I took a big step: In-home care

This afternoon I met with a social worker with an in-home health care agency. She is someone that I have known at least 15 years, perhaps 17. She used to work for the physician practice with which my mom and dad’s doctor was affiliated. Later she worked at the VA where I also knew her since Dad got his prescriptions there. In addition, I also know the marketing representative for the agency. I had worked with her in providing rehab services for my father’s companion after her hospitalization in 2007 or 2008. Another reason I feel comfortable with this agency is that Kate had interviewed the owner during the time that another agency was providing care for Kate’s mother. Kate had been impressed with him. In addition, one of the social workers at Kate’s physician’s practice (the same one my parents used) had given me the name of this agency and one other as places she felt good about.

I was impressed with the listening skills of the social worker. She didn’t interrupt me once as I was giving her information. That is rare. After giving her all the background information I wanted her to have, she gave me information about the agency and their services. Then she completed a form with information about Kate and had me sign a contract.

We plan to start the Wednesday after Labor Day. We will begin with a three day a week schedule. They have a 4-hour minimum. On Monday, someone will be there at noon so that I can get to Rotary. After Rotary, I will go to the Y and then back home. On Wednesday and Friday, a caregiver will come at 1:00. I will go to the Y at that time run errands or meet someone for coffee or whatever so that I can be home by 5:00.

I set up an appointment for the social worker to meet Kate on August 23. We are going to meet at Panera. The plan is for it to appear as a chance meeting. We will be there a little early. When the social worker arrives, she will stop by our table and say hello. I will invite her to sit down with us.

I haven’t figured out exactly how to explain the caregiver to Kate. My plan is not to define her as a caregiver. This is an important first step. I am optimistic that it will work out fine.

Feeling Sad, Anxious

Kate’s confusion related to pulling leaves from the neighbor’s shrub as well as a number of other things have caused me to believe she may be on a more serious decline than in the past. On my agenda today is a phone call to one of the agencies with which I spoke a month or so ago. I am going to let them know that we are coming closer to using their services. I also plan to ask them what they have learned about transitioning to in-home care for those patients who don’t believe they are ready for it.

I also need to call Transamerica again regarding the completion of their application. First, I am going to review the application as though I were filling it out. I am bound to notice things that are not clear. I will jot those down before making my call. I also want to make sure of whether or not there is a requirement that we go through an agency as opposed to hiring caregivers directly.

This is ironic that I should be feeling the last stage of this disease closing in on us just as we are about to embark on new relationships with two couples
The good thing is that Kate doesn’t seem to be affected emotionally by what is going on. She still feels quite normal and happy though as some other caregivers have noted her happiness is flatter. I get sparks of the former Kate when we go to Opera Thursday and Broadway Night at Casa Bella.

Home Care Part 2

I took the next step in the pursuit of home care for Kate. I called a agency that was a top recommendation of the social worker at Kate’s physicians’s practice. I spoke with the son-in-law of the owner(s). They introduced this national franchise to the Knoxville area in 2011. The first one began in California in the late 1990s.

I explained our situation to and told him that I was planning ahead. I explained that I did not envision initiating home care in the next couple of months. I also told him that I would probably start on a small scale, perhaps just four hours one day a week and increasing the service as Kate required more attention or I needed to be away from the house more.

He told me about their services which entail everything from simply being in the house as a sitter to cooking, bathing, dressing, taking care of medications, etc. They charge by the hour for most things. There is a two-hour minimum at $27.50 hr. Four hours or more is billed at $21.50 hr. Fulltime (24/7) is billed at $19.50. They have another fulltime option that would involve two people. One would work 24/7 for three days, the other four. I think he said that is billed at $272 daily.

He asked if he could call back in next week to see how things are going. I told him he was welcome to call back, but I emphasized that I didn’t envision moving forward in the next couple of months.

Home Care

For several weeks I have thought about contacting the social worker at Kate’s physician’s practice to talk about options for home care. She was busy at the time I called but called back a short time later. I explained our situation and asked if she had any thoughts about potential sources of home care. She gave me three names. The first two are national franchises while the last one is a listing service for people who provide care and those who are seeking home care. I have been thinking about an agency for simplicity, but I want to keep all options open for the time being. I know that in the long run, it will be significantly more expensive to hire an agency. On the other hand, it would require a lot of me to manage a number of caregivers as well as their payroll.

I told her that our son is a social worker and is employed as a geriatric care manager. It turns out that she is also a GCM and has a private practice independent of the physician’s practice. I don’t immediately foresee the need for me to engage her services, but it is nice to know. Right now I think I have access to all she knows through the physician’s office.

Wondering When to Bring in Help

The past couple of weeks have been busier for me than usual. I accepted a request to serve as program committee chair for a dinner honoring our former pastor on May 17. I selected a great committee, but there are still things that require some extra involvement on my part. At the same time my responsibilities on a United Way committee that is working to engage more of our retirees to continue their relationship with UW through volunteering and financial contributions. We are hosting a luncheon on May 1 to be a kick off event in the recruitment of charter members of a new affinity group for retirees. I will be the moderator for that event. In addition, we have conducted a brief survey. I have been involved with those efforts as well.

This coming Monday is our annual Rotary golf tournament. I have always served as a volunteer and signed up this year. I am becoming more sensitive about leaving Kate. I have not seen any special signs that she might wander away, but I know that she can’t remember where I am. That could mean she worries while I am away.

For the first time, I am thinking about asking a couple of friends if they might help out when I need to be away. It would be especially nice if I could find someone who would take Kate to lunch each Monday when I attend Rotary. I have two possibilities. One is friend whom we have known from the early 70s when I was at UT. We are having lunch with her today. The other is staff member at our church. She is a friend of Kate’s. They became quite close when Kate was the church librarian. She is still working part-time and has expressed an interest in helping Kate. I might call on her.

I don’t think Kate would accept a caregiver right now, but she would easily accept someone she knows. She would actually love that.