MSU Grant Focus on Caregivers 

MSU logo represents MSU grant focus on caregivers

 

For the past six months Executive Director, John Stauffer, has been serving as a contributor to an MSU Grant Focus on Caregivers, an important alliance for Helping Hands Respite Care. Called the IMPART Alliance, the group was formed to provide critical and anecdotal information for a $500,000 MSU Research Grant process targeting “personal care attendants, or PCAs,” in our vernacular – caregivers. The grant came from the Michigan Health Endowment Fund in the category of Special Projects and Emerging Ideas Grants. Written by MSU professor Clare Luz in the Department of Family Medicine, the grant outlines a program called Integrated Model for Personal Assistant Research Training (IMPART).Clare Luz, author of MSU Grant Focus on Caregivers

Focus of  MSU Grant About Funding for Training and Service

Major topics being explored through this grant include:
– Creative Ways to Finance PCA Training and Workforce Development
– Exploring Diverse Sources of Funds to Pay for Training and Service for PCAs

 

Background for this initiative began 6 to 7 years ago with a federal grant that was offered in several states to focus on standardized training for PCAs. The acronym for the program was BTBQ which stood for Better Training, Better Quality. Contrary to most of the participating states in this program, in Michigan the BTBQ training never made it to the implementation phase before the funding ran out.
In Michigan, the reason for the evaporation of funding is because unlike the other participating states, Michigan is a state which does not license many of the care facilities/organizations and as such has no uniform training standards across the state.

In this generation of focus on the training, the IMPART alliance proposes going back to the other states to gather lessons learned from their implementation strategies to inform the research goals going forward in Michigan.

Across the country there is a consensus that there is no way forward in an environment where PCAs being paid at minimum wage creates an effective response for the ever-growing need for Personal Care Attendants. As the Executive Director of a program widely recognized as providing top-shelf training, John Stauffer’s role in the committee is to be a strong voice for the methods of training which are relevant to the target audience and appropriately reflects the reality of training for a new generation of caregivers which includes more and more college-age caregivers.

Legislators Recognize Value of Respite with Action – Consult with IMPART Committee of MSU Grant Focus on Caregivers

The IMPART alliance includes a sub-committee, which John Stauffer also serves on, which is focused on future implementation and needed wage increases across the board. And, currently this sub-committee includes several members who were responsible for input on some new state legislation targeted at immediately raising wages for PCA’s. The conversation began with legislators and lobbyists proposing a $2 an hour wage increase for these care attendants. The proposal was ultimately reduced to $.50 an hour, for budget reasons, and specifically targeted to those providing care for Michigan Community Mental Health (CMH) programs supporting respite care for families with members needing care due to cognitive/physical disabilities.

State Legislation Passed Will Positively Impact Some PCA/Caregivers

The $.50 increase for PCA’s caring for individuals supported by CMH went into effect October 1st. At Helping Hands Respite Care approximately 45% of those we care for draw some funds from CMH. Because Helping Hands Respite Care has a broad mission of caring for individuals from the very young to the oldest, the remainder of our programs may draw funds from Tri-County Office on Aging for our senior programs, the Veteran’s Administration and their benefits for respite care for spouses of those who have been in-service to our nation, and finally families privately paying or using long-term care insurance policies. “The diversity of our service and programs means that there will be some caregivers/PCA’s who will not see an increase in their pay,” commented Stauffer.

Minimum Wage Increase Coming January 2018

“However, there has been preparation for addressing a broader increase across more of our care staff with the coming of a $.35 increase in minimum wage in Michigan beginning January 1st. Current care staff should watch for a letter which outlines how these two increases – the CMH wage increase and the minimum wage increase will be reflected in their paychecks. It should be noted that the language of the CMH wage increase provides the $.50 per hour increase to go both to the direct care agency and the care providers. At Helping Hands Respite Care we prioritize the well-being of the families we serve by making sure that all of the increased funds go directly to caregivers,” concluded Stauffer.

 

Why We Made the Switch to Clear Care

Caregiver has more time to care when she uses the Clear Care system for reporting

If you are a client/family, caregiver, or contracting agency, most of you may already be feeling the effects of our switch over from the VINCENT scheduling system to Clear Care Online. For us the decision to switch over was easy, based on the research done before hand. We were propelled by the fact that as an early adopter of the VINCENT system we experienced some disappointment in getting changes made to the system to accommodate our needs or simply to fix glitches. After a month and a half of preparation, and with the help of the Clear Care transition team and a dedicated transition counselor we went LIVE on May 1st and began the change-over transition.

Even with all our hopes for the better solution for the families we serve and the care givers who help us keep our promises – there is never a great time to make a transition. We are so proud of our Office Administrator Janette Lauzon, and our Scheduler Rhonda Mliakoff. Together these two have done a fabulous job of coordinating this transition. Not going to lie, there were frustrations along the way, but we have never had the kind of daily and intensive support from a vendor like we have had from Clear Care.Clear Care logo

What the Clear Care Benefits are to the Families We Serve

The Family Room Forum – Each family has their own “room” to communicate with us and the caregivers scheduled to provide care. The Family Room provides a place for communicating back and forth. Family members can request some additional tasks, offer reminders on one-time events which the caregiver may need to be aware of; and likewise, the caregivers can share comments on things that happened during their shift that may help the family. Once you get into the swing of using the Family Room Forum we predict an even better experience for both the families and the caregivers.

Schedule View – The families can see the schedule online, either from your desktop computer or your smart phone. The schedule is a living document and shows the shifts with times and who is covering that shift. The whole month view of the calendar gives you a comprehensive look at a color-coded plan which lets you know which shifts are scheduled, shifts that are still open, those in process and those completed. Notes can be appended to the schedule such as when a caregiver did not show or the family had to call off a shift – this is making the billing process so much easier!

Care Notes – The Clear Care system will hold the details of the Person-Centered-Plans (PCP) including a list of all the required Activities of Daily Living (ADL) and show those needed for a particular shift. When a caregiver checks in via their phone, they will see what is on the schedule for that shift, and when they clock out they will only be able to do so after answering the questions related to the ADL tasks. A simple “YES” if a task was completed, a “NO” with an explanation why. The system will also capture mileage related to any activity where the caregiver took the client out into the community as well as any comments or concerns for the family. This instant capture of care notes creates a foundation for a paperless system and makes for a much better snapshot of what happened on each shift, and that information is always available to the families. The supervisors will also have access. As our caregivers get used to checking in and clocking out, and reporting, we are convinced that the level of care will get even better.

What Clear Care Means to the Administration of Services

As you can imagine the job of administering, scheduling and managing up to 75 caregivers to deliver over 5000 hours of care each month (and growing) to 100 or more families through the six programs offered by Helping Hands Respite Care…it can get complicated. Clear Care is beginning to uncomplicate these processes for us in some meaningful ways.

The paperless care notes system provides far more accurate documentation of what happens on every shift and provides alerts for action items. Already we are finding the system to be intuitive, user-friendly, and much faster.

The information that comes out of the system and immediately interfaces with our billing system provides for a more accurate monthly invoice which reflects the many variables involved such as acuity level, role of caregiver, and variable pay structure of the caregiver in a group setting such as the Respite House, and the specific requirements of the various contract sources. This also translates to a more streamlined payroll process. For example, within our Adult Day Services program those members who attend and receive support from the Veteran’s Administration (VA) must receive a particular rate prescribed by the VA. In the past, reviewing the daily care notes for a particular pay period to determine which caregiver served which member to satisfy the contract would take up to an hour. Now it takes 10 minutes!

We are only just now beginning to realize the benefits of simplifying the scheduling process with Clear Care. It is not uncommon to have to accommodate a last minute change in a schedule due to illness. On Thursday at 5pm a caregiver called in to let us know that she would be unable to fill an overnight/awake shift at the Respite House beginning at 6pm on Friday. By going into the Clear Care system after clicking on the shift that needed to be covered, in just a few minutes we clicked a few buttons to reflect the criteria we needed in a caregiver for this shift, including finding all those that could possibly work that time frame without going into overtime. We found eight potential workers which met our criteria. Their names were clicked and a text message was sent to all asking if they wanted the shift. Within 5 minutes, the shift was filled!

As you can tell, excitement is rising for us as we continue the transition begun on May 1st. On June 1 we will be doing our first billing process and with any luck it will yield the same kind of benefits we have realized on the scheduling and payroll side of the equation.

Bottom line, it looks like we have a winner. We know it may take time for everyone to get up to speed on using this new system …which means the information and accuracy is only going to improve. If you are having challenges with the system, please do not hesitate to reach out to us so we can help you with your learning curve. This is a system that supports us all in ways that help us continue to keep the families that we serve in a position to receive the full benefits of respite, while their loved one gets the best care possible.

Welcome Missy Dahlgren

Welcome Missy Dahlgren

Join us in welcoming Melissa (Missy) Dahlgren to our team as the new child-in-home/respite supervisor. She has worked as an in home supervisor/therapist to families for the past four years at another agency. She has also served as a respite home manager for a brief time. So, you can see why we are thrilled to have her as part of our team.

Before leaving her former employer, Missy was the chief administrator of the respite program. She supervised three respite facilities and their corresponding managers. “I am hoping to transfer the skills from my last position to Helping Hands Respite Care and am committed to helping us grow as an agency,” shared Dahlgren. “I am a friendly person and hope that the next time you stop by the administrative offices that you will look for me for a quick chat. My hobbies are farming, spending time with my two daughters and husband, as well as shopping. I am looking forward to working with everyone.”

For those of you who were wondering, Tarra Boris has moved on to a position as a social worker in the Waverly School system. We were honored to have her for as long as we deed and wish her the very best on the career path that she had dreamed of from the beginning.

A Tale of Two Caregivers

 

This is a story of two caregivers and the service they provide for two young men seeking independence in two very different sets of circumstance.  

Nate and Max

Let’s look at Nate and his charge Max, a 22-year old with Down’s Syndrome. Since Nate’s arrival on the scene significant progress has been noted. Before Nate, Max was overly attached to his father who lives in one side of a duplex while Max occupies the other side in a group home format with one other man, each with their own care plan and caregiver.

On his good days, Max was an excitable and enthusiastic young man, fond of super heroes and music. On his bad days, his mood could cycle to combative and argumentative – a real handful for care providers. Max struggled with impulse control which expressed itself in behavior problems and poor diet, leaving Max extremely overweight and often unhappy. The group home environment had devolved to a chaotic, messy and even dirty space.Tale of two caregivers, Nate and Max

Several months ago, another care provider had intervened to engage Max and his housemates in a deep-cleaning and organizational mission. This mission turned into a reset of sorts for the house, the housemates, and Max in particular. As Nate arrived on the scene, armed with a care plan for Max and an intuition that some significant behavior changes could be made using the cleaner more organized environment as a way to attach incentives and awareness of healthy behaviors which would foster more independence and stability for Max.

In addition to a more orderly home environment Nate encouraged Max to make better food choices and to get moving by rewarding with favorite music to dance to. The results? Significant weight loss for Max, a heightened sense of responsibility, independence and a much better environment. Max is  still enthusiastic and excitable but that energy is channeled towards articulating and achieving his goals. Max is known to loudly chant his mantra:  Do it good! Make it better!

In many cases care providers are engaged to “do-for” what the client cannot do themselves. Nate’s wisdom and insight to know that Max’s journey towards independence is more about enabling Max to “do-for” himself.  We give kudos to Nate for his dedication and commitment to Max. Recently, we had another caregiving engagement where we thought Nate would be a good fit. Nate declined because he felt Max’s gains in independence were too new to sustain the loss of the connection he had established as a trusted caregiver. That’s dedication.

Sieta and Thomas

By contrast the relationship between Sieta and her charge, Thomas, are very different from Nate and Max but no less critical. Thomas is 20 years old. His disability comes from the physical challenges of Cerebral Palsy which means he must rely on a wheelchair to navigate his world.  Thomas has big dreams. He is attending Lansing Community College and someday would like to be a “stand-up” comedian – minus the stand-up part which is physically impossible.

Thomas’ needs from a care provider are very narrowly drawn. His self-determination is clear as are his goals, and his conviction to accomplish them.  For example, even though his care-provider could drive him to and from school, Thomas prefers to take public transportation.  Throughout his daily routine there are some speed-bumps he can’t get over without some help.  Here is a list of duties Sieta carries out to assist Thomas:

  • Sit with Thomas and catch up on the week or watch ESPN while waiting for the bus
  • Travel with Thomas on the bus, driver operates the lift which gets Thomas on the bus
  • Open the doors at the entrance of the Gannon building and the classroom
  • Move the chair away from the desk so Thomas can fit in with his wheelchair
  • Sit next to Thomas during class and assist with reading or writing as needed during the presentation
  • After class wait in cafeteria for bus to arrive, help with doors
  • Back at home review class material or study, offer assistance if needed

To outside observers Sieta and Thomas would appear to be friends on a similar path. However, the small services Sieta provides make a huge difference in his school life.  Being able to get to class on time, having a little help with physical obstacles, and then having the help to open a book to the right place during a lecture, or make notes for later are an enormous help.  Sieta appreciates the fact that Thomas participates in class and is a contributing member in group projects for class credit.

These services, although not the normal supports you would expect, are critically important to Thomas  for him to fully participate in class, which gets him closer to his life goals.

Tips to Reduce Risk of Falls

Alzheimer’s and Falling: Tips to Reduce Risks

By Ava M. Stinnett

As our loved ones age, the risk of falling increases. This may be due to changes in vision or perception, difficulty with balance, or cognitive impairment. Side effects from certain medications and medical conditions can cause dizziness or lightheadedness when standing. People with Alzheimer’s are generally at greater risk of falling. In fact, some studies show that problems with balance, walking, and falling may be an early sign of dementia. Falls are dangerous in that there is not only the risk of serious injury but there can also be the fear of falling again and a loss of confidence, leading to decreased activity.

A study from the medical journal Age and Ageing found that people with Alzheimer’s are three times more likely to suffer from hip fractures than those without the disease. If surgery and hospitalization are required, the resulting depression, disorientation, and disability may increase the chances that the person with Alzheimer’s can no longer be cared for at home.

Here are some suggestions to help prevent falls and allow your loved one to remain mobile and independent for as long as possible.

  • Daily exercise, such as walking in the neighborhood, at a local store, or on a treadmill to improve strength and balance
  • Regular eye exams to determine if cataracts, double vision, poorly fitting eyeglasses (or an old prescription), or changes to the visual field have occurred
  • Increasing light to achieve uniformity across spaces to minimize sudden changes in light levels, shadows or dark areas, and glare; using daylight where possible to help with depression or sleep disorders and improve general health
  • Maintaining good foot hygiene—examining the feet for cuts or bruises or long toenails—and wearing shoes that provide good support and have non-slip soles
  • Removing clutter, such as books, clothes, slippers, or other objects that someone could trip over, and making sure that rugs, loose carpets, or furniture aren’t posing a potential hazard
  • Installing grab bars or handrails where needed

Keep in mind that as Alzheimer’s progresses, it may be accompanied by poor judgment or decision-making skills. Your loved one may attempt to walk alone down the steps, walk outside when the sidewalks are slick from rain or snow, or try to get up from a chair or out of bed without help. Despite gentle and, perhaps, daily reminders, memory loss causes some people with dementia to continue trying to do things independently when it’s no longer safe to do so. Patience, understanding, and the implementation of safety measures are the best solutions for dealing with a challenging disease like Alzheimer’s.

 

Milestones for In-Home Supervisor

Child In-Home Supervisor Tarra Boris marking new milestones.

Tarra Boris our in -home children’s program supervisor is marking some new milestones. She recently graduated from Michigan State University. Over the past year and a half Tarra has divided her time at Helping Hands in service to the organization and in pursuit of her Masters of Social Work via an internship “I am still in process towards earning the distinction of having the MSW letters added to my title,” shared Boris. “Hopefully, I will be able to work in the necessary hours and the exam in the near future.”

Facing another life milestone,Tarra is expecting the pending arrival of her baby and is busy preparing a transition team (Dawn Todd and Leah Gavin) to carry on her work during her maternity leave. Tarra shared that her baby is a girl and will be named Arabella.

Tarra is also working on a Play Therapy Certification which she expects will be very useful in her work with families with children, in-home care, participants in the Breaking Barriers Today program, and of course the Respite House.

When asked what we would need to fully outfit the Respite House with toys, tools, or materials with state of the art resources for children attending the program, she was quick to list the following: more sifting toys, a wide range of sensory input toys, weighted blankets and vests, swings, bean bag chairs, and colorful art or murals. “There are some really great advances being made in research on play therapy designed to de-escalate behaviors, especially with those children on the autism spectrum. It would be wonderful to have more of the tools and resources appropriate for occupational or play therapy at the Respite House.”

Dementia and Using Clocks

Photo of a memory clock - Dementia and using clocks.

Losing Track of Time:The Benefits of Using Clocks for Dementia
An article for the Alzheimer’s Association by Ava M. Stinnett

How did it get so late so soon? It’s night before it’s afternoon. December is here before it’s June. My goodness how the time has flewn. How did it get so late so soon? (Dr. Seuss)

What can we learn about dementia and using clocks? We know that aging and dementia-related disorders such as Alzheimer’s disease can cause confusion, memory loss, and difficulty performing everyday activities. Another symptom of Alzheimer’s disease involves losing track of time, dates, and seasons of the year. As the disease progresses, it may also be more difficult to differentiate between night and day.

Although calendars may help those affected, it’s important to keep in mind that a person with Alzheimer’s not only forgets to look at the calendar but they often forget how to read a calendar. For example, the person with Alzheimer’s might suppose that the sixth day of the month on the calendar refers to the sixth month of the year. When it comes to keeping track of time, a large easy-to-read clock may seem like a good idea. But your loved one may not know how to interpret what the hands on the face of a clock mean. They may ask you repeatedly what day or what time it is, perhaps because they forgot that they’d just asked you.

If a loved one can’t determine what day it is, what year it is, or even what time of day it is, how can they be expected to remember whether they’ve taken the day’s medication or if they have a medical appointment or plans for a visitor to stop by? As caregivers, we may not realize that it’s common for those with Alzheimer’s to feel confused or too embarrassed to admit that they can no longer read or make sense of a calendar, a clock, or a watch.

Fortunately, there are a variety of clocks on the market that are designed specifically to help people with dementia and using clocks. Sometimes referred to as “Alzheimer’s clocks” or “dementia user-friendly clocks,” they help those affected by the disease keep track of dates and times in a way that helps them maintain the routine, structure, and focus they need to ease confusion and anxiety.

When shopping for a clock, look for the following features:
• Clear and simple display of time, day of the week, month, and year
• Images to indicate whether it is morning, afternoon, evening, or night
• Clearly visible at night without being too bright
• Easy to set up
• Tamper-proof buttons to avoid accidental interference

There is an increasing amount of evidence about the benefits of using clocks for dementia. An understanding of the correct time, day, and date can reduce stress and help those with dementia feel less alone or lost in the past. When they are able to stay anchored in the present, independence is improved and, perhaps, they will feel as if they are functioning the same way as everyone else.

New Schedule More Access for Families

new schedule for supervisors, image of clock on red background

New schedule designed to provide more access for families.

Frustrated because you can’t reach a supervisor in one of our in-home programs or the ADS program? In an effort to provide more consistent coverage and access to our supervisors who are reached at our administrative offices Monday through Friday we are experimenting with a flex schedule which will guarantee a supervisor will be present every day of the week from 8am to 5pm. In the past, there were too many hours at the end of the day with no supervisor present. Supervisors Alison Sarkozy, Jeff Nunham and Tarra Boris will be working four day weeks with longer daily schedules in order to provide full day coverage throughout the week.

To reach our Respite House Supervisor Dawn Todd, plan on calling our administrative office on Monday or Friday, and Breaking Barriers Today Supervisor Kathryn Green is available daily at 372-6671 extension 106, leave a message and she will get back to you as soon as possible.

Please let us know if we are on the right track.

Hearing Aids Not Working?

hearing aid not working, close up of ear without hearing aid

If you have hearing aids which are not working and you are hesitating because of the high cost of replacement, we are pleased to let you know that there are hearing aid repair options. Soma Hearing Aid Repair has an alternative solution to the costly practice of replacing broken hearing aids. Prices for repair may range from $199 to $299 and can be a reasonable alternative to the thousands of dollars for replacement.

In a recent report in the AARP magazine there is a story about hearing loss being linked to memory loss and dementia. Don’t resist repairing your hearing aid because you may be at risk of losing cognitive ability without the aids.

This article is not an endorsement but an alternative worth pursuing. For Hearing Aid Repair contact Jeremy Nordquist at 248-719-3241 or email Jeremynordquist@yahoo.com

Realizing The Value of Saying Yes

One of the reasons I enjoy working with Helping Hands Respite Care is because our director, John Stauffer is a “see the need and try to meet it” kind of man. He knows the value of saying yes. He has this interesting combination of a great heart of compassion and the American Entrepreneurial Spirit. As a director, I see John lead with his heart much of the time, though he is sometimes painfully aware of the pennies and the “bottom line”. (Just ask him sometime about our Adult Day Service coffee pot situation). He recently spoke about the difference between For Profit and Not For Profit Care Agencies. He said, “the For Profit Agency cares for people in order to make money, while we, the Not For Profit Agency must make money so that we can care for people. I love the orientation of this observation. We are a Person Centered agency who strives to earn money so that we can provide respite for families who care for a loved one with a disability.

 

Discovering the Value of Saying Yes

This was recently illustrated in a way that has made a deep impression on me. At one of our “Walk Beyond the Barriers” information sessions this past winter, we hosted a couple who live more than an hour from East Lansing. They come to East Lansing at least once a week to deliver enough home cooked meals to keep their son nourished for a week. Their son, who I will call Jim, lives independently near campus, but he doesn’t cook. They had not had a vacation in years and were desperately trying to find an agency who could stop by Jim’s apartment and check on him for a few minutes while they were out of state. Though this is not the typical service we provide, leading with his heart, John said, “Yes, I think we can do that for you.”

Let me tell you about our new friend, I will call him Jim. Jim works on campus about 30 hours a week. He walks to his job, does his work and goes home to his apartment. His social interaction is primarily his work. He lives alone. Jim loves MSU sports; actually, he loves all sports. He has season tickets to Spartan Basketball, loves to play golf, and shoot baskets. He keeps his apartment immaculate. He is tall, lean and very athletic for a 42 year old man. He is a very kind and gentle man, who when you meet him, you feel like you want to spend as much time as possible with him. The reason? He listens like he really cares. He is very quick to smile and his eyes express warmth and acceptance. Who wouldn’t want to spend time with someone like Jim? The only challenge in spending time with this wonderful man is his disability. Jim has Cerebral Palsy. It has robbed him of the ability to speak clearly. This makes being with people very difficult. The result is isolation. Isolation means never feeling comfortable going to the store, restaurant or the bank without his parent. More than this, his disability has robbed his community of meeting and interacting with a very interesting and engaging man.

Recently, Jim and his mother and I met to talk about ways that Helping Hands Respite Care could help Jim expand his world. We discussed Jim’s invitation for us to come alongside him and teach him some of the daily activities that he has never ventured to learn. We are going to journey with Jim. We will explore the amazing (often extremely frustrating) world of the computer. We will be learning about shopping, going to the bank and any other activity Jim wants to do. Wow, what a joy this will be for Jim and our care provider.

Once again, I see the wisdom of meeting needs as the first priority of our Not For Profit Agency over all other possible first priorities. Thanks John for leading with your heart. The wonderful gift this gives, is the opportunity to serve an amazing man like Jim. This is why we’re here; and this is what we do.

Postscript from Executive Director, John Stauffer.