Posts tagged ‘pca’

I just received some disturbing news today.

I work part time as a pca, that is, a Personal Care Attendant. These are people that help the disabled and elderly with chores they cannot do easily for themselves. I fill in as I am needed when someone’s regular pca is unable to make a scheduled time or if a client needs something during an “off” hour when no one is scheduled anyway.

I have one client that employs two pcas on a regular basis. They divide up the days between each other but both come in at 8 in the morning and leave at noon. They then come back at 6 at night and stay until 9.

She was recently thinking of firing one of them. The girl is an alcoholic and will disappear for days drinking heavily or she will check herself into rehab. At the same time wine has been disappearing from the house. My client feels terribly about wanting to do this because the pca really has a problem. But when it happens she has to scrounge around and fill in the times the girl is not available.

I will pick up some of the hours occasionally but I can’t be there for all of them.

This wasn’t the disturbing news however. It has to do with the other pca. You see, we work on the clock. This means that each week our clients fill out and sign time sheets for us. These are turned into the state which sends out payment checks to us.

It seems my client noticed that when the other pca was filling out her sheets she was putting down a start time of 7:30 in the morning. As I mentioned earlier she doesn’t begin work until 8; so she is getting paid for an extra half hour each day. After discovering this my client went over her time sheets for the passed year and found out this girl had started initially by filling out the correct time. Then part way through the year she began entering 7:45. This went on for awhile but apparently when she realized my client hadn’t noticed the change she decided to add the extra half hour.

But this isn’t all of it. My client will cash checks a lot of times and use the money to buy groceries and essentials. For some time she was noticing that the money was going very quickly; she assumed she was just buying more things than she remembered. But now she realizes that this pca has been stealing the money.

What can she do? Many people have told her to fire both of them but then what? She will have to interview for two open positions. But this has been rough on her. She started looking for people for the first pca. One girl came highly recommended by a friend of hers. She met her and loved her. The girl was smart, capable, and would be able to do the job without any problems.

The day before she hired her the friend called all upset. He had just discovered that the girl had been stealing his money and medicine. He had gone to the police about it and found out they already knew all about her; she does this on a regular basis. He was very apologetic when he told my client.

I know these people are thinking that the money is coming from the state so who’s going to miss it if they take a little more. The drugs are paid for by insurance so these won’t be missed either. And what little pocket money that disabled or elderly people have will be more than compensated by Social Security.

But this isn’t really the case:

• The state money is budgeted; each client has a certain amount to use for pcas. If one gets more than they are supposed to, another will get less.

• There are no extras on prescription medicines. If a doctor orders 10 pills the pharmacist will not include an extra one or two. And for a lot of medications the insurance company will only pay for the amount prescribed. That is, if a patient runs out before the end of a month and requires more the extra will not be paid for.

• Social Security sends out one check per month for a specific amount. They will not replace any money that is stolen.

• The bottom line is that it is the client that is being hurt.

So now she is very discouraged. She has decided she will keep the thief. The woman has her own addictions that she has been fighting. My client is going to sit down and have a talk with her. She plans on telling her that this passed year was a bonus period but from now on everyone is going to follow the rules. Only time worked will be signed for on the time sheets. She won’t be cashing checks anymore either so that there won’t be any cash available for the taking.

It was very disappointing for me to hear all of this. Most pcas are honest, wonderful, and caring people. I like to think I am too. We are there to help people who have trouble doing things on their own. Sadly, in every profession there are bad apples that can ruin it for everyone else.

As a PCA (Personal Care Assistant) I work with many different people. I don’t have a specific set schedule but I fill in for regular pcas when they can’t make one of their scheduled days. In the process I come in contact with people that have a lot of physical and mental issues. Sometimes they have problems coming to terms with what is happening to them.

I am not a psychologist. I can only listen to them and perhaps offer an opinion if they ask. For example, I have one client who seems to have been hit with a lot of things at once. Instead of being able to work on one problem at a time he is overwhelmed with trying to come up with solutions for all of them.

• These are some of his current issues:Just this past Christmas he needed an operation on his lower back because his spinal cord was being constricted by cartilage. Ever since he has been wheelchair bound. He is able to move himself around his apartment but if he goes outside he needs someone else to push him. This is very different from when, as a carpenter, he would be up and down ladders all day building houses.

• His brother died last year. This was the last of his siblings. Something like this can really emphasize your mortality.

• He and his wife have spent the last of their money. Now they are living on her social security check. This means that they have had to move from a decent 2 room apartment to a smaller 2 room subsidized apartment. This has the affect of making him feel like a failure at taking care of his wife.

• More and more medicine has been prescribed for him lately. Now he is suffering from side effects. For example, some of them can cause short term memory loss. And now we find that he will repeat a question over and over again because he has forgotten that he has asked it already. Now certainly this can be the start of Alzheimer’s but when several meds suggest this as a side effect, it is something to look at. But for him it is just another sign of losing his independence. He has to rely on people to take care of him.

• He still owns a car but since the fall he has not been able to drive it. It just sits in the driveway. His pcas all do his shopping for him now. If his wife needs to go on an errand she will call their neighbor. They are also paying too much in car insurance. His decision after a lot of soul searching and talking to his wife is to sell the car. She told me that when they discussed it she cried and perhaps he did too. The man has been driving since he was 10 years old on his father’s farm. That’s 75 years. Yet another sign of lost independence.

• And most recently he complained about pain and swelling in his knee. It appears that he has “water on the knee”. He doesn’t remember falling or bruising it so the cause is a mystery. I was contracted to take him to a doctor. It wasn’t as bad as everyone had thought and the decision was to put him on physical therapy for a couple of weeks. This was more evidence of him getting old and his body failing.

With everything hitting him at once like this he has become very unhappy. I can’t say that he is suffering from depression. That will be something that a doctor would have to determine but I know he dreads ending up in a nursing home. If that happens, he says, he will get into bed, turn his face to the wall, and wait for the end.

I have heard a lot of people say things like:

“Come on, he is in his 80′s now. He should expect these things to be happening.”

“He is lucky to even be alive at this age.”

“He should just slow down and accept any help that is offered.”

“You know if I was his age I’d love to be going into assisted living.”

But I’ll tell you a secret. These people will say this now but when they actually get that age they will be resistant to the change as well. Why? Because they will find that they are losing their independence. They won’t have any control anymore over the things that they do or how they spend their money. Or worst of all, keeping their bodies from falling apart.

This is where my client is at. He has gone from being a strong robust independent man to an invalid. His wife is also in her 80s and she has been declining so she cannot help him very much. This means that he has to rely on strangers to take care of him. He has been having a very difficult time coming to terms with all of this.

When I am with him we get to laugh a lot. To him I am “the kid” even though I’m in my 50s. I do as much as I have to to get him where he needs to be but otherwise I let him do as much as he can himself. And I listen to his stories. He’s got a lot of them.

When I am his age I hope I have lots of stories to tell my son who is 9 now. Max has been trying to make sure I stay healthy.

He gets me working out constantly: “Max, how many times do you think I can run around the track??”

He is after me to lose weight: “Come on Max, I’m not that heavy!!”

But you know what, I can see myself in 30 years being in the same place my client is. I see it as part of my job to help him transition from unhappiness to acceptance and perhaps be able to take a more active interest in life again.

We were deluged with rain last Thursday.  It filled our basement; it killed our water heater; and we lost power for a short time.  I had to find a pump to get rid of the water; most stores were out of them.  I have finally gotten the water out, now I have to plan for actual cleanup, we lost quite a few possessions.

In the grand scheme of things it isn’t much.  Between New Hampshire and Massachusetts 300,000 homes lost power.  This winter the mid-Atlantic states were dumped on with snow.  Haiti and Chile were destroyed by earthquakes.  I will survive what problems I have right now.

With all of this however, I still have work to do.  I have several jobs one of which is as an on-call Personal Care Assistant (PCA).  I work for several people who have regular PCAs; I fill in if an assistant can’t make it on a given day or there is an emergency.  This weekend was one such situation.  One client has two regular PCAs that come to his apartment to clean his house, give him baths, and to dress him, among other things.  His legs are paralyzed so he is wheelchair bound.  My job is to be his chauffeur; I take him to doctors’ offices, hospitals, and to visit family members.

On Thursday night his apartment complex lost power in the storm.  It is a government-sponsored low income building that doesn’t have a generator.  Since the temperature started dropping in the evening they were in danger of freezing if he and his wife stayed there overnight.  When I spoke to them they were content to stay.  They found that if they boiled pots of water on the stove they got some heat.  They were prepared to do this until the power came back on.

As I mentioned he is in a wheelchair and has PCAs come in to dress and bathe him.  His wife, though mobile, has difficulty lifting much more than Styrofoam cups of liquid.  Between the two of them they were going to have trouble just keeping the pots full of water.

I informed them that they would be staying in a hotel for the evening.  I called around to discover that all the hotels and motels in the area were full; everyone needed to get out of their homes.  I finally found an open room; luckily it was what they call handicap-accessible.  I called my client; he was shocked but grateful.  At 8 pm I headed out to take care of them.

When I arrived at their apartment the first thing I had to do was help him get dressed before moving him into his wheelchair.  While I did this his wife packed a few belongings.  I pushed him down the long ramp to the car and loaded him up.  After helping his wife in as well I packed the chair in the trunk.

Now comes the fun part.  When we got to the motel we found a shabby ramshackle place.  The room was in the back side of it.  I had to roll him up a broken cement ramp into the building then down a hallway that sloped up and down like a rollercoaster.  The room was located at the far end of the corridor.  Inside this “handicap” room was a double bed that took up most of it.  There was barely enough space to squeeze the chair between the bed and the walls.  It was a tight turn into the bathroom and for a moment we thought we wouldn’t be able to make it.

But the door was wide enough to get in and we found a very large room with railings.  My client was able to maneuver around very easily.  And as it turns out he had no problem rolling himself around the bedroom.  He is very adept at getting around corners.

I got him to bed and then left for the evening.  In the morning I picked them up and took them to breakfast at a small diner down the road.  Afterwards I called the apartment complex and discovered that they now had power.  Even though it was only for one night you’ve never seen two more excited people when they finally got home.  I left them profusely thanking me for taking care of them during the storm.

So according to the title this post is about “PCA Storm Therapy”.  In this case it is about therapy for the PCA.  It took me away from all the stress at home.  The pump took care of the water in the basement without me. I didn’t worry about scheduling the installation of a new water heater or getting ready to clean up our ruined possessions.  Not only did it feel good helping my client and his wife but I was able to stay relaxed while doing it.

Sunday was mom’s birthday.   I’m not gonna tell you how old she is; she’d kill me if I tried.   It started out a great day but we were afraid that it was going to rain later on.   We were hoping to get the party well on its way before that happened; it was held at my sister’s house.  My wife and Max left to make the 45 minute trip up into New Hampshire so that he could spend time with his cousins before everyone else showed up.

On weekends my mother goes to my other sister’s house to take care of her.  My sister and I both have multiple sclerosis.   Mine is the “funny you don’t look sick” kind.  My sister is bad and continues to get worse.   She is in a wheelchair and must have Personal Care Attendants or PCAs available to help her on a daily basis.  She cannot get out of bed, dress herself, bathe, or use the bathroom without help.  One of the things she loves the most is to be placed on her scooter so she can tool around town in good weather and see her friends.

She has several pcas that work with her during the week.  As I mentioned Mom takes care of her on weekends.   I am generally the “pca on call”.  This means that if she has doctor’s or chiropractor appointments I’m generally the one that helps her get there.   If she’s got a party to go to who’s she gonna call?

Today my job was to travel an hour south to pick up both my mom and my sister and then drive them in the reverse direction an hour and a half to the party.  I’m glad to do it; Sis was my best friend when we were kids.   I can still remember when she was in kindergarten coming home to spend time with her 3 year old brother who would be lonely waiting for her all day. Now we are in our 50s and I can now be there for her.

When I got to her place she and mom were in the bathroom getting ready to go.  Uh oh, she has a new wide screen HDTV; man I’d love to have that!  I sat down to play with it while I was waiting for them.  I didn’t get enough time with it; I was called to help get her onto her chair.

Getting her out of the bathroom is nice now that the state rebuilt the door so it is wide enough to get the wheelchair through.  There are other things they did too such as putting in a new tub, handrails all over the house, and for me something else.  When we were ready to go I pushed her out over the new small ramp onto the back deck and then down the new long ramp on the side of the house to the driveway.  It is so much nicer now than when I would have to position a chair in the house and one in the drive and then carry her up and down the stairs.

I’m also always learning the best ways to help her.  Every time I see her she has a new way to lift her out of the chair and put her into the car.  Today she directed me how to do it.  Like always I position the chair close to the car and then remove the foot rests.  The next step is to move in front of her and stand with my legs on each side of hers.  I then squat a little and reach around behind her to grab the belt she wears underneath her clothes.  On a count of 3 I stand straight up bringing her with me and hold her close.  I spin and lower her onto the car seat.

Now comes the tricky part.  When I set her down she always ends up lying down with her feet still on the driveway.  I have to slide my arm under her armpit and lift her to a seated position.  Today was a little easier because mom climbed into the driver’s side and helped lift her.  Once she was seated I swung her legs into the car and we positioned her so she was comfortable.  Then I put the seat belt on her and threw the wheelchair into the trunk.

Once we were on the road mom took a nap in the back seat and we chatted on about different things.   She and I are both website developers so we talked about things we were working on.  She has not yet seen my blog so we talked about that as well.  The point is that while we are driving we are family and friends having a good conversation.  She does not have to worry about all of her problems, which is a good thing!

When we got to our sister’s house there was a mad rush of kids because grandma and sis were here!   And after that it was time to reverse the procedure by putting her back on the chair and then getting her into the house.  This time my brother-in-law and I had to lift the chair over the steps and inside.  The final stop was out on the back deck.  She spent the afternoon watching the kids swimming in the pool or playing games like hide-n-seek and tag with me.  She loves relaxing and seeing all of this.

My duties were over for the day.   If she needed bathroom breaks our sister took care of it.  Everyone helps her; even the kids brought her hot dogs and burgers.  And I can’t forget mom; this is her day after all.   We sang and brought out the cake. My 8 year old boy gave her a birthday card and grandma laughed when she found a dollar in it, “to spend any way that she’d like.”

The party was still going strong when my wife, Max, and I left.  That seems to be always the case.  When he starts getting tired he can act out like all kids do but his disorders tend to make him worse.  We find it best when it reaches 7:30 at night to make a nice relaxed retreat before anything happens.

I didn’t forget my mother and sister.  My brother and his family had arrived after we did and he stepped up to take them home.  So mom was ecstatic, it was the best time she had had with her family in a long time especially since she hadn’t had to worry about my sister.  She does that enough anyway.  And my sister had a wonderful time.   She doesn’t get to see her nieces and nephews very often and she misses them and it is gratifying to her to find they miss her too.