PER­SONAL HEALTH CARE FOR EL­DERLY

Right at Home helps clients re­main in­de­pen­dent

San Antonio Express-News (Sunday) - - Business - By Lynn Bre­zosky STAFF WRITER

It started out as a sim­ple frac­ture, a cracked bone at the knee joint. The screws that her doc­tor put in held for a while, but then one day Jamie Sny­der’s leg bowed out. Her sub­se­quent knee re­place­ment was a suc­cess — un­til an in­fec­tion set in.

“I no­ticed a lit­tle pim­ple on my leg that turned into a big boil,” said Sny­der, 66, a for­mer Air Force nurse. “And we don’t know where it came from, how it got there.”

A visit­ing wound care nurse keeps an eye on the in­fec­tion, and a phys­i­cal ther­a­pist helps Sny­der to­ward her goal of walk­ing and driv­ing again. And three days a week, home health aide Bar­bara Stephen helps Sny­der with more mun­dane tasks: driv­ing her to doc­tor ap­point­ments and the gro­cery store, chang­ing her bed­ding, cook­ing meals, and check­ing on her beloved cat and dog.

Stephen’s reg­u­lar vis­its al­low Sny­der to live in­de­pen­dently in her North­east Side home, rather than at the re­ha­bil­i­ta­tion fa­cil­ity where she spent time af­ter her last trip to the hos­pi­tal. It’s a form of sup­port that more and more Amer­i­cans are com­ing to de­pend on as the pop­u­la­tion ages. Sny­der’s sis­ter lives across the street but can help only so much be­cause she has a full­time job of her own.

“It took a lot off of me to be able to come home and make sure my pets were OK, more than any­thing else,” Sny­der

“You have to care for oth­ers. You can’t just look at it as, ‘I’m just get­ting a pay­check.’ ”

Sloane Wen­dell, owner of Right at Home, a home health care fran­chise

said the other day as her small dog, Ch­ester, leaped onto her bed. “Plus, to tell you the truth, the longer I stayed where I was, the more I was more afraid of get­ting re-in­fected.”

Sny­der is a client of Right at Home, a home health care agency that works through lo­cal fran­chises to con­nect care­givers with clients need­ing com­pan­ion­ship, help with ev­ery­day chores or as­sis­tance cop­ing with se­ri­ous con­di­tions such as ad­vanced Parkin­son’s dis­ease or Alzheimer’s.

Right at Home, founded by a for­mer hos­pi­tal ad­min­is­tra­tor and based in Omaha, Neb., di­rectly em­ploys care­givers and matches them to clients. It now has more than 500 fran­chises across the U.S. and in­ter­na­tion­ally.

Sloane Wen­dell took over the San An­to­nio fran­chise about a year ago, par­lay­ing decades in cor­po­rate man­age­ment and 15 years of ex­pe­ri­ence car­ing for her aging grand­par­ents into a piece of a $103 bil­lion in­dus­try that’s ex­pected to grow to nearly $173 bil­lion by 2026. Her ros­ter of em­ploy­ees has ex­panded to 55, a 30 per­cent in­crease.

Wen­dell ex­pects the hol­i­day sea­son to be a busy time.

“A lot of peo­ple come home and see their mom and dad, aunts and un­cles, who maybe they haven’t seen since last Thanks­giv­ing, and they’ve re­gressed a lot,” she said. “And they’re like, ‘Oh my gosh, we need to get them some help.’”

Home health care is one of the na­tion’s fastest grow­ing oc­cu­pa­tions. Ac­cord­ing to the Home Care As­so­ci­a­tion of Amer­ica, it em­ploys 1.8 mil­lion peo­ple and is ex­pected to grow 28 per­cent through 2024, com­pared to 6.5 per­cent for all other oc­cu­pa­tions.

Sixty mil­lion Amer­i­cans are ex­pected to en­ter the 65-and-older bracket by 2020. By 2050, 19 mil­lion Amer­i­cans will be over 85.

Seventy per­cent of those 65 and older will need as­sis­tance at some point, and 40 per­cent will need help daily, ac­cord­ing to the Home Care As­so­ci­a­tion, which rep­re­sents providers of non­med­i­cal, pri­vate-duty home care.

Nine out of 10 el­derly Amer­i­cans say they want to live at home as long as pos­si­ble. But the pool of adult chil­dren, the tra­di­tional base of home care, is shrink­ing.

“There’s go­ing to be a whole lot more older peo­ple and a lot fewer younger peo­ple,” said Mike Flair, vice pres­i­dent of fran­chise busi­ness so­lu­tions for Right at Home. “It’s kind of stag­ger­ing to think what’s driv­ing this, and it comes down to peo­ple just had fewer kids and now it’s catch­ing up with us.

Texas has nearly 6,000 li­censed home care agen­cies, said Becky Camp­bell, di­rec­tor of mem­ber­ship re­cruit­ment for the Texas As­so­ci­a­tion for Home Care & Hospice, a trade or­ga­ni­za­tion.

De­spite the grow­ing de­mand for ser­vice, the pay is low. The me­dian wage for home health and per­sonal care aides in 2017 was $11.12 an hour, or $23,130 per year, ac­cord­ing to the fed­eral Bu­reau of La­bor Sta­tis­tics. By com­par­i­son, the me­dian an­nual salary in the U.S. was $44,564.

Non­med­i­cal care such as that pro­vided by Right at Home is usu­ally not cov­ered by in­sur­ance. It’s a “pri­vate-duty” ser­vice, pro­vided out­side the gov­ern­ment safety net, and clients or their fam­i­lies shoul­der the cost. That puts a damper on wages.

Agen­cies do of­fer work­ers’ com­pen­sa­tion in­sur­ance and deduct pay­roll taxes from care­givers’ wages. They also carry in­sur­ance to pro­tect clients against li­a­bil­ity in case a care­giver is in­jured on the job.

Rates run $20 to $30 an hour, mean­ing that a sin­gle three-hour ap­point­ment can set a fam­ily back as much as $90.

“In­sur­ance doesn’t pay for this,” Flair said. “There’s some gov­ern­ment as­sis­tance if you’re a vet­eran, but typ­i­cally this is what we call pri­vate pay.”

“We have some clients that we’re with lit­er­ally seven days a week, so it can add up for a fam­ily to be able to af­ford to take care of Mom, to keep her in­de­pen­dent in her home, es­pe­cially when those chil­dren have moved away,” he said.

The in­dus­try is try­ing to im­prove its im­age. Right at Home de­clared Nov. 12 to 18 “Pro­fes­sional Care­givers Week” and says it wants com­peti­tors to join a na­tional con­ver­sa­tion “to cel­e­brate our per­sonal care­givers.”

“Peo­ple typ­i­cally think they’re not ed­u­cated, they’re not trained, they’re sort of clas­si­fied as maybe a min­i­mum-wage-type po­si­tion,” Flair said. “That’s un­for­tu­nately a stereo­type we’re try­ing to break.”

“This is more than just a nanny to a granny,” he said, not­ing that care­givers in­cluded re­tired teach­ers and nurses as well as stay-ath­ome moth­ers look­ing to work part-time. “Our care­givers are trained. They’re in­sured. They’re ac­tual em­ploy­ees. They’re su­per­vised, and they de­serve to be re­spected.”

Wen­dell, now 41, said she got into the busi­ness look­ing for per­sonal ful­fill­ment.

“I de­cided I didn’t want to be in cor­po­rate Amer­ica any more. I was work­ing 80 hours a week, and I’d kind of hit a glass ceil­ing,” she said. “I sat down and kind of re­flected, did some soul-search­ing, and just thought about all the re­wards that I had got­ten from tak­ing care of my grand­par­ents. And I also looked at where the mar­kets were go­ing and where busi­ness was grow­ing, and I”thought this was a great place to go.”

She also liked the fran­chise model. Tech­nol­ogy has helped agen­cies like Right at Home balance the needs and per­son­al­i­ties of care­givers and clients. A smart­phone app tracks when care­givers are on lo­ca­tion and al­lows them to call up the day’s treat­ment plan for a par­tic­u­lar client.

Since Wen­dell has a pool of em­ploy­ees, she can find sub­sti­tutes if a care­giver calls in sick. And clients’ fam­i­lies, she said, can en­joy peace of mind know­ing the agency is state-cer­ti­fied and has thor­oughly vet­ted ev­ery em­ployee.

But re­cruit­ment is a con­stant chal­lenge, she said. Home health care work­ers do not need ex­ten­sive ed­u­ca­tion — some are cer­ti­fied nurs­ing as­sis­tants, med­i­cal as­sis­tants or li­censed vo­ca­tional nurses. But it takes a cer­tain type of per­son to suc­ceed in the job, Wen­dell said.

“You have to care for oth­ers,” she said. “You can’t just look at it as, ‘I’m just get­ting a pay­check.’ Those peo­ple don’t stay, and they don’t work out.”

Which may be why Stephen, Sny­der’s care­giver, has been at it more than 20 years.

“I have a pas­sion for it. I wouldn’t be here if I didn’t have a pas­sion for it,” she said, leav­ing Syn­der with an “I love you” and a good-bye hug.

Pho­tos by Robin Jer­stad / Con­trib­u­tor

Right at Home care­giver Bar­bara Stephen helps Jamie Sny­der out of her wheel­chair dur­ing a re­cent visit.

Pho­tos by Robin Jer­stad Con­trib­u­tor

Jamie Sny­der gets a hug from Right at Home care­giver Bar­bara Stephen dur­ing a re­cent visit to Sny­der’s home.

Sny­der dis­cusses the home health care pro­vided by lo­cal fran­chise Right at Home and its owner, Sloane Wen­dell. Keep­ing an eye on the con­ver­sa­tion is her dog, Ch­ester.

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