by Roy Herndon Smith
Frail elderly people and those who care for them cry out for affordable home care. Because of their poverty, often the only way to pay for sufficient home care is to get Medicaid. But even those who can privately pay for home care or who get it through Medicaid often still suffer from isolation and devaluation. Sometimes, the home care worker is a frail elderly person’s only regular social contact.
Here is a proposal for community organizing with the frail elderly, their family members and friends, and their community. In this proposal, I use a Naturally Occurring Retirement Community (NORC) as an example of a community. The social work staff of the NORC would carry out the initial steps of the plan.
1. Identify and hold a meeting with those residents of the NORC who are concerned about the need for home care. Be sure that this meeting includes at least one frail elderly person and at least one person who is currently caring for a frail elderly person, as well as others who make have more time to do community work. Introduce the following plan to them. Invite them to question and modify the plan. Ask them if they would be willing to take oversight responsibility for implementing the plan.
2. Work with this group to set up weekly community gatherings that focus on the abilities of those who are frail and those who are helping them. Plan for the gatherings to be celebratory and social events, as well as times people can meet and trade abilities and resources. Invite all community members to participate in the gatherings. As much as possible, include the frail in the events.
3. Use the gatherings to disseminate information and recruit people with skills to do needed tasks. For instance, perhaps a homebound retired social worker can become a resident expert on Medicaid and pooled income trusts and can help people fill out these documents. Perhaps a retired lawyer or legal aide can help people with Power of Attorneys, Health Care Proxies, and Living Wills. Provide access fot these community workers to the information and resources they need to do the tasks. For instance, provide educational workshops on Medicaid and pooled income trusts.
4. Map the NORC. Identify people who might have time and abilities related to personal home care, housekeeping, escort, shopping, escort and companionship. Also ask what their needs are. Identify the frail and homebound residents and their abilities, interests and needs. Where possible, facilitate links between the two groups.
5. Identify those in and around the NORC who need paid home care. Identify those in and around the NORC who might have the time and abilities to be home care aides and who need or want a job. Contract with a home care agency to train and employ those who are able and willing to become aides. As much as possible, have these resident aides be the ones for the resident frail people. Submit Medicaid applications through the agency that trains and employs the resident aides.
6. Set up congregate home care where possible. Bring two or three frail people together and have one aide provide for their care.
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