The Resource Newsletter - 2009 Edition
Massachusetts Rehabilitation Commission Home Care Assistance Program

Contents:
Communication is the key theme!
MRC-HCAP Staff List
What's New in Home Care?
Vendor Showcase: SMILE
Consumer Pages: Consumers' suggestions and opinions about communicating with homemakers and providers
Community Resources:
Response Link
Life Center
My Life, My Health
Vendor Recipe

Director's Notes
Submitted by Betty Maher, MRC-HCAP Director

We hope the information in this issue of The Resource will be helpful to you. Each issue of this newsletter is planned out during our Advisory Committee meetings, which includes a representation of HCAP Staff, Consumers and Providers. It is during the discussions around program needs and program development that the theme for each newsletter is agreed upon. COMMUNICATION has emerged as a key theme for this year as the staff at HCAP have been busy with developing and reviewing contracts with providers, implementing provider training sessions, and utilizing a new database system for collecting essential information regarding spending, services, and provider performance. How we speak to each other, what information we wish to convey, how we remain open to hearing another's perspective all have a direct impact on how services are provided, and all of us have a responsibility to be effective communicators.

In this newsletter, you will find some tips from consumers on how to make the best of the relationship with homemakers, and you will hear from the providers on some of the challenges that impact their ability to recruit and maintain a quality workforce. Anthony Robbins, a motivational speaker, says: "To effectively communicate, we must realize that we are all different in the way we perceive the world and use this understanding as a guide to our communication with others". Remember, communication is equal parts speaking and listening. We must learn about others' perceptions of a situation in order to fully communicate the information we wish them to know. For consumers, this means taking the time to understand what the homemaker knows or thinks you need, or what challenges they may be facing in performing their job.

For providers, it means learning about the consumers' specific situation, expectations, abilities and needs. For staff in HCAP, it means learning the needs, strengths and challenges faced by our consumers and providers and helping them to reach a common understanding. So, whether you are a provider or a consumer, as you approach each new situation, I encourage you to stop and think about your own communication: are you making assumptions about another person, or have you taken the time to learn about others' perspectives? I am sure you'll find the investment of time up front to learn where the other person is coming from will reap great rewards in the future as you work to effectively resolve any problems in service delivery that may arise.

In the Home Care Assistance Program, we work hard on a daily basis to be effective communicators and to respect the opinions and perspectives of all parties. As always, I invite interested consumers and providers to join our Advisory Committee, which meets in Boston on a quarterly basis. Since I have heard from many consumers saying that they would have too difficult a time getting to Boston, I am considering holding the meetings in other parts of the state. If you are interested in participating, I am interested in hearing from you. Please give me a call at (617)204-3631 or email me at: betty.maher@state.ma.us.

I hope you enjoy this newsletter and find the information and resources helpful.

HCAP Staff

MANAGEMENT
Betty Maher, Director
Angela Cipriano, Supervisor
Felix Jordan, Supervisor

SUPPORT STAFF
Christine Rinaldi, Administrative Assistant
Bonny Taforo, Clerk
Lilly Lau, Accountant
Edward Loring, Accountant

INTAKE
Call: 1800-223-2559

CASE MANAGERS
April Anderson, South Worcester County, Worcester A-G and surrounding towns of Middlesex and Norfolk Counties
Duncan Arden, Essex County and surrounding towns of Middlesex County
Katherine Chesebro, Bristol County and surrounding towns of Norfolk County
Eloise Cruz, Boston I-M and surrounding towns of Middlesex and Norfolk County
Maria King-Bynoe, Boston N-Z and surrounding towns of Suffolk and Middlesex Counties
Paulina Mauras, Southwestern MA
Megan McNally, Boston A-H, Brookline, and surrounding towns of Norfolk County
Liz Morin, Northwestern MA and surrounding towns of Middlesex County
Chris O'Brien, Worcester H-Z, Greater Worcester and MetroWest
Debra Visocchi, Middlesex County
Jodi Watson, Plymouth County, Cape and the Islands, and surrounding towns of Bristol County



What's New with the HCAP?
Submitted by June Hailer, Consumer

The Home Care Advisory Committee is made up of staff from MRC's Home Care Assistance Program, provider representatives and consumers of the program. This committee has been busy, in the last year, revising the RFR or Request for Response. The RFR is a document Home Care Agencies have to complete and sign in order for them to contract with the Massachusetts Rehabilitation Commission to provide said services. At a time when resources may be limited, the RFR exists to clearly outline the responsibilities of the providers and insure the needs of the consumers, under the parameters of the program, are being addressed.

In many areas of the state, there are Home Care Agencies that are able to continue to contract with the MRC year after year and for this the Home Care Assistance Program is very grateful. Yet, in other areas of the Commonwealth this is not possible and searches are done for potential new providers. In some instances, though, the above-mentioned providers cannot be found and the only answer is to have consumers find their own Home Care Assistants (HCA's). We are now looking into developing an RFR for the 60 to 80 HCA's statewide.

The Home Care Advisory Committee has highlighted "Health and Wellness" as a related topic of interest. Referrals are made where needed and we are working toward the goal of having consumers (who wish to) share their information on their health care successes, even when it comes to smoking cessation.

Finally, MRC's Home Care Assistance Program has 1 new intern, Kelly Callahan from Wheelock College and 1 new staff: Megan McNally is a new Case Manager with an MSW from Wheelock. She formerly interned here, and began working as a Case Manager in May '08. Megan manages the Boston ( A-H) caseload and the towns of Newton, Brookline and surrounding towns of Norfolk County.

Vendor Showcase: SMILE, Inc.
(Southeastern MA Independent Living Enterprise, Inc.)
Submitted by Laurendy Moore, Vice President

Southeastern Massachusetts Independent Living Enterprise, Inc. came into being as a natural progression of my desire to care for children, the elderly and adults with disabilities. I began caring when I was quite young in Africa. I used to take care of other people's children at my house, feeding them, fixing their hair and dressing them. My parents did not always like that, but I managed to convince them.
I grew up and had my own children but I continued to take care of others. I worked various jobs in human services and eventually trained as a certified nurse's aide. After years of working as an aide, I dreamed of recruiting and training others to provide care. I met a man who practically dreamed the same dream but who liked doing the administrative duties of the dream. We decided to put a smile on all the faces we met……!
SMILE recognizes the need for professional and caring people to care for loved ones. We recruit from local colleges and career centers, and from personal referrals in Bristol County and surrounding areas. We run background and reference checks on all our professionals prior to matching them with our consumers. Supervision is provided by our Registered Nurse on a regular basis.
SMILE works with Bristol Elder Services, Massachusetts Rehabilitation Commission, Family Service Association and private pay clients. We provide homemaking, evaluations, personal care, certified nurse attendants, residential counselors, companions and respite.

SMILE- Southeastern Massachusetts Independent Living Enterprise, Inc
88 Sandalwood Drive, P.O. Box 3160, Attleboro, MA 02703
Phone: 508-851-0095 ; Fax: 508-455-0684
( * SMILE is a new provider with HCAP. Their contract began July'08)

Getting Along with Different People
Submitted by Walter King, Consumer

Homemakers are people too. I was reminded of this fact by what happened to me in 2008. When the year began, I had one homemaker I had known for the better half of the last six years. It would seem safe to predict I could count on seeing her for the whole year. But I was wrong.

She told me not long after the year began that she was going to have to leave for personal reasons. I was devastated. I had gotten to know her well and depended on her. She was a great help for getting housework done. We had a great relationship which developed over time. Now it was time to learn to work with new people again. My homemaker and I had a great deal in common. However, when I got to know other folks, I figured this would be just as true: we would have a great deal in common but it would be from a different list of things.

When a new homemaker came to my apartment, I took a positive approach to working with her and that was to try to get to know her as a person. As long as we got along, were flexible and accomplished work, then I was sure there would be no problems. Sadly, the first homemaker that came over just didn't work out. We had no "chemistry" between us and we did not get anything accomplished.

I contacted my agency to request a new homemaker and I did much better with the next homemaker assigned to me. Now, she is different from my first homemaker as night and day, but so what? As an individual, my homemaker has many wonderful qualities and I am very happy I have her come to help me in my home!

Communication with Your Homemaker
Submitted by Marcia Tritter, Consumer

Having had the helpful services of many homemakers since I became eligible, there are certain steps I take to make the most of the situation. The goal is a win-win: the homemaker provides services and feels good about that AND you get the help you really want and need.

The first step, of course, is attitude. Be welcoming when the homemaker arrives, after all it's not easy for them to come to a totally unfamiliar setting and within 3-5 hours (per your plan from the MRC) accomplish a lot. Help her find a place to put her things (coat, purse, etc). Then give her a brief tour of the apartment so she has an idea of what she's dealing with. Also, show her the type of things you have and help her start thinking about what she will be doing for you.

After the tour, I explain my priorities: laundry first, so we can leave it while doing other things; cleaning the bathroom to make it sparkly clean; kitchen counter tops and dishes to make the kitchen orderly and clean; and, possibly some dusting in the living room. All floors need to be cleaned by vacuum, broom, and/or mop.

Next, I show her where the cleaning materials are stored; now she has her tools for the job. We then go back to the bedroom and together we sort whites and colored laundry. I also have 2 mesh bags to put delicate items in and/or to identify the items NOT to go into the dryer, but hung to dry.

Then I lead the way downstairs to the basement to show her where the washing machine and dryer are. Getting there, I make sure to point out any steps or pipes on the floor, to avoid tripping and show precisely where all the lights are, and have her put them on and off in my presence. That way, we both know she will have proper lighting and safety. I also am very clear on the type of action (cold-cold) that I like in the washing machine and how much liquid detergent to use.

So she is now set for the laundry, having together gone through the paces. I always ask if there are any questions, which are welcomed.

When we return upstairs I show her where she can hang the items to dry in the red mesh bag, not to be put in the dryer. By this time, we have a bit of a relationship established. During this process, I am very appreciative, thanking her for helping me carry things, etc. Then any other bedroom activities are completed (e.g., changing the sheets, etc). At that point I suggest doing the bathroom next, then the kitchen, and the living room. I continuously ask if she has any questions, do not hesitate to ask.

Now, I am fairly tired, and let her proceed in the bathroom and kitchen. I pop in whenever it seems like a bit of time has passed to check "if everything is going OK."

When it comes to using any tools like the vacuum, I am very clear how to put it together. I also indicate how it should be taken apart as well, and that I want it stored a certain way, to avoid any damage. I make a point of "teaching" a new homemaker my style of folding things, such as laundry. Unfortunately, some homemakers have trouble with this, and it's important for me to be able to accept limitations in certain areas. Since many of the homemakers come from different parts of the world, I understand that folding something from a dryer "just so" is not part of their background nor a priority for them

I never ask for any of my objects to be picked up and dusted; actually I make a point of advising them only to do the open tabletops, etc. in the living room. The communication has a consistent air of appreciation as well as respect for the tasks being done to help me: a simple "thank you" goes a long way.

When they are leaving, after finishing and filling out the necessary paperwork, I help to gather their things so they see I treat them with the dignity and respect they deserve. Then we have a win-win situation.

The next time the same homemaker comes, I ask if they want me to go with them, through the laundry process in the basement, etc. They usually reject the offer, but it doesn't hurt to offer. I always go through the sorting of the laundry with the homemaker, having learned from past experience that I know what needs what, and the homemaker could only guess.

There are many other things that transpire during the session with the homemaker, especially involving any cooking. However, I apply the same principles of respect for the homemaker and appreciation that I'm am getting the help I need and the results are indicative of good communication.



Community Resources: Fall Prevention and Responselink
Submitted by Duncan Arden, MRC-HCAP Case Manager

Injuries in the home account for one third of all injuries experienced in the US and the home is the second most common location for fall injuries. Falls are the leading cause of unintentional deaths in the home, followed by poisoning and fire/burns (Home Safety Council, 2008). Muscoskeletal diseases such as Osteoporosis or Arthritis are a common cause of falls, particularly hip fractures (Netdoctor.co.uk) and are a common diagnosis in many MRC-HCAP consumers, affecting at least 14% of people served. As we grow older and approach middle age (45-60) our bones and joints may become less flexible and lose their strength. The median age range of MRC-HCAP consumers is 50, statistically placing them in the higher risk category for falls.

Quick Tips for Fall Prevention:
Begin a regular exercise program - much exercise is free; Tai Chi and Yoga can improve balance, posture and coordination. Other exercises, such as walking and weight training may improve muscle strength.
Have your physicians review your medications - they can may cause dizziness, tiredness, and a loss of balance.
Have your vision checked - at least once a year.
Make your home safer - remove small throw rugs, install grab bars, improve home lighting. ( Source: CDCP)

Nevertheless, falls can affect anyone of any age. In addition to the above, those with a neurological or visual impairment, such as Cerebral Palsy, Multiple Sclerosis, or Retinopathy may be at risk for falls, as their balance or depth perception may be compromised. Those with heart or respiratory conditions may be at risk. Serious falls can result in extended and expensive periods of hospitalization and rehab, a loss in one's independence such as the ability to drive, a head injury and even death.

A personal emergency response system is also (often referred to as "PERS" or "Lifeline") an excellent resource for MRC consumers of any age whose disability may put them at risk for falling, and who live alone. PERS is a medical alert system in which consumers are provided the choice of a pendant or bracelet that they wear, featuring a button, that when pushed, communicates a signal to a speaker box connected to a call center via the consumer's telephone line. If the person falls and cannot get up, or experiences a life threatening emergency and cannot get to the phone to call 911, one push of the button will send a signal to the customer service center, where a live agent will respond instantly by asking if a consumer needs help. The call center will notify and dispatch emergency contacts, neighbors and emergency services personnel. The PERS button operates within a 100 meter radius of the home and is waterproof so can be worn in the tub. It is free of charge to recipients with MassHealth Standard coverage. For those without MassHealth Standard most companies will waive the installation fee, and charge a monthly fee of approximately $30-40 as part of a service agreement. The speaker box can be programmed to record medication reminders and other important memos. All call centers are open 24 hours a day, 7 days a week. Some people with PERS worry about accidentally hitting the button and causing a false alarm, however, the customer service agent will only send help if the person says they need it. Call center staff are trained to call each consumer once a month to test that the unit is working.

Responselink is a statewide provider of PERS and has technicians who can install the device to virtually all customers within a day of the referral. While there are several PERS providers that accept MassHealth insurance, Responselink stands alone as being the only agency that installs the device without waiting for medical authorization from the consumer's doctor. They realize that consumers have an imminent need for the device and the authorization may take a matter of weeks, and so make it a practice to supply the unit and obtain the authorization later.

For information on how to obtain a PERS unit, consult about costs or to make a referral, call 1866-802-3676 or visit www.responselink.com. For information about other PERS providers, contact your case manager or your doctor.

Community Resources: Life Center, Brockton, MA
Submitted by Chris O'Brien, MRC-HCAP Case Manager

In September 2008, several case managers visited Rae Zuckerman of the Life Center at 54 Haverhill St. in Brockton. It is a social program for people with physical disabilities, where you can meet others, socialize, make friends and have fun. Consumers meet 3 days a week to do arts and crafts, play cards and board games and enjoy lunch together. One day a week they go to a restaurant together and on Mondays they go to bowling. Members pay a yearly fee of $35.00. It is a great place to meet other people and socialize.

While anyone from the State is invited, not everyone can travel that distance. Rae started the program herself 25 years ago and it gradually evolved to a program serving more than one hundred people a year.

We're curious. Are you aware of similar programs in your area or are you looking for a similar program? Please share your thoughts by contacting your MRC-HCAP Case Manager at 1-800-223-2559. Thank you!


My Life, My Health

Is living with your chronic condition preventing you from really living? A chronic disease self-management program is being offered to adults of any age who are living with one or more chronic conditions.

Share what you know. Learn from others who are experiencing similar challenges.
Learn to use tools that will help you:

  • Have fun!
  • Set and meet personal goals
  • Talk to your doctor about your health
  • Make choices about your treatment
  • Handle stress and learn to relax
  • Increase your energy level
  • Identify and try out simple techniques that may improve your quality of life

Groups meet 2 ½ hours a day, once a week for 6 weeks. Meetings can be held at various community settings such as libraries, churches and senior centers in your region. Participation is free of charge, however a weekly commitment to attending the program is expected.

To find out more, please contact your MRC Homecare Case Manager. Additional information about the program is also available at:
http://patienteducation.stanford.edu/programs/

This proven program was developed by the Stanford University Medical Center and is offered to adults of any age by the Massachusetts Department of Public Health and the Massachusetts Rehabilitation Commission.

Vendor Recipe
Submitted by Dana Dufur, Service Coordinator at Premier Home Health, Lenox MA.

Hungarian Goulash

Ingredients:

1 Tbsp oil (vegetable or olive) 16 oz egg noodles
2 ½ lbs hamburger ¼ tsp thyme
1 cup chopped onion 2 bay leaves
1 clove minced garlic 3 ½ c stewed tomatoes
¼ cup flour 1 cup sour cream
1 ½ tbsp paprika A dash of salt & pepper

Directions:

Brown meat in a skillet with oil. Reduce heat, add onion and garlic, cook until onion is tender but not brown. Blend in flour, paprika, thyme, bay leaves, salt and pepper. Add stewed tomatoes. Cover and simmer; stirring occasionally for 1 hour. While simmering, cook noodles according to package. At end of hour, mix sour cream and noodles in meat mixture.

Don't eat meat? Leave out the hamburger for a satisfying vegetarian meal that won't break the bank!


Inspirational Quotes & Communication Tips

  • When people talk: listen completely. Most people never listen.
    - Ernest Hemingway
  • We make a living by what we get, we make a life by what we give.
    -Sir Winston Churchill
  • Good communication is as stimulating as black coffee, and just as hard to sleep after.
    -Anne Morrow Lindbergh
  • I quote others only in order to better express myself.
    - Michel De Montaigne
  • Communication leads to community, that is, to understanding intimacy and mutual valuing.
    - Rollo May
  • Feelings of worth can flourish only in an atmosphere where individual differences are appreciated, mistakes are tolerated, communication is open, and rules are flexible - the kind of atmosphere that is found in a nurturing family.
    - Virginia Satir
  • The more elaborate our means of communication, the less we communicate.
    -Joseph Priestly
  • The most important thing about communication is to hear what is not being said.
    - Peter F. Drucker


The MRC Home Care Assistance Program staff encourage consumers to call with questions or concerns regarding homemaking services.

We're on the web! www.mass.gov/mrc

The Resource Newsletter
Massachusetts Rehabilitation Commission Home Care Assistance Program
27 Wormwood Street, Ste. 600
Boston, MA 02210-1616

Phone/TDD: 617-204-3853
Toll Free: 1-800-223-2559

Deval Patrick
Governor

Timothy Murray
Lieutenant Governor

Dr. JudyAnn Bigby
Secretary

Charles Carr
Commissioner





This information is provided by the Massachusetts Rehabilitation Commission.