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 Post subject: Geriatric caregivers?
PostPosted: Sat Jan 19, 2013 4:06 am 
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I'm not quite sure where to start, so I hope maybe someone here can help point me in a good direction.

My mom, sister and grandma live together in Clayton = a tiny city next to Concord and WC. (I live in the Netherlands and was supposed to be there for 2 months now, but have been dealing with oral surgery hell here instead.) Mom works in Palo Alto and is gone 12-14 hours a day; my sister just started chiropractic school in Hayward and is now also gone 12-14 hours a day; and my grandma, who is 91, is at home by herself with a small fluffy dog.

The last two years have been rough on grandma: She had a heart attack in 2011 and has been in and out of the hospital since then because her heart's failing, her body's suffering from it, and the dr.'s are kind of at a loss for what to do for her. My sister is starting to look for alternative therapies, which grandma is finally open to, but there's still the day-to-day living that has to happen, but is now too hard for her, and not really possible for my family to help her with anymore.

Grandma lives upstairs and is in too much pain to go downstairs to the kitchen anymore. She also is really, really insistent on *not* moving downstairs, because she's been in her room for 13 years and it has her everything. We've tried to talk her into it, and offered to rearrange the house and anything else she could want to make it more comfortable for her, but no.

So we're now looking for ways to get someone in the house to cook for her (mid-dayish, to prepare 2 grandma-sized meals) and clean up a bit, and maybe also keep grandma company. 2-3 hours a day, 5 days a week. (Negotiable time; but not more than $15-20 per hour, which might be the problem.) Kaiser gave her a list of geriatric caregivers to call, but no one answers. She also called Meals on Wheels, but there's a huge waiting list and they won't even tell her what her number is on it. I'm sure the internet has ideas, but I'm not sure where to start or how to get get past all the crepe.

Do you have any ideas?

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 Post subject: Re: Geriatric caregivers?
PostPosted: Sat Jan 19, 2013 4:53 am 
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I'm sorry to hear your Grandma is in this situation.

Is there anything in her area like a seniors' drop in centre or lunch club? Even if your Grandma can't get to these (They might offer a 'taxi' service with carers who can help her to get in and out of the house so she can attend.) they should be able to provide some really useful information on how to get her the help she needs. Residential care homes or nursing homes in her area could also provide information on services and entitlements.

Are there any local authorities that could help? For example, in the UK there's a system of social workers and adult safeguarding policies that tries to ensure that older adults get the help and care they need. Seniors are entitled to certain services, such as an annual monetary heating allowance from the government, assistance with care fees if they have low income/assets, a portion of their weekly income dedicated to 'personal allowance' for clothing, toiletries, etc. Admittedly these systems don't always work well and sometimes don't work at all.

Hope she can get the help she needs.


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 Post subject: Re: Geriatric caregivers?
PostPosted: Sat Jan 19, 2013 7:09 am 
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8ball's idea about the senior center is great- towns usually offer some sort of services for seniors. Contact the city hall and asked to be put through to the person who takes care of senior citizen activities/outreach.
Her name is on the meals on wheels list. Even if it's long, her name is on the list.
is there a kaiser rep you can call to say that nobody is even answering the phone on the list? maybe there's a mistake. that failing, can you call up her doctor and say she needs some sort of care, can they push kaiser into providing someone? usually the doctors are sympathetic and want to avoid more hospitalization and will help make things happen.
or maybe i'm unclear and you're paying, not kaiser. if you're paying, you might want to call a local nursing school and ask if there are any nursing students who would be interested in a part time gig that they could recommend. since she doesn't need skilled nursing care it doesn't really matter if the person is certified or not, and you have a better chance of getting a decent person if the school recommends. i know several people who've found homecare staff this way.

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 Post subject: Re: Geriatric caregivers?
PostPosted: Sat Jan 19, 2013 7:22 am 
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I am so sorry that you're dealing with this on top of your oral surgery hell, and I'm sending you tons of good thoughts for a quick and painless recovery and an easy resolution to things with your grandmother.

A lot is going to depend on what your family's town has, but here were my ideas. Our town has a senior center that is free and there are for-profit adult daycares. If you call town hall, they should know about public senior centers. Does your family belong to any churches or local service agencies? If so, you could go through local recommendations or check church bulletin boards for someone able to care for her. Is she still continent and does she have any other medical challenges? It is easier to find someone who can do light assisting and doesn't need to be able to lift her or change her or do the beds etc.

And finally, if I were your family, I'd start looking into retirement communities/nursing homes. My stepmother's mom was in a fantastic one in Asheville- they were set up for every level of challenge. She started off in a nice little apt (with staff that cleaned and 24/7 med personnel on site and a restaurant) and moved to more managed care until she passed. It was fantastic and the staff was wonderful and kind and she adored them and they her.

By contrast, my mom wanted to live alone as long as she could (she was only 68 when she died) and her medical challenges meant she couldn't take good care of herself and ended up falling and hurting herself. And in the middle of an emergency situation, the hospital sent her to the first nursing home which had an open bed, and it wasn't a nice place and my mother hated it.

If your grandmother is willing, she might find a place she likes and may be willing to move to a place that can support her needs. But even if not, if you know some good facilities, just keep a list in case you end up needing them.

Again, I am so sorry for all you're going through! Good thoughts to your family and grandmother <3

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 Post subject: Re: Geriatric caregivers?
PostPosted: Sat Jan 19, 2013 7:40 am 
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I'm in Canada, so I realize services are different where you live. That said...

Pretty much every community I've ever visited in my province has a seniors outreach program/system, be it governed by the health region or the town/RM.

For example: My Baba is in Montreal, and she was referred to a nurse-run senior's day clinic... three times a week they pick her up in a handi-bus, bring her to the centre, she has lunch with the other participants and joins whatever activity is going on that day: music, crafts, puzzles, exercises. They'll check her blood pressure and blood glucose. She pays $13 per day, and it's a half-day excursion.

Another example: In my city there's a network of teams (made up of RNs, Occupational therapists, Physiotherapists, Social Workers) called Geriatric Program Assessment Teams. Anyone can refer anyone over age 65 to this program. The team calls to arrange a home visit, and the appropriate team member will visit the person's home to do some baseline assessments, and from there they can refer the person to some helpful community/public/private health and social services, be that Home Care, Meals on Wheels (and similar programs), etc.

I'm positive these can't be the only such programs in existence.

Also, torque's suggestion is an excellent idea! I would have certainly loved a gig like that while I was in nursing school. (Only issue might be finding a student available mid-day during the week.)

Good luck!

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 Post subject: Re: Geriatric caregivers?
PostPosted: Sat Jan 19, 2013 8:03 am 
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usually geriatric caregivers like what you're asking for are called Home Health Aides and there should be agencies near you that can help. You also might find some answers on the dept for the aging's website
http://www.aging.ca.gov/

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 Post subject: Re: Geriatric caregivers?
PostPosted: Sat Jan 19, 2013 8:26 am 
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I'm not sure if she'd be interested but there are also daytime caregiver places where she could interact with other people and seniors. I volunteered at one many years ago that was for Alzheimer's patients but I'm guessing there are similar ones for those with other needs.

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 Post subject: Re: Geriatric caregivers?
PostPosted: Sat Jan 19, 2013 8:50 am 
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My mil is under Hospice care, which is end of life care. There are workers there who work side jobs of taking care an elderly person who does not need end of life care, just someone to help bathe, put her to bed or light housekeeping. So you could call them and tell them of your grandma's needs and see if they can offer something. This would probably be an out of pocket hourly rate.

My mil has been with Hospice going on for four years now. She's bedridden, but a fairly healthy 96 year old and not going anywhere anytime soon. She never leaves the house, everyone from Hospice comes to see her. We didn't want to put her in a nursing home so Hospice was an alternative. It's paid through Medicare.


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 Post subject: Re: Geriatric caregivers?
PostPosted: Sat Jan 19, 2013 2:10 pm 
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Hi lutin,

I have worked as a Home Health Aide and a CNA in SF, so I hope I can help.

As IJDI said, you are probably looking for a Home Health Aide. HHAs are usually employed by an agency and are trained to provide medical care (esp. for older adults) as well as perform tasks such as cooking and light housekeeping. Sometimes the latter is referred to as "non-medical care", "household care", or "companion care".

You can Google "home health agencies" in Concord and Walnut Creek -- you'll see that there are many -- and inquire about rates appropriate to your Grandma's current needs. Another road to take is through online forums or listings (i.e. craigslist), where you may be able to hire someone at a lower rate. Your Grandma's mobility and health concerns may decline, so you'll definitely want to hire someone who is both HHA and Certified Nursing Assistant certified (this gives them more medical training), and you'll want someone with experience. All CNAs and HHAs are licensed through the state with a number that you can check here: http://www.apps.cdph.ca.gov/cvl/SearchPage.aspx

The longest/biggest/most important part of the process will be finding a caretaker who is a good fit with your Grandma and your family. It is totally normal for this to take a few tries, and to ask an agency to send you a different caretaker. Trust your instincts.

The Family Caregiver Alliance might be useful resource to you, and when the time comes, Hospice By The Bay may also be very helpful. Good luck finding the right person to care for your Grandma -- he or she is out there!

ETA: Hospice By The Bay doesn't offer their services in Contra Costa county, but I am certain that they would be a good resource in suggesting entities that do.


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 Post subject: Re: Geriatric caregivers?
PostPosted: Sat Jan 19, 2013 2:58 pm 
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PPK, you are amazing. Thank you, thank you, thank you!
(Bonus thanks to lizzielove for naming groups in the Bay I/we can contact.)

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 Post subject: Re: Geriatric caregivers?
PostPosted: Sat Jan 19, 2013 6:01 pm 
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If your grandmother needs home health care as opposed to non-medical home care (cleaning, bathing, errands, meal prepartion, etc.), it might be possible to have her health insurance pay for it if her doctor orders it.

For non-medical home care, around here most of the agencies have a 4 hour minimum (hourly prices vary, but the numbers you said you wanted to stay with in are the ballpark for our local agencies).


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