'Raised to Care'
A chronic-care foot soldier takes pride in her work but sees flaws in the system.
If you don't have caring in your heart, the home health care business "is not the place for you," says Janey Dixon.
The 42-year-old Philadelphian was raised to be a foot soldier in chronic care. Growing up in South Carolina, Janey often stayed with sick relatives to provide care and comfort for them and relief to their families. After moving to Philadelphia, she started working as a live-in aide, staying with her first family for two years. She read books on home health care, taking various live-in jobs where she remained until a patient didn't need her anymore or died.
Today, Janey is employed by Home Care Associates, where she has worked since 1993. Though she loves the job, she acknowledges her industry has real shortcomings. Principally, it's the pay: Earning a modest $7.25 an hour (slightly above the industry average of $6 to $7 an hour), Janey says, "Most of us feel we are not paid enough." The pay is so low that many home health care companies struggle to find employees.
Another complaint Janey has is Medicare cutbacks. "One of my clients used to get her catheter changed whenever she wanted to," she notes. "Now she has to wait at least six weeks." Janey says that sometimes nurses train aides to do certain tasks because Medicare doesn't pay for nursing care. She is supposed to spend only an hour at the home of patients who rely solely on Medicare. However, she, like many other aides, almost always stays longer anyway. "It's not fair to us, but you care, and if you see somebody in a diaper that needs changing, you're gonna change it."
Janey says her Home Care Associates training was unique. Over the course of three weeks, she learned how to deliver personal care, from meals to bathing and grooming, laundry and light housekeeping. Her longest client relationship lasted five years. "Seeing the people dying, that's the hardest part for me," says Janey. A counselor is on staff to help aides deal with the grieving that often comes with their work.
The people she helps are her motivation, Janey says. "A lot of them are sick and terminal, and it takes a lot to give them special, private care." Her advice to new caregivers is to focus on the patients, if necessary thinking of them as if they were family members. "Do your best, and it will take you a long way," she says.
Today, home health care depends on the dedication and courage of people like Janey Dixon. But as health experts project a sharply increased demand for home health care services, meeting those needs will likely require more than the will and good faith of Janey and her fellow foot soldiers.