PERSONAL CARE ATENDANT GUIDE: part 2

SOME HELP IN FINDING HELP

By Heidi Johnson-Wright

For a person with mobility limitations, a personal care attendant offers help and independence. But finding the right attendant can be daunting. Here are a few tips from someone who knows the ropes.


As you conduct your Personal Care Attendant search, keep several things in mind. Decide if the gender of the person matters to you, especially if the attendant will be helping with dressing and bathing. Same-sex attendants can more easily assist you in public restrooms and clothing store changing rooms. If you require no personal care or gender is not an issue, consider both men and women for the job.

In regard to age, I've had excellent attendants from the ages of 20 to70. My experience has been that older people are more responsible, while younger folks are in better physical shape if they need to lift you out of a tub or up from a chair. For me, it's never been a major consideration.

Experience is a great asset, but usually not necessary unless you require specialized care such as catheterization or help with exercises. I'd rather hire someone who is punctual, dependable and inexperienced over someone I can't rely on. I can always train someone to assist me, but I can't make her responsible if she's not.

Whether you're hiring through an agency or on your own, be specific about what you want. If you hire your own attendant, use that added control to learn as much as you can about the prospect before you make a final decision. Even if a person sounds perfect over the phone, insist on a face-to-face meeting at least once, even if it's just a 30-minute informal interview. You'll be surprised at what you'll learn about someone just by seeing him or her in person.

While it's important to know what you want in an attendant, it's also important to keep an open mind. For example, a woman I know who usually hired females was surprised to find that her first male attendant ironed clothes better than any attendant she'd ever had.

Most of all, listen to your gut reaction. Although it's tough to do when you're in a hurry to get someone, don't hire any prospect who makes you feel uneasy.

If you use an in-home health care service, the cost per hour can vary between companies in the same city and even between franchises of the same service in different locations.

According to home health care professionals, the cost of a service is often higher in large, metropolitan areas than in smaller, rural regions.

Some health insurance carriers will pay for some or all attendant care services. The factors that make coverage more likely are:

• The attendant is providing direct personal care and not acting solely as a companion.

• A doctor verifies that the attendant care is medically necessary for the patient to remain independent.

• Care is provided by an in-home health care service rather than someone hired directly.

Whether attendant care will be paid by insurance depends on the terms of your policy. When checking, don't assume that a provision addressing the coverage of long-term care refers to attendant care. Long-term care can sometimes mean institutional or nursing home care only.

If you have insurance coverage, you'll want to know what the policy limits are. Insurance companies may limit coverage to a number of hours per day and/or a total dollar amount per year.

What you pay someone you hire directly is entirely up to you. Keep in mind, however, that you'll have to provide compensation competitive with the other employers in your area.

Of course, how much you ultimately pay will be a combination of factors -- how much (if any) care your insurance covers, the hourly rate of the person you hire and how many hours the person works. While some people may need almost round-the-clock help, others do fine with only three or four hours per week.

Whether your relationship with your attendant becomes a life-long friendship or merely a brief boss-employee relationship, the benefits of having a personal attendant can be great.

Attendant care has enabled me to go away to college and law school, to live alone when I was single, and helps me to take care of my house now that I'm married and practicing law.

It's a wonderful tool for gaining independence -- independence that equals quality of life.

PERSONAL CARE ATENDANT GUIDE: part 1

SOME HELP IN FINDING HELP

By Heidi Johnson-Wright

For a person with mobility limitations, a personal care attendant offers help and independence. But finding the right attendant can be daunting. Here are a few tips from someone who knows the ropes.

The arrival of my 18th birthday heralded several major events in my life. The stabilization of my juvenile arthritis, the beginning of college, and working with a personal care attendant who was not a parent or sibling.Laura was my attendant all four years of college. We became great friends, both majored in English and even took some classes together.

Today, 27 years later, I realize that my relationship with Laura was unusual in its longevity and compatibility. But what I learned from working with her, as well as the dozen or so attendants who have followed her, should answer many questions you might have if you or someone you love are considering taking the big step.

If you have a chronic health condition that may limit your mobility or require surgery, chances are you'll need an attendant sometime in your life.

I was diagnosed with juvenile rheumatoid arthritis at age nine. As a result, I've had nearly a dozen surgeries, including six joint replacements.

My pain and limited range of motion have made assistance with personal care a fact of life for me. I've been hiring attendants since I left home as a young adult.

But for someone who's led an active life and hasn't experienced the effects a disability until middle age or beyond, it may be harder to know when you need an attendant.

If you're unsure, ask yourself a few questions:

• Are you frequently wearing easy-to-put-on casual clothes because getting dressed up is too painful or difficult?

• Do you hesitate to have friends over because you can't clean like you used to and you're embarrassed by your messy house?

• Have you given up fun activities or hobbies because you're too sore or tired after doing the regular household chores?

• Is it taking you longer and longer to dress, groom, bathe, prepare meals and do housework?
•
If you find yourself answering affirmatively, it may be time to seek an attendant.

Exactly how and how much your attendant will help you will depend on several factors: the areas where you need help, the skills and interests of the person you hire and, of course, how much you're willing to pay.

Generally, attendants assist with personal care, such as bathing and dressing. Often they do light housekeeping, laundry and meal preparation as well. Some people hire attendants to drive them to the grocery store or appointments, or the attendants themselves run errands. A person with paralysis who owns a home may even need assistance with handyman chores and small repairs.

Of course, what you hire an attendant to do will match your particular needs. There are no hard and fast rules.

Basically, there are two ways to find an attendant -- on your own or through an in-home health care service. Each way has its advantages and its drawbacks. For example, hiring your own attendant can be a lengthy process, but a service can often supply someone virtually overnight.

I have used both methods. Usually I have one attendant at a time that I've hired on my own. My attendants have typically been female college students. They do a combination of personal care and housework. My husband helps me when the attendant isn't there.

Twice, however, I've had to use an in-home health care service because I needed nearly full-time care while recovering from an injury. Using a service was the only way to get a qualified attendant who could work 40-plus hours per week.

If you want to hire your own attendant, there are at least a couple of ways to get started. First, and probably best, is to use your connections. Take advantage of any contacts you may have at local universities or colleges. College students in health care-related programs often make excellent attendants.

Another option is to advertise in the newspaper. Hiring an attendant directly, on the plus side, allows you hands-on control over whom you'll hire and how much you'll pay.

The advantages of using a service include getting an attendant who is usually trained and experienced and never having to worry about substitutes if an aid is sick.

Also, the services usually pay their share of federal and state taxes, unemployment and workers' compensation for their employees so there is less concern about liability if an attendant is injured on the job.

Drawbacks of a service may include a minimum number of hours that the aid must work -- some won't send an aid for less than four hours per day -- and higher pay. (Remember, you're paying for the services of both the aid and the agency in that case.) Also, there's no guarantee that you'll get along with the person who shows up at your door.