Below are the full success and client stories from the Warren County Elderly Services Program (ESP) 2022 Annual Report. These stories illustrate the impact ESP has on older adults and caregivers in Warren County.
New app helps ESP clients get in-home care services, despite national aide shortage
Donna had recently retired from a job with a local nonprofit when a friend encouraged her to reach out to the Elderly Services Program (ESP) for help. She was dealing with balance issues related to diabetes and neuropathy. Through ESP, she was eligible for an emergency response system and home delivered meals. She was also eligible for the program’s homecare assistance service, which includes help with housekeeping, personal care and other household tasks.
However, Donna enrolled in ESP at a difficult time. Because of a national shortage of home care workers, Donna and other clients often wait weeks – or even months – to be matched with an aide from a homecare agency.
Council on Aging (COA), ESP’s administrator, has been working to find solutions to this problem. Over the last decade, COA has held focus groups with homecare aides, piloted wage increases, adjusted requirements for service providers, and tested new service models, all with the goal of providing reliable, quality care.
One area where COA saw success was in providing opportunities for clients to hire their own aides. Called consumer directed care, this care model allows clients to hire someone they know – a friend, neighbor or someone in their social circle – to provide their care. The client acts as the employer and the individual they hire is their employee. ESP pays for services approved in the client’s care plan. While this requires a more hands-on approach for clients, satisfaction levels in the program are high because clients have more control over their care.
But, many ESP clients who could benefit from this model of care do not know anyone they could hire to provide the care they need. These individuals have been left to wait until an aide can be identified through a local service provider.
Enter AddnAide. Council on Aging and its subsidiary, home52, launched AddnAide in July 2022 after four years of development. AddnAide is an app (available online and downloadable through traditional app stores) that helps ESP clients match with people in the community who are available to provide homecare services. It’s an expansion of consumer directed care in that it gives clients with limited social circles an opportunity to find and hire an aide.
That’s how Donna connected with her aide. After enrolling in ESP, Donna’s care manager, Shannon, told her about consumer directed care and AddnAide. Together, Donna and Shannon decided it would be worthwhile to give AddnAide a try.
Donna was one of the first ESP clients to use AddnAide. Her care manager set up her account in AddnAide, including details about her care plan. Donna then completed her profile by adding details about the days and hours she preferred to receive care, as well as the type of help she needed (all within the scope of her ESP care plan). She was particularly interested in finding someone to help her with cleaning and organizing. The combination of neuropathy and poor eyesight often left Donna unsteady on her feet. The thought of bending down to scrub her shower floor really frightened her. “It’s hard for me to do everything I’d like to do on my own,” Donna said.
With her profile complete, AddnAide helped Donna identify aides who matched her service needs. She exchanged messages with a few aides and then connected with her current aide, Lorinda. After they texted and spoke on the phone about her care needs, Donna said she knew Lorinda would be a good fit. The variety of services Lorinda was available to help with was appealing – especially cleaning and organizing.
One of the goals of AddnAide is to expand the pool of individuals available to serve older adults who need in-home care. Targeted marketing has been helping to achieve that goal, attracting people like Lorinda to AddnAide. Based on successful gig economy models used by companies like Uber, AddnAide is ideal for individuals who want flexibility in their work schedule, including stay-at-home parents, retirees, those with other employment and students. It’s also ideal for community-minded individuals who want to give back while supplementing their income.
Lorinda joined AddnAide in August 2022 after seeing an ad on Facebook. She’d been doing gig work since leaving a full-time retail position. AddnAide appealed to her because it’s like gig work, but the financial details, including taxes, are all managed in the app. She even clocks in and out within the app as she comes and goes from clients’ homes.
Lorinda also liked the flexibility AddnAide offered – it was easy to fit into her schedule along with work she was already doing with Instacart and Amazon Flex. “You’re your own boss, set your hours, choose who you want to work for,” Lorinda said. “It’s freedom from the 9 to 5.”
Lorinda provides care for three ESP clients via AddnAide. When choosing who to work for, Lorinda looks at the type of care they need and always meets them before accepting the job. “It’s important for me to have a good relationship with my clients,” she said.
For example, while Lorinda does not want to provide personal care, she is more than willing to help with cleaning, organizing, running errands, prepping meals and cooking, or just providing companionship – all services most ESP clients need.
During their first meeting, Donna and Lorinda walked through the house and discussed Donna’s needs. Lorinda helps Donna with a variety of tasks, including heavy cleaning, changing bed linens and organizing.
“I don’t want to feel like I’m just sitting around not doing anything, because I can do things,” Donna said. “I do my laundry, sweep and take care of the cats.”
But she acknowledges that having Lorinda available means she doesn’t need to take unnecessary risks. “It’s all the little things she does,” Donna said. “It’s nice to have the help.”
For Lorinda’s part, she enjoys working with older adults and making connections. She recognizes that her clients don’t have much support in their lives. “Some weeks, it’s just me and the meals on wheels driver my clients see,” she said, adding, “This job feeds my soul, my spirit. Not just my wallet.”
Donna, Lorinda and other users have shared feedback about their experience with AddnAide. For example, based on suggestions from clients and aides, COA and home52 made changes to the required background check process and began offering in-home support to help ESP clients get started in the app. Educational materials have also been added and improved over time.
Donna was a caregiver for her own mother before dementia made it necessary to move her into a care facility. She understands how hard it can be to take care of someone else, and she also knows many older adults have no one to take care of them.
“There is such a need,” Donna said. “Not everyone has family – or family who wants to help.”
Donna would encourage other ESP clients who are waiting for in-home help to try AddnAide. “It’s not as intimidating as I thought it would be,” she said of using AddnAide and hiring her own aide. “I trust Lorinda so much. It’s very comforting to know you have someone who cares. And I’m speaking from a position of not having family to help. Give it a try.”
Creative solutions help meet common needs of older adults
Most older adults want to remain independent in their homes for as long as possible. But for one reason or another, many older adults are reluctant to accept help or support that could prolong their independence.
Council on Aging, ESP’s administrator, works with the Warren County Elderly Services Advisory Council to identify and implement creative ways to help ESP clients get the support they need to remain independent in their homes.
Because of health and safety concerns, many older adults enrolled in ESP need hands on assistance with everyday tasks such as cleaning and laundry. But in other cases, if given the proper tools, ESP clients can safely manage these tasks on their own, increasing their sense of independence.
For example, COA recently expanded the equipment available through ESP’s Durable Medical Equipment service to include adaptive cleaning supplies such as lightweight cordless mops and vacuums, and laundry carts.
“In the same way grab bars or a ramp can help an older adult be more independent and prevent an accident or injury at home, a lightweight vacuum or a laundry cart can also be a safe and cost-effective way to help them experience a greater sense of independence,” said Ken Wilson, COA’s vice president of program operations.
For clients who are physically able and prefer to do light housekeeping and laundry on their own, the equipment helps them meet a daily need, while also gaining a sense of independence. The adaptive cleaning supplies were first made available to ESP clients in May, with 94 clients receiving supplies through the end of the year.
Laundry service lightens the load for client during recovery from illness
When suddenly sidelined by new physical limitations due to illness or injury, many older adults find themselves in unfamiliar territory, requiring help to take care of themselves and their households, even if only during their recovery period.
Kent, 75, found himself in just this situation after becoming critically ill from sepsis due to a tumor obstructing his bowel. Taken to the hospital by ambulance, he underwent surgery, which resulted in a week on a ventilator and an ileostomy – an alternative way for the digestive system to eliminate waste into an external bag. He also suffered multiple strokes.
After 43 days of treatment and rehabilitation, Kent was able to return home to fully recover and began to receive temporary supportive services through Council on Aging’s (COA) FastTrack Home program, which is available in Warren County via the Elderly Services Program (ESP).
“We knew he did a ton of stuff around the house and most of the cooking,” Kent’s daughter Colleen said. She and her two siblings help their father and his wife as much as they can, but none of them live close by, and they have jobs and families to tend to as well. “Trying to juggle all that has been quite challenging,” Colleen said.
Through FastTrack Home Kent receives home-delivered meals and limited housekeeping assistance and grab bars were installed in his bathroom upon his arrival home from the hospital. But perhaps most helpful of all is the laundry service he receives.
The tumor that resulted in Kent’s surgery was from cancer he has lived with since 2013. The cancer caused chronic digestive issues, and with the ileostomy, Kent was dealing with ongoing incontinence. “This causes a ton of laundry,” Colleen said. “The sheets have to be changed almost daily.”
Traditionally, assistance with laundry and other housekeeping through ESP and FastTrack Home is provided by home health aides employed through home health agencies in Council on Aging’s provider network. Due to a critical aide shortage in COA’s service area and the nation, COA clients are experiencing disruptions in these services. Some clients must wait weeks or even months for an aide.
To get around this, COA has sought innovative ways to help its clients get the assistance they need. Clients who are physically unable to do their laundry may now choose to use a laundry service provider, rather than waiting for an aide to become available. In Kent’s case, there were only very limited aide hours available to him, so his COA care manager offered the laundry service as an option to enable the aide to focus on other housekeeping tasks.
This new laundry service model is available to ESP and FastTrack Home clients. The service picks up dirty laundry and linens and returns them clean and folded. Clients have a range of detergents to choose from and can receive text and email reminders about their service. So far, 11 clients have opted to try the service, and their feedback has been overwhelmingly positive.
“Having the laundry service is amazing,” said Colleen. “They come every Monday and it sits on the porch. It disappears and comes back clean and folded. It’s been extremely helpful, especially when we’re so overwhelmed.”