Sunday, Sep. 28, 2008

Need for caregivers is exceeding supply

Priscilla Aguirre knelt down to rouse Isabell Bravaro, 87, who was dozing off in her chair. Pestered, Bravaro turned her face toward Aguirre and darted out her tongue. Aguirre flinched, but continued to coax Bravaro out of bed.

It's all part of being an in-home caregiver.

In-home health care is one of the fastest- growing jobs in the United States. Demand for compassionate caregivers like Aguirre is on the rise, but a capable supply of such workers isn't keeping up.

If working in difficult situations with difficult people doesn't turn off potential workers, the low wages and poor benefits do, in-home care workers' unions and recipients say.

"It's hard because when you find someone who's really good, they move on to another job," said Katherine Caldwell, 54, of Oakdale.

Finding the right fit can be tough. Judy Melton, 78, of Turlock went through 10 in-home care workers in seven years before finding someone who made her feel comfortable.

"If they weren't crazy, they made me think I was crazy. I don't think it's crazy to want someone to do their job, keep their hands off of my medication and jewelry, and not bring their emotions in here," Melton said.

"I'd heard stories of people ripping off old ladies, so I was ready for that. But I didn't expect the saps," she said. "I don't feel sorry for myself, and I don't want anyone else feeling sorry for me, either."

Corie Moyers, service director at Arcadia Health Care in Modesto, is adept at weeding out in-home care applicants who don't belong in the field, but matching in-home care workers with clients is tough, she said.

"The bottom line is: It's up to the client. I interview people and do all I can to have a successful personality match, but I'm not a mind reader," she said.

Sometimes matches don't work because the in-home care provider simply shouldn't have a job in which he or she is responsible for cooking, cleaning, entertaining and ensuring clients take their medication, said Sharon Simmons, who owns Compassionate Care in Modesto.

"I'm learning to read people to protect our clients and protect ourselves, too. You have to be witty. There are some really smart ones that get through, but in time they show their true selves," said Simmons of the search for top-quality in-home caregivers.

"In this business, you have to be compassionate," she said. "You can train a person to do a job, but you can't train people to have compassion. If I don't see that in them, they're out."

Caldwell has been bedridden for six years with health issues that stem from injuries suffered when she fell off of her horse during an endurance ride in a remote mountainous area on the California-Oregon border.

"Since then, I've had the most bizarre assortment of people come through my home: drug addicts, thieves, women with dangerous boyfriends," she said.

Fed up with the situation, Caldwell's daughter, Amy Lowe, finally quit her trucking job, which paid about $1,000 a week, to be her mother's full-time caregiver. Lowe, 24, now makes $358 a week, which is paid through In-Home Support Services.

Few options for low-income recipients

Most families have two options when it comes to in-home care. Low-income recipients can find in-home care workers through the county. Higher-income recipients, who pay out of pocket or with health insurance, generally go to private agencies.

Now that her daughter cares for her, Caldwell understands the irony of a situation in which someone provides constant care, makes about a dollar an hour above minimum wage and doesn't receive health benefits.