IMPACT OF PROPOSED CHOICES FOR CARE CUTS ON RECIPIENTS
Source: Central Vermont Council on Aging Case Managers
(Lamoille, Orange and Washington Counties)
I spoke again yesterday to the daughter of an elderly resident with Alzheimer’s . Her mother has recently been approved for CFC after a long and arduous process of applying, being placed on the High Needs Wait List and then once her mom’s condition worsened with late night wandering in the community, mom being granted Highest Needs CFC.
She told me yesterday that she is willing to provide testimony about her desperate need to acquire supervision, services and safety for her mom in her own home vs. a nursing home. She and her family are worn out trying to stay at their jobs, provide for meals for their mother and addressing mom’s confusion, fears and inability to care for herself or stay at home alone for long periods.
I case manage a large surrogate/consumer-directed caseload in Central VT. This area is rurally isolated and at the fringe of home health service territories. In general, residents routinely experience a lack of home health services.
Seemingly not taken into consideration with the proposed CFC cuts are the numerous CFC clients who are 24/7 care, with dementia and other conditions, who are currently just barely managing on CFC home-based services. These cuts will severely threaten their home-based care, and seem a statement of callous indifference to the most vulnerable population struggling to remain in their communities.
I have a young male client w/multiple myeloma and blindness on dialysis 3x/wk, who uses companionship hours to cover medical transportation from his home to Dartmouth Hitchcock Medical Center (100 mi round- trip); I have clients who have maximized the equity in their homes with no other means by which to remain in their home; I have numerous clients in shared living whose families live out-of-state that rely on caregivers to assist them round the clock. As it is caregivers work for $10.14/hr, or less, and the bundled IADLs and Companionship/Respite hours are currently insufficient to meet the present needs.
As I see it, these proposed cuts would be a poor financial decision as they will ultimately drive up nursing home costs.
I couldn’t believe the lack of understanding of the utilization of CFC home-based services revealed in the comments of administration officials quoted in the TA article—snow removal!!!, a service not acknowledged by our LTCCC re the bundled IADLs. Two of my CFC clients use this IADL time for transportation to dialysis treatment 3x/wk, and they’re not the only clients who use this time for medically necessary transportation. Frankly, the proposed cuts will cause an untenable situation for my home-based group, who live an hour away from most services. Repite/Companionship hrs are vital to dementia clients.
I hope that somebody informs the administration officials that the Bundled IADLs include: Household maintenance, phone (scheduling of appts), money management, light housekeeping, laundry, shopping, transportation, and equipment management—all necessary activities for someone remaining in their own home. To only consider the ADLs, is to look at someone as though they live in a res care facility with built in services. For administration officials to state that these people can get these needs met via other means in the community shows an utter disconnect of the reality that my clients face in this rurally isolated territory. I wish they would do some home visits.
Woman in late 70s, married 60 years, lives with husband. She has increasingly worsening dementia. Husband tries to take care of her but he does not have caregiving or housekeeping skills. She needs cueing for everything, can’t do her medications, can’t make meals, can’t clean up after toileting, can’t bathe by herself, can’t clean, can’t dress without extensive help and cueing. She gets up at night with hallucinations at times. They get by with the dementia grant and some help from a daughter in law, who works full time. They also have a senior companion. There is great risk of husband burn out in this situation as he is “on” 24/7 except when he has a break through the grant or the SC.