Stories from Living at Home/Block Nurse Programs
Minnesota: Urban Programs
Como Park A 75-year-old woman with Alzheimer's disease, living with her daughter who also works full-time…
Highland Park A request for help from a woman in her 60's who is providing meals, rides and assistance for her parents who are both in their 90's.
Merriam Park "Rachel" is 84 years old and has been a participant in the Merriam Park Living at Home/Block Nurse Program for two years.
North End South Como We first started providing homecare services to Dan, a 73-year- old bachelor, in l994.
West 7th "Delores," an 82-year-old woman, was referred to our Program by a local clinic in 1992 after she was hospitalized for dehydration and weight loss.
Minnesota: Rural Programs
Argyle Ted is a soft-spoken person who does not like to make waves nor does he feel comfortable asking for assistance.
Grove City Since 1997, Emma has donated over 525 hours of service to her neighbors and friends.
Owatonna An elderly couple was brought to our attention by their niece.
Park Rapids One day an elderly man came to our office to say he would like some help…
Warren A 62-year-old woman who has lived alone for the past ten years…
Mrs. B. is a 75-year-old woman with Alzheimer's disease. She lives with her daughter who also works full-time. The daughter called the Program wanting information that could assist her in caring for her mother. Mrs. B's dementia was worsening and as a result, her need for assistance with personal cares was increasing. The Program Service Coordinator made a home visit and determined that Mrs. B was eligible for Alternative Care Grant Funds. The Coordinator also recognized that the adult daughter was under significant stress and would probably benefit from caregiver support. The plan was put in place to have an ACG screening done. The Como Park LAH/BNP would serve as an advocate for the family by assisting them through the application process. We then moved forward to implement the plan that was developed in collaboration with the family and the county case manager.
Mrs. B. now has a home health aide three times a week to help her get ready for an adult day health program. At the daughter's request, we arranged for a volunteer to visit Mrs. B. weekly to play cards and go on short outings in the neighborhood with her. The daughter also requested a respite volunteer to stay with her mom once a month for a few hours so she could spend time with friends. We were able to recruit a very experienced respite volunteer to help. The Program checks in with the caregiver/daughter every two weeks to see how things are going. As this situation changes, we will be available to help this family cope with the increasing challenges they will face when dealing with Alzheimer's disease.
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Our Program received a phone call from a woman in her 60's who is providing meals, rides, assistance with errands and frequent "check-ins" for her parents who are both in their 90's. She has often had to take time off from her job to accomplish these things. Her mother has severe dementia and her father is trying to care for her at home. His eyesight is failing, however, and he is quite frail. Recently, the daughter was injured and unable to drive. Our involvement began when we provided a ride for the mother to her hair appointment and did their grocery shopping. The daughter needed rides to medical appointments and we were able to assist with that as well.
Eventually, we were able to arrange to have a nurse and home health aide come to their home for assessments and bathing/laundry help. The daughter was recovering and went to California for a week. While she was away, we checked in with her parents daily.
The daughter is thrilled to have found us and very appreciative that the care-giving responsibilities she was shouldering alone are now being shared with the Living at Home/Block Nurse Program. Both parents accept our support, which eases the responsibilities of the father as well.
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"Rachel" is 84 years old. She lives in Merriam Park in the house her father bought when she was a teenager. Her only relative is a cousin who lives in rural Minnesota. She has been a participant in the Merriam Park Living at Home/Block Nurse Program for two years.
Rachel was first referred to our Program because of failing eyesight caused by cataracts. She was fearful of having surgery to remove the cataracts in spite of her loss of vision and independence. Rachel's other health concerns included asthma and arthritis. When we met her, her house was in disrepair. She expressed feelings of helplessness.
The Program Director and Nurse worked together to coordinate the following services for her:
- Home health aide visits to assist with bathing, light housekeeping, laundry and meal preparation.
- Monthly in-home visits and medication monitoring.
- Volunteer support that provided transportation for appointments and errands, companionship and yard chores.
Over the past two years since Rachel has been a participant in our Program, she has developed a close relationship with her home health aide and her volunteers. Last summer she finally decided to have one cataract removed. The surgery went so well that she can't wait for the second to be completed this winter. She recently surprised everyone and successfully contracted to have her house painted. Now that her home looks so nice, it's a source of pride for her.
During the years Rachel has visited with one particular volunteer telling her many stories of summers spent with her cousin in rural Minnesota. Being an only child, he is like her brother but because of the distance between them, she had not seen him in over 15 years. After several offers by her volunteer to drive her to see him, Rachel finally accepted. She and her volunteer/friend traveled to visit her cousin and had a wonderful reunion. She visited the site of some of her fondest memories as well as her family's cemetery where she plans to be buried.
Rachel still has limitations but she has rediscovered a sense of control in her life. She is content in her home surrounded by neighbors who care about her.
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North End- South Como
We first started providing homecare services to Dan, a 73- year- old bachelor, in l994.
At that time he was in danger of being evicted from public housing because of his poor housekeeping skills. Not only was he unable to pass the yearly inspections but he didn't have the money to hire a housekeeper. Much of Dan's free time was spent playing nickel machines at a casino or at the Mall of America trying to catch shoplifters - activities far more interesting than vacuuming or doing laundry.
We opened Dan to supervisory nursing with a home health aide assisting him twice a week. The plan was that this would be short term and that Dan could be taught the homemaking skills he was lacking. It didn't take long before the public health nurse uncovered more problems than housekeeping. Dan was not showering, not doing his laundry, had no idea how to do even the most basic of household chores and was deeply in debt because of his casino trips. We used our sliding fee scale (ACG was contacted but refused to pay for these services for Dan because he was not in danger of entering a nursing home - actually he was more in danger of homelessness but that didn't meet their criteria) to make the services affordable for Dan. We also involved Family Services to help Dan straighten out his financial situation.
Six years later, Dan passed his PHA inspections with flying colors. He has a neat and tidy apartment, enjoys helping his home health aide with the household chores, showers when directed, is debt-free and has learned to do his own laundry. He has even become a program volunteer - he gets the mail for homebound residents in the hi-rise, takes garbage out for folks, handles the pop can recycling and brags about the Block Nurse Program whenever he can.
Two years ago, ACG did agree to pay for his homecare services.
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"Delores," an 82-year-old woman, was referred to our Program by a local clinic in 1992 after she was hospitalized for dehydration and weight loss. Her primary diagnosis was clinical depression and her physician had concerns about her ability to stay in her home. Our Senior Case Manager did an in-home assessment.
Widowed and living alone in her home, Delores had been suffering with clinical depression for many years. Her husband had been physically and mentally abusive to her. Her family and social support systems were weak and she was very isolated. Delores had 4 children, 3 of whom were alcoholics.
For the past 8 years our Program has provided the following continuum of services:
The West 7th Living at Home/Block Nurse Program, in collaboration with volunteers and health care professionals, has worked to arrange and/or provide services for many years to Beverly. The result has been to enhance her quality of life and support her as she remains safe yet connected while living in her own home.
- Volunteers offer telephone reassurance, rides to medical appointments, help with home repairs/yard work and assist with being a part of the school "pen-pal" program.
- A Senior Companion helps to address the isolation issues.
- Monthly monitoring and case management visits include coordination of in-home therapist visits and access to programs for which she was financially eligible (ex. ACG, RAP, equipment loans and Lifeline.)
- Consultations with her physicians after her depression intensified following the death of her daughter.
- Nursing interventions related to medication and weight monitoring
- Weekly home health aide and homemaking services
- Meals on Wheels
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Minnesota: Rural Programs
The following is a story about one elder in Argyle who needed assistance in several areas and how, with the leadership of our local Living at Home/Block Nurse Program, the community pulled together to provide support to this life-long resident.
"Ted" is a single man. He has a nephew, along with his wife and two children, who lives in Argyle. His sister resides in Rhode Island but visits him twice a year staying for 4-6 weeks at a time.
Ted is a soft-spoken person who does not like to make waves nor does he feel comfortable asking for assistance. His sister, "Nancy," understands this about him and takes it upon herself to line up various services when she visits. She visits our office each time she is in Argyle and together we work to assess and provide support for her brother.
Last June, Ted began to show signs that he was failing.
Nancy wanted Ted to be able to live at home for the summer and then consider moving to either a nursing home or assisted living facility for the winter. She noticed several things that he would need assistance with if he were to remain at home. Our job became that of finding the right combination of volunteer and professional help that would enable Ted to enjoy one more summer and fall at home.
In order to improve circulation, Ted began to wear specialized, tight stockings that proved difficult for him to put on without assistance.
Meals were a concern. Often he would forget to eat.
Another concern was how to help with his medications. Initially, and with help setting up his medications in a pillbox, he was able to remember to take them. As autumn approached, he became more forgetful which resulted in his not taking his medications as scheduled.
He also developed a tendency to sleep away most of the day and volunteers found it difficult to waken him.
Cleanliness was also an area that by September was becoming problematic.
We lined up several trained volunteers who took turns assisting Ted with his stockings each day. He was also helped with bathing.
Meals were handled in a couple of ways. Through our office, frozen meals from the Warren LSS nutrition site were delivered weekly. Ted would go to the local café for his noon meal - which gave him an opportunity to get out of the house for a while and visit with neighbors. The people at the café were also concerned about Ted's health and would contact us if they noticed something that did not seem right with him.
When Ted's sister could not be here, his niece would be his advocate working with us on his behalf and accompanying him to clinic appointments. When she noticed that Ted was not taking all of his medications, she alerted his doctor and our nurse. Our primary nurse was contracted to set up his medications every two weeks. The medication set up was in our office and provided our nurse with an opportunity to visit with Ted and keep track of any changes. It also gave us a chance to observe and assess him.
By September, it was obvious Ted needed more care than he could receive living alone, especially for the winter. Together with his sister, we contacted assisted living facilities and nursing homes to determine which would be the best place for Ted over the winter. We also supported the family during the difficult time when they discussed with him moving out of his home.
In October, arrangements were made for Ted to move into an assisted living facility in our community. Our office arranged for volunteers to move his furniture and help Nancy with getting him settled in his new home.
This is a wonderful example of our community coming together to assist with the care of one of our lifelong friends and neighbors. We miss seeing Ted on a regular basis but also feel better knowing he is safe and still among people he knows.
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From her post as the clerk at the grocery store, Emma has seen many changes in this, her hometown. ("I can recall checking groceries for four generations from one family through the years.") One of the most positive changes is the addition of the Grove City Area Living at Home/Block Nurse Program.
Emma has been an active volunteer with the Program since its beginning in 1997. In those few short years, Emma has donated over 525 hours of service to her neighbors and friends. She decided to become a volunteer because as she stated, "I felt like I needed to do what I can to help others . . .and someday I might need help."
"Someday" came sooner than expected. In February 1999, she experienced a major heart attack. In the weeks that followed, Emma found herself on the receiving end of services that she one so willingly provided for others. She benefited greatly from friendly visitors and home-delivered meals. Because she was not permitted to drive herself, Emma relied on Program volunteers to take her to Cardiac Rehab. About her volunteers, Emma exclaimed, " I never had to ask more than once and it was fun because it was somebody different each time."
After recovering from her heart attack, Emma resumed volunteering with the Program. These days when she isn't serving the Program, she's benefiting from it by attending educational opportunities and events that the Program sponsors. In fact, Emma can often be counted on to "drum up business" by giving rides to other people who want to attend.
Emma believes that while many of the older adults in the community know about the Program, some find it difficult to accept the offered services. She encourages them to call, telling them that "they will help with whatever you need or they will provide information and a referral to someone who can."
Emma states the rewards of being a part of the Program are "on the inside. It's people helping people." And that's what life is all about.
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An elderly couple was brought to our attention by their niece who was looking for some assistance on their behalf but felt somewhat intimidated in asking for help. She was afraid of her uncle's disapproval and did not want him to know she had made a referral to our Program.
While the uncle experiences allergic reactions arising from his days of farming, his wife is dealing with Alzheimer's disease. The uncle manifests a difficult personality style and has alienated family members as well as health care providers from himself.
We talked with him. More importantly, we tried to listen to him. We focused on validating him as a person while supporting what control he still had over decisions that had to be made.
Part of our assistance included providing a volunteer to walk with his wife as he worried she would be unable to remember how to return home from a trip outside of the house.
We also encouraged family conferences, despite the strained family dynamics, because of other issues the couple was facing. We helped foster a supportive, holistic atmosphere where ideas and options were discussed and explored in a positive, respectful manner.
Recently, it was arranged for the couple to move to a memory care facility as they wished. They are able to continue to live together yet receive the specialized services they are both increasingly needing.
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One day an elderly man came to our office to say he would like some help. Specifically, he wanted a handrail put by his front steps that would enable him to get up and down easier and more safely. Eighty-seven years old, he says his legs are "giving up" on him. We arranged for a volunteer to put up the handrail. The following day, this gentleman returned and wanted to pay us for the benefit he received. I told him that we do not charge for this but if he wanted to make a donation that would be fine. He did make a donation and then took some of our Program brochures to share with his friends. Within the next few days, several of those friends called and we helped them as well with various chores.
I learned that the best way to develop community awareness is to do one small job for a senior neighbor and do it well. Your reputation and that of the Program will become known and the trust relationship -- which is so vital to working effectively within the senior population -- will be well on its way towards being established.
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Miss K. is a 62-year-old who has lived alone for the past ten years. Her parents are deceased. Her home is clean and her general hygiene is good. She is a conservative and proud person. Because of some mental disabilities, she is unable to work. She has never driven a car and the savings that were left to her after her father died was slowly being depleted. Our local Living at Home/Block Nurse Program was contacted by a home health agency to assist this woman.
After an initial assessment the Program was able to work with Social Services to apply for SSI and MA. A staff person from the Program accompanied Miss. K. to meetings regarding these initial applications. Once a year she is again assisted with applications for renewal.
Heating assistance and home weatherizing was also arranged for with the help of the Program.
The Living at Home/Block Nurse provides monthly in-home visits to assess her living abilities and general well being. Case managers also meet with her regularly to re-evaluate her needs and make arrangements for service provision as appropriate. Friendly neighborhood volunteers help out with grocery shopping, hair appointments, senior meals transportation needs and yard work. Church members drive her to church gatherings.
With our Living at Home/Block Nurse Program arranging and collaborating the efforts of volunteers and health care professionals, Miss K continues to enjoy the pleasures of remaining in her own home and participating in the life of her church and community.
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