A few weeks ago, my wife’s mother passed away. Paula was a young 82 and as hard as that loss was, it was magnified for my two teenagers. She was their last living grandparent. Both my parents, and my wife’s parents, were present in the lives of my children from birth. Their memories are full of their grandparent’s stories, and the experiences they shared.  In this, I know that my children are fortunate. Not everyone is lucky enough to have known all four of their grandparents. As time passes and the pain of the immediate loss dulls, I hope they come to focus on the blessings of having had their grandparents in their lives.

Mom, Dad, and my father-in-law, Frank, had long illnesses that each of them reacted to differently. My mother’s cancer at the relatively early age of 80 was, in many ways, a time of strength and affirmation for her of the community and family support she had built. In February 2003 she danced and sang at her 80^th birthday celebration. That August she went into hospice and died shortly thereafter. My dad was ill with dementia for a long, long time causing severe financial and emotional strain on my stepmother. We watched as he slipped further and further away and when he died the overwhelming feeling was sadness, tempered by relief. My wife’s father, Frank, spent almost 2 years going from one medical crisis to another that strained the family, and he left this world in pain and exhausted.

Paula, on the other hand, was dressing to go out one Friday morning when she suddenly collapsed. Although we knew she had refused operations to help her with known heart problems, it was a shock when we got the call. Of the four grandparents, Paula’s passing was the most shocking and at the same time the most straightforward and uncomplicated. Upon reflection, my wife believes that over the previous few weeks her mom had a sense of what was happening and was saying good-bye. She died quickly and on her own terms. No lingering illnesses to deal with. No long-term suffering. She was here, and then she was gone.

Living a life takes many shapes and forms, and so does dying. We grieve for those who are gone and for others who must bear the loss. The grief is however an affirmation of how much they meant to us and in our grief we are at the same time fortunate.

May their memories be for a blessing

With House Bill 1494, Washington State was one of the first states to introduce legislation that would regulate elder placement referral agencies. Due in part to the 2011 Seattle Times exposé “The Bed Brokers,” HB 1494 was signed into law and took effect in January 2012. The law requires that vulnerable adult referral professionals meet certain minimum standards of conduct. Among other provisions, referral agencies operating in the state of WA are now required to keep accurate records, make full disclosures to consumers including fees they are paid, and to make sure a qualified professional conducts all assessments.

We are pleased at the initiative taken by our state representatives, but across the country there are still referral – placement agencies operating under deceptive business practices that leave consumers with less choice and more cost. The federal government now is starting to take notice:

The Federal Trade Commission (FTC) recently went after two online placement services that did not check out the long-term care facilities from whom they pocketed fees for recommending them to consumers. These two companies have agreed to settle Federal Trade Commission charges that they misled consumers to think that they had researched the facilities and had detailed knowledge about them. The proposed settlements, which prohibit the respondents from misrepresenting their services in the future, resolve the FTC’s first cases involving Internet-based companies that offer placement assistance for seniors who need institution-based, long-term care.

“Senior citizens need honest information when they’re considering long term care options,” said David Vladeck, Director of the FTC’s Bureau of Consumer Protection. “Companies that claim to know which facilities to recommend to consumers need to be able to back up their claims or they will hear from the FTC.”

The two agencies, CarePatrol Inc. and ABCSP Inc., offer consumers free assistance to obtain placements at care facilities for senior citizens. They are paid by the facilities for the placements.

Family Resource caregiver Lito Gimenez, was honored with the National Private Duty Association (NPDA) “Caregiver of the Year” award at an awards ceremony September 13 in Orlando, Florida. The NPDA is the national home care association for private pay providers with 1,200 member home care agencies and over 250,000 caregivers from across the country.

Lito believes there are four key reasons for his success as a caregiver. One is respect. “I look at my clients as family, and return the kindness and respect that they show to me.” Next is experience. “My confidence lets my clients know that I am doing things the right way. I also try to anticipate their needs so they feel well taken care of and understood.” Exercise and activity is next. “Whatever they want to do, we do,” he says. “Sometimes we’ll go shopping, or out to eat, or to a doctor’s appointment. I try to keep my clients as active as possible.” The fourth and final key to his success is humor. “Hearing my client’s laughter just makes me happy.”

At Family Resource Home Care, we know that our caregivers are going above and beyond what is expected when their client calls or writes to us about them. Lito’s personnel file is full of such letters. Here is just one:

“You just don’t meet people like Lito, everyday. For the past two years, three times a week, Lito cares for my dad. Every morning that he comes to our house it seems he makes it a point to lift my dad’s spirits and leave him in a better mood than he found him in. He cares for my dad in a way that, if I’m being honest, I find it hard to do myself sometimes; plus Lito never complains. It’s easy to say that’s his job, but I believe it goes much deeper than that. Lito bathes and prepares food for my dad. He takes him to the doctor and gives him haircuts. To put it simply, he has improved my dad’s quality of life by making sure that he is treated with dignity and respect even in his weakened state. Over the past two years Lito has cared for my dad, but it turns out that he has cared for all three of us.”

Most agencies that offer long-term care have always provided continuing education for their employees but now, with the passage of I-1163 last November, long-term caregivers (LTC’s) will be required to earn continuing education credits. Starting on July 1st of this year, all LTC’s must obtain 12 hours of approved CEs (continuing education credits) each year.

With the new requirements of I-1163, additional classes and training opportunities are in development to help LTC’s meet the new CE standards. However, all classes, even those offered internally by agencies for their own employees, must first be approved by the State before they can count toward the CE requirement. DSHS is working hard to approve teachers and classes to provide enough CE opportunities but because this is a new law and new program, the State has a backlog of proposed classes waiting for approval. We expect that after the state and local providers put the pieces in place and there are increased opportunities for approved training, it will increase the skill level of caregivers working for licensed home care agencies in Washington State.

The following is excerpted from the May 10, 2012 opening address given by David Lawrence, CEO of Family Resource Home Care and President, Washington Private Duty Association (WAPDA), at the 2012 WAPDA Conference:

When the average person hears the phrase “home care,” what image comes to their mind? How about when they hear the word “caregiver?” What about “Home Care Agency?” I hope they’re positive images featuring patient, skilled, responsible caregivers and their highly professional agencies. But I don’t know. I can only hope.

I do know however that the public’s perception of these terms largely did not come from the people it should have come from — it probably didn’t come from you or your colleagues. The impression that the public has of home care, home care agencies, and caregivers may be wonderful. It may have come from a very satisfying experience they had, or a neighbor had. Or the perception may come from something negative they read about concerning a caregiver from a registry accused of elder abuse; or about an unsupervised independent provider who took advantage of a client. Or maybe their impression stems from a story of a family in crisis whose complex needs overwhelmed the good hearted but unskilled and unsupported caregiver the family hired through Craig’s list.

The public’s perception — their image of what we do, probably did not come from you because, as a profession, we’re new. Family Resource has been around only since 1996, and we’re one of the older ones. But private duty home care is growing by leaps and bounds. In fact health care, paraprofessional health care and home care is expected to become one of the leading sources of new jobs in the next 10 years. Our profession only recently came to see the value of speaking in one voice, and became organized to do so.

In the coming years, as our agencies and services grow, what we do will increasingly shape the public’s perception of all of us, for good or for bad, and as such affects not only our own future, but the whole profession.

If we’re to grow and prosper, not just as individual agencies but as an entire industry, we need to know absolutely that we’re in this together. As Benjamin Franklin put it; ‘We must hang together or most assuredly we will hang separately.’

Today, and in the future, the understanding the public has of private duty home care will increasingly come from us, because we’re growing and the public is discovering the value of what we do. When someone 5— 10 years from now thinks of “caregiver” or “home care” they will increasingly think not of someone from Craig’s list, somebody unreliable, a bureaucratic uncaring organization, or a fly-by-night registry, they’ll think of us. And it’s under our control whether the perception the public has will be a positive or negative one.