Struggling to stay in their homes

Baker City Herald July 23, 2010 03:16 am

http://www.bakercityherald.com/content/view/81120/31/

Struggling to stay in their homes

George and Shirley Dyke of Halfway depend on a service that Oregon officials aren’t sure the state will be able to afford beyond this winter.

It’s called Oregon Project Independence (OPI).

OPI has allowed elderly people to continue living in their homes by supplying them with an in-home caregiver who helps with daily activities such as cooking, cleaning and making medical appointments.

George, 81, has a bad hip, rheumatoid arthritis and has frequent hospital check-ups because of side-effects brought on by chemotherapy treatment during a battle with prostate cancer.

His wife Shirley, 80, has Alzheimer’s disease, and George has been her sole caretaker since she was diagnosed more than 10 years ago.

“(OPI) has been a tremendous help, a real blessing,” George said.

The program, which started in 1974, was slated to end Aug. 1, a victim of the state’s $577 million budget deficit.

OPI helps 2,400 clients, including 16 in Baker, Union and Wallowa counties.

But after the state had sent letters to clients and caregivers earlier this month, notifying them that OPI was being cut, legislative leaders scrambled to spare the relatively inexpensive program.

On Thursday the Legislature’s Emergency Board voted to restore $15.4 million to the Department of Human Services, which oversees Project Independence

DHS, responding to Gov. Ted Kulongoski’s order earlier this year to trim 9 percent from state agency budgets, proposed cuts totaling $158 million.

The casualties included OPI, which costs about $3.8 million per year.

The Emergency Board’s vote, combined with $1.7 million in savings DHS officials announced, will allow OPI and some other programs to continue at 85 percent of normal operation until at least the end of February 2011.

“We can’t do it all and we are still not out of it. We’re moving forward carefully,” Peter Courtney, Senate President and co-chairman of the Emergency Board, said in a Monday press release.

Betty Landis, DHS’ home care coordinator for Baker, Union and Wallowa counties, said OPI has helped hundreds of people find the least restrictive route to remaining independent and in their own home.

“It was really groundbreaking in its day,” she said of the 36-year-old program.

Landis said the enrollment process is relatively simple. Those wishing to be enrolled are visited in their home by a specialist and if the person meets the criteria, he or she is immediately assigned a caregiver based on individual needs.

When reviewing applicants, the specialist look for:

• Fall risk;

• Cognitive ability;

• Mobility; and

• Income.

“It takes about an hour and a half,” Landis said.

The Dykes’ in-home caregiver, Rose Darting, also of Halfway, comes in twice a day. She cooks meals for the couple, and when George has to go to a doctor’s appointment either in Boise or Baker City, Darting stays with Shirley.

Shirley requires some help getting in and out of bed.

Darting also helps with daily chores such as vacuuming and washing dishes.

“I can do it, but it’s very, very painful,” George said. “I have that pain in my hip, legs and feet.”

The Dykes have three daughters. All live at least 125 miles away: one in Clarkston, Wash., one in Springfield and one in Junction City.

“Kids grow up. There is not much industry here and they go to where they can find a job,” George said.

He also had a son who died five years ago from cancer. His daughter-in-law has since remarried but she does still help around the house. Her husband has even helped with cleaning the flue in the Dykes’ fireplace.

“I’m a little hesitant to ask for help. I hate to be a nuisance,” George said.

He said that since receiving a notice from the state about the OPI cuts, he has been searching his options. None sounded as comfortable as being in his own home.

“I’d like to stay here. We both like it here, it’s a great community. If you ask for help, someone will come do it for you. But I always get into trouble because I don’t ask” he said. “I dread the day I have to move away. I love it here.”

George retired from the Forest Service in 1990 after a 30-year career. He doubts his pension will be enough to pay for a caregiver if OPI ends.

Darting said she’s irritated about the state even considering ending the program.

She’s skeptical that the cut would save the state’s taxpayers money in the long run.

“If they take away this program, these people are going to end up in a nursing home which the state pays for anyway,” she said.

“I thought we were supposed to get better healthcare,” she said, referring to the recently passed federal healthcare reform law.

The monthly cost of most nursing homes is between $3,000 and $6,000 per person. The cost of OPI, according to Landis, is $255 per household per month.

Darting has three elderly clients she cares for. George and Shirley count as one since they both live in the same home. The two others clients are not enrolled in OPI and pay her out of their own pockets.

Because of the nature of her work, she said she charges what her clients can afford, in some cases as little as $8 an hour, below the state’s minimum wage of $8.40. One of her clients has offered to let her live with her in exchange for services.

In addition to providing in-home care, Darting has a full time job at Halfway Mercantile.

She said OPI pays her for 25 hours a month at $10.25 per hour. However, she often works more than that and does not charge her clients for the extra time.

According to Marilyn Spicer of Ideal Partners, a private care specialist in Baker City, the cost of private in-home care generally ranges between $17.50 and $25 per hour depending on where the client lives and how much care is needed.

George said if the program is cut, he doesn’t know what his next step would be.

“I’d be in worse shape if I hadn’t worked for the government,” he said. “There are others who don’t have other options.”

In Wallowa, Merel Hawkins, 73, has an in-home caregiver whose primary role is to check on him and make sure he’s all right.

“I don’t go very far from the house most days, I’m not totally immobile,” he said. “I can go out to the barn with the walker or crutches to check on the irrigation.”

He said OPI has been instrumental in securing his independence.

“To me, I’m getting cut off. (OPI) made it so I could live alone, it’s a heck of a deal to keep folks out of nursing homes,” he said.

Because of several back injuries, Hawkins has little feeling in his legs and he depends on the walker.

He doesn’t know what he’ll do if his in-home care ends.

“I’ll keep going somewhere, I just haven’t figured out where yet,” he said. “I’m not going to leave my home yet. Those gosh-dang in-home services cost so much, I just don’t have the money.”

Hawkins enlisted into the U.S. Army in 1959. He said he is trying to get low-income veterans assistance but he’s not sure he’ll qualify.

He has two daughters, but only one lives nearby and she’s often out of town for three or four days in a row.

Hawkins said neither of his daughters can afford expensive private care.

“I’ll get by better than most of these people. A lot of these people around here they are taking off that don’t have the back-up or extra finances, well I have no idea what they’re gonna do,” he said.

Like Darting, Hawkins wonders how cutting OPI will actually save the state money.

“With cutting this off, people gotta go on state welfare and into nursing homes and hospitals. It’s gonna cost the taxpayers more,” he said.

Bette Stewart, 89, lives in La Grande. She is blind, she can’t walk on her own because of an artificial left hip that was damaged during physical therapy, both of her arms have substantial damage and she is on oxygen.

She said that without her in-home caregiver, Jessica Dockweiler of La Grande, she doesn’t know where she will go.

“(Dockweiler) does all my shopping, laundry, she writes my checks and reads my mail,” she said. “I can sign my name but everything else is illegible.”

Stewart was notified on June 1 that her care would end on July 31. Now, though, it appears she has until at least February.

“We’re at a loss figuring out what is going on,” she said.

Dockweiler said, “She can still dress herself and get to the bathroom, but I read her mail, make sure she gets to the hospital and get her medication for her.”

She said Stewart can’t afford private, unsubsidized in-home care.

Stewart said her daughter, who lives in Las Vegas, can’t pay for private care that’s at the same level OPI provides.

Dockweiler said she’s concerned with not only Stewart’s future but all elderly people in Oregon who may lose their caregivers if more money does not become available in February.

“I don’t know what these people are going to do. I guess they want to let them die,” she said.

The loss of OPI will not only affect elderly clients, the in-home caregivers also will be looking at either finding new jobs or having their hours greatly reduced.

“This is going to affect the care givers wages,” says Margaret Davidson, the executive director of Community Connection in Baker, Union and Wallowa counties.

All of the care givers had been notified that the state wouldn’t pay them after July 31.

Official notice that OPI would be cut came on July 6. Believing the move was imminent; Davidson said all clients had been notified in person or over the phone that the program was ending.

After the Legislature acted to save OPI,  Landis began making calls to everyone who had been notified of the cuts.

Landis said she’s not sure, however, whether all local OPI clients will remain in the program, or whether caregivers will have their compensated hours reduced.

She said she will send official letters to clients when she’s certain of what is being cut and what isn’t.

“It’s ridiculous it didn’t come to this point earlier,” she said amid the frustration of having to renotify both clients and care givers that the program will continue at least until February.