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Vashon’s home health program will turn to volunteers

For the past 25 years, a program has quietly served a small number of Vashon’s elderly residents, helping them remain in their homes as long as possible by providing free in-home care. As of Oct. 1, that program, because of budget cuts, will no longer accept new clients.

The agency that funds that program, however, says it takes its mission of providing services to seniors seriously and intends to meet the needs of older residents on Vashon by strengthening existing resources, improving connections among them and working to create a robust volunteer program to serve even more seniors than it had before.

“The challenge is we need more programs on the Island through volunteers,” said Selina Chow, an operations manager for Seattle’s Aging & Disability Services.

The affected program, Vashon Health Center’s Home Care Program, is open to all Island residents age 60 and older and receives the majority of its funds from the federal and state government via Seattle’s Aging and Disability Services, which is responsible for a variety of senior services in Seattle and King County.

Participants in the home care program receive visits from home health aides, who provide a variety of services aimed at helping seniors be as independent as possible. Services range from blood pressure checks to assistance with dressing, eating, exercises and housekeeping, all at no cost to the recipients.

“The goal is to have seniors stay home as long as possible,” said Susan Pitiger, a registered nurse, who has managed the program for 18 years.

Without the program, seniors or their families will be forced to pay for caregivers, Pitiger said, an expense of at least $15 an hour, a hardship for many.

“They’re going to end up in a nursing home,” she said.

Chow, however, said she and her colleagues intend to be compassionate and humane and will provide funding for clients in the program as of Oct. 1 to continue receiving services in their homes for as long as they need them. Pitiger, though, believes the realities of running a program that cannot accept new clients will force the program to close sooner than Chow indicates; her staff, Pitiger says, will need more work than the program can supply and will thus move on, bringing an end to the program’s in-home work with seniors.

Virginia Friend is one such senior; she has been part of the program for a year. “I’ve really appreciated it. I’m 91 years old, and I’m kind of slow,” she said.

Twice each week, Pat Campbell — who has been a home health aid for 40 years, 24 of them on Vashon — goes to Friend’s house to help her shower and shampoo, change the bed linens and tend to some of the dishes and laundry.

Still independent, Friend has a hard time standing but takes care of most chores herself. Some tasks, though, are too difficult for her alone.

Her daughter, Louise Friend, who is a nurse, is grateful for the program and wonders if volunteers can really do the work that would be asked of them.

“Some things you can fix with volunteers. But some things require more skill and supervision,” she said.

Pitiger agrees. The two aids with the program are certified nursing assistants, and much of the work they do requires some medical training, including taking a person’s vitals. They also provide foot care, which requires skill, especially if the client is diabetic.

The two aids with the program work a combined total of 45 hours a week, Pitiger said. If a volunteer would give five hours a week, that would be nine volunteers doing what two people do now. With volunteers, there would have to be back-up people in place, so at least twice that many people would need to be trained. And that number poses another hurdle, Pitiger said, aside from the logistics of training people to do what is often intimate work.

“Old people do not want multiple people coming in,” she said. “Seniors do not do well with change.”

Rotating people would also likely mean that some health problems would be missed, lessening the qualilty of care, according to Pitiger.

“A robust volunteer system sounds delightful, but it will not serve the needs we fill,” she said.

Pitiger also noted that the program used to use a sliding scale, and she recommended that it be restored to help with the finances. That is not going to happen, and Pitiger said she understands with people paying $5 or $12 an hour, their contributions might not help enough.

Chow concedes maintaining the in-home program would be ideal, but economic pressures are forcing this change. In an effort to meet the challenge, she and her colleagues plan to collaborate with a variety of entities on the Island — Vashon Park District, Vashon Youth & Family Services, Vashon Community Care, the Vashon Senior Center, the Vashon Health Center and others — to see how the variety of current senior services could be strengthened. They may also consider providing a one-time grant to an agency to develop a volunteer chore or transportation program — a grant that could go to an Island agency that uses volunteers or an off-Island agency that specializes in volunteer coordination.

But volunteers are the key. If resources were plush, Chow said, “no one would bat an eye” at continuing to fund the program here, which, in 2010, received $57,000 to provide care to participating seniors.

But resources are not plush, and in early 2010, large cuts were expected from the state in funding for senior citizens. In preparation for those, members of the Citizens Advisory Council on Aging and Disability Services began looking for areas to prune. Vashon’s in-home program is the only one like it in all of King County, and members of the committee wondered about fairness, Chow said.

They undertook a deliberate process of study on the Island, she noted, and then determined to halt enrollment in the in-home care program and set in place steps to meet the needs of the Island in a different way. The situation on Vashon will be monitored, Chow said. If the new plans and programs do not meet seniors’ needs, her office will reconsider their funding decision and potentially restore the home care program.

In the meantime, Chow and her colleagues will begin networking on Vashon with the hope of creating a pool of support for Vashon’s seniors.

“It’s not going to be easy,” Chow said. “Right now everything is shrinking. But we do believe there are people who will help out.”

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