister resides, meals were provided but because of the pandemic, she is now charged $5 if she asks that they bring the tray up to her room.

Can you imagine someone with limited hand and arm strength opening her door to go out in the hall, wheel herself down the hall, enter an elevator, pick up her food tray and then make the reverse trip. How can this be safe?

So my friend makes meals to freeze that can be warmed up in the microwave. Her sister is getting limited social interaction and my friend is taking on another job.

When Home Care does come, part of the service is meal preparation. The reality is that they are only allowed to make toast, salads or sandwiches. If we care about nutrition this is simply not enough.

The sister requires medication twice a day and Home Care does come in to administer the drugs. Again there is a time limit to these visits so it is quick.

What I have noticed in the condo where my parents resided and now our condo is there are many different Home Care staff arriving at different times of the day to assist people who need help.

I wonder if those visits couldn’t be better coordinated so it was always the same three or four staff who visited a building. Wouldn’t that make more sense, be a better use of time and be easier on those who need the help?

For my parents, in-laws and other friend’s parents and siblings, we step up and help when needed, sometimes at our expense.

For caregivers this can become a full time job and many are wearing out, stressed and financially burdened. We are aging too.

What happens to the vulnerable who have no one? How about those who don’t have the bank account to be able to hire extra help. It is frightening to think of their fate.

I hear arguments about cost and certainly this needs to be considered. Let’s sit down and talk about what could work better? If there a different way that is more humane?

I understand that moving the vulnerable into institutions isn’t popular, especially after we see what is happening in many, and yet for us as caregivers it was reassuring to know that qualified staff was on site 24/7.
Also most residents get more social stimulation which is so necessary to their physical and mental health.

In it’s present state, Home Care is not enough to keep our vulnerable in the best safe spot we would expect for our loved ones.

Seniors and those living with degenerative diseases deserve the respect and care we give to children. We need more doctors, nurse practitioners and trained staff who specialize in this care.