Laundry And Shopping

My friend Brad has been over for most of the afternoon. He just left about 15 minutes ago. I asked him to come over today, to help me with a couple of household chores; doing some laundry and doing some shopping. In both of these there is a small story, enlightening nonetheless.

Laundry is a task which has been taken care of by my HCA's for a very long time, at least a couple of years. Yet on Monday when I asked my newest HCA to do a load of laundry, she refused, declaring it not to be in the care plan. I repeated the request on Tuesday, at which point she got quite huffy, declaring that she is not supposed to do work that is not on the care plan. I asked why all the other HCA's were doing it for me, at which point she got even huffier. I backed down, deciding instead to talk to her supervisor.

The RN Supervisor came to visit today. I asked her about the laundry. She read the care plan, only to tell me that a some point the "Wash" checkbox for laundry had been checked, but nothing else. She went on to tell me that even the "Wash" instruction had been crossed out. I asked about the past, to which she shrugged her shoulders, telling me they shouldn't have been doing it. It is not on the care plan.

I wonder about a couple of things here. Why, knowing full well that I cannot do my own laundry, would my AHS caseworker have started to note "Wash, Dry, Fold", only to scribble it out after checking the first box? Second, how could this process have gone on so long without someone noticing, until a fairly lazy HCA seeking to avoid a task discovered the error?

In defence of the RN Supervisor, she had been trying to contact my AHS Caseworker to get an updated care plan. The reality is that time allotments for me are based on the care plan. If there is time allotted for doing laundry, which there is, it had damned well better be on the care plan. If no, someone is either paying for a service not delivered or not being paid for the work they do.

Shopping, on the other hand, is a task home care will not do. It is not within their mandate. I don't mind so much; I enjoy doing my own grocery shopping. The problem is that increasingly the barriers to my life make it more difficult for me to get out of my building. This makes going shopping a challenge, one I will often pass on, instead asking friends to pick up things for me. Then, every once in a while, I will impose on one of my friends to make a major shopping trip with me. It's fun for me, and I get some great company.

Both of these situations highlight the differences between self-managed care and vendor-managed care. With vendor-managed care, a case worker with AHS writes the care plan. Part of their mandate is to deliver only those services with they feel I need, within the AHS guidelines. On the other hand, with self-managed care, I write the care plan with whatever I think I need, as long as I stay within the AHS budget. That's why I am working so hard, why David and Anne are working so hard, to get a self-managed caregiver for me. It's what I will need increasingly as I get worse and worse.