"You People Are Heaven Sent! I Don't Know What I'd Do Without My Red Cross Aides."

Mrs. Medors, Tara Campbell and Precious enjoy their last day together.

It is a typical muggy South Carolina Lowcountry morning. It is already 87 degrees and the heat index makes it feel more like 92. We knock on the door of Mrs. Marie Medors' ground floor apartment and receive a cheerful greeting from Tara Campbell, Red Cross Personal Care Aide (PCA), and from Precious, Mrs. Medors' lively little poodle.

Mrs. Medors greets us with a warm hug and Precious dances around our feet, wanting to be picked up so she can give us doggie kisses. Wonderful aromas are coming from the kitchen, where Tara is preparing lunch for Marie, and talking with her at the same time. Tara arrived at the apartment at 8:00 this morning and has quietly, quickly, and efficiently been doing her assigned tasks.

"Tara does just about everything around here," says Marie. "She gave me a bath and helped me dress this morning" Dressed in a pretty flowered cotton dress with a lace scarf and bright red shoes, she tells us that Tara does light housekeeping, takes out her trash, does her laundry, and occasionally runs errands for her. There is an obvious affection in her voice when she speaks of all the things Tara does for her. "We also laugh quite a bit," she says, with a twinkle in her eye as she watches Tara. "She is just as sweet as she can be."

76 Years Young
Marie Medors is 76 years young and has a host of health problems usually associated with getting older: Type II diabetes, high blood pressure, coronary artery disease, and severe asthma. Her mobility is limited and her main source of exercise is when she takes Precious out three times a day to the dog walking area right across from her apartment.

A widow for about two years now, Marie has been living alone for about ten years. Her beloved husband spent the last eight years of his life in a nursing home. About a year ago, she moved out of the home that she and her husband shared for over thirty years. She finally had to admit that she could no longer keep up with the bigger house and the yard. Although she likes her apartment, she admits to being quite lonely a lot of the time. Most of her friends from her old neighborhood are aging also, and it is difficult for them to come and see her. Marie hasn't made many new friends in her new apartment. "People just don't visit like they used to, " she reflects. "No one has been by to see me since I moved in. Of course, they are a lot younger and they all work. If it wasn't for Tara coming in, I could go for a week or two at a time without seeing anyone." There is no self pity in this statement, Mrs. Medors is merely commenting on a fact of life that many of our senior citizens endure daily.

When asked how she connected the American Red Cross In-Home Care program, she stated that in 1996, when she was about to be released from the hospital, a Red Cross nurse supervisor with the program came to her room and explained that she qualified to receive in home services to enable her to stay in her own home as long as possible. "You people are heaven sent, I don't know what I would do without the Red Cross aides. It is especially important to me now that I am in this apartment and away from my old neighborhood."

A Bittersweet Parting
Today is a bittersweet day, because it is PCA Tara Campbell's last day to serve Mrs. Medors and the other six clients she serves. Tara is leaving the Red Cross program to go on to nursing school. She has been accepted in an accelerated program at Trident Technical College and will receive her RN in two years time. She has been working with the Red Cross program for about three years now. Before that, she worked in nursing homes and other elderly health care settings. "Deciding to leave the Red Cross and go to nursing school was a terribly difficult decision for me,"she says. "I have come to love all the clients I have been blessed to serve. My plans are to graduate from nursing school and spend two years in a hospital setting for experience, and then get back into home care, caring for the elderly. That's where my heart really is. If my schedule permits it, I would still like to see one or two clients while I am in school. Working for the Red Cross really helped me to realize what I wanted to do with my life."

While Tara is finishing up, Joyce Dopson LPN, Nurse Supervisor for the program , is explaining to Mrs.Medors, that she will be having a new personal care aide beginning next week. She asks her to be patient while they both get used to each other and explains that the new person is an experienced aide, having been with the program for several years. Tara says a brief goodbye to Mrs. Medors and hurries out the door, promising to keep in touch. It is a tough moment for all concerned. Tara has become an integral part of Mrs. Medors life in the time she has been serving her.

Back at the office, Joyce Dopson busily works on charting the visits to the clients she has seen this day. It is her responsibility to supervise the 17 PCAs who care for the 70-plus clients that the Red Cross program serves. She checks the PCA reports for any sign of change in a client's condition. When she sees something that concerns her, she calls the client or the PCA to clarify the situation, and if she deems it necessary, schedules an extra visit to makes sure that everything is ok. She makes a quick call to the case manager to discuss her concerns about a client. The chapter is notified about another homebound senior whose condition is deteriorating and whose family seems to be neglecting him.

Joyce has been with the Red Cross program for more than three years. When asked why she stays, given the critical shortage of nurses, and the fact that she could almost certainly be making more money elsewhere in a hospital setting or private nursing home, Joyce states that "the personal contact with our clients and the caring attitude of all our personal care aides are what keep me here. I enjoy working for the Red Cross and working with the elderly…that is worth more to me than the money I could be making elsewhere."

For more than 20 years, the Senior Advocacy department of the American Red Cross Carolina Lowcountry Chapter, has been providing In-Home Care, Respite Services, and Home Delivered Meals to homebound seniors in the Charleston S.C. area. The mission of the program is to keep homebound elderly living in their homes as long as possible and to allow them to live with dignity and respect. Under the auspices of the Older American Act, created in 1965, by the federal government, states are required to provide services to make it easier for the elderly to remain in their homes and not have to go into long term care facilities.

Partnerships
The monies to pay for the Senior Advocacy program come mainly from federal and state sources, with some funding from the local United Way. The Senior Advocacy Department has been designated by the local Area on Aging to provide these In-Home services. The Personal Care program is not medical care. The program works in partnership with other programs, that provide medical care, case management and oversight to allow the individual to remain in the home.

Some of the services provided are:

• Personal care such as bathing, dressing, shaving, changing an incontinent client, assisting with prescribed exercise, assisting with mobility
• Assistance with following treatment prescribed by a physician
• Emotional support and encouragement
• Assistance with errands
• Light Housekeeping
• Meal Preparation

Jacquelin Richardson, Homecare Supervisor, has been with the Red Cross program since 1987. She maintains the schedules for the PCAs, keeps up with their hours, and does the billing for the confusing array of programs. She is also a cheerful source of encouragement to the PCAs when they call about a problem.

She is concerned about the decline in the number of clients served by the program. "In 1996, we employed 25 PCAs and served about 90 clients. Now we have 17 PCAs and serve 71 clients." In the past year, the Senior Advocacy program has received over 230 referrals for service in Charleston County that it has been unable to fill. Jacqulin says that the program has difficulty hiring and keeping qualified PCAs because they are going elsewhere to get more money. The for-profit home health agencies can afford to provide salaries and benefits that cannot be matched at this time by the Red Cross. "But we are working on it," says Ms. Richardson. "We hope someday to be competitive."

Lack of competitive salaries and benefits, while disturbing, isn't a barrier to hiring for all the PCAs, however. Most of the 17 ladies have been on the job for several years. The employee with the longest term of employment has been with the program for fifteen years. Twelve others have been there for three years or more. The newest member of the team has just been hired to replace Tara Campbell.

What is disturbing, however, is that sometimes, client care is interrupted because there are no PCAs to substitute if one is sick or on vacation. "Our ladies are working at capacity now. The In-Home Care program is staffed by dedicated women who are committed to their clients, but there is no room for much flexibility" states Ms. Richardson.

Penny Todd, the Senior Advocacy Director, has been with the program for about two months, and is impressed with the professionalism of the staff and the aides. "Each time I talk with a client about the services we provide, the person always compliments the aide and the staff. These folks are so grateful to the Red Cross for sending people in to help them out. In most cases, the care provided by the aide makes the difference on whether or not the elderly homebound individual can stay in his or her own home. I am new to the aging network and the American Red Cross. This program has heart as well as being professional. I am proud to be a part of it."

For more information about the Carolina Lowcountry Chapter, visit their Web site.

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