UC Cooperative Extension educates Sacramento home care providers

Daniel Mathes knows what to do when his mother, who suffers from dementia, makes a cutting remark.

"I don't reply to the literal content," he said. "A person with dementia might say something outrageous and it could lead to anger. A lot of things can go wrong by giving a quick reply. Now I take a deep breath and think about it first."

These nuggets of wisdom were gleaned from a University of California Cooperative Extension workshop in Sacramento County offered in partnership with In-Home Supportive Services (IHSS) Public Authority. IHSS is a government-funded program that allows elderly and disabled people to be cared for in their own homes by people of their own choosing. The caregivers are paid an hourly wage by IHSS and some receive medical benefits. They can be the patient's own adult child, a neighbor, a friend or an acquaintance. IHSS also maintains a registry of caregivers to refer to people who don't have a personal contact available.

Sacramento County UCCE director Gloria Barrett designed lessons to increase caregivers' knowledge, boost their confidence and help them feel better about their work. A registered nurse and former UC nutrition, family and consumer sciences program representative, Barrett has presented many of the classes herself.

"Sometimes we (caregivers) get lost," said Mathes, who is responsible for his 46-year-old disabled brother and 70-year-old diabetic mother. "We forget the things we learned. We get isolated. Gloria, bless that lady's heart, puts us in a classroom and takes us through the basics. She gives us the current thinking in the fields that need to be applied at home."

The program provides participants with knowledge and skills in nutrition, activities of daily living and resource management. Last year, a total of 16 hours of training were offered in those three areas. This year, due to budget cuts, Barrett teaches a six-hour "activities for daily living" course and a four-hour job skills unit. The "activities of daily living" unit includes such topics as bowel, bladder and wound care, diabetes, fall prevention, infection control, self-neglect and dementia.

Another of Barrett's students is Gloria Cummings, a human services assistant for Senior Nutrition Services in the Sacramento County Department of Human Assistance. Cummings visits and delivers meals to seniors living alone.

"I do home visits, so I see things that are signs of dementia," Cummings said. "In class we talked about how to senior-proof a home for someone who has dementia."

As part of the program, Barrett suggests caregivers do a safety assessment of the home to prevent injuries.

"Are steps in good shape? Do rugs have non-skid surfaces? Are there grab bars in the bathroom? Is the shower slippery? We suggest keeping appliances out of reach and the environment uncluttered," Barrett said.
Cummings also noted the value of spending time in the class with other caregivers.

"I like the interaction with others in the career," Cummings said. "A lot of home support workers are providing care 24 hours a day. They've seen a lot, they're very experienced and they come from all walks of life. We all learn from each other."

Bernadette Lynch is the executive director of Sacramento County IHSS. Lynch said 50 California counties have Public Authorities as the employer of record for in-home caregivers of low-income elderly and disabled persons. The Public Authority is mandated to give the caregivers access to education, however, in many cases lacks adequate staff to handle the demand for training. Lynch initiated the training program with UC Cooperative Extension and praised the outcome.

"It's been a wonderful partnership," Lynch said. "The classes increase caregivers' knowledge and skills, which makes them better providers. This is a collaborative effort that benefits the community."

(June 2004)

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