A place to call home
By Maureen Tuggey
Elder Services’ Adult Family Care (AFC) Program has been an important and unique living alternative for seniors and disabled adults in Massachusetts since the 1980s. Through this program, seniors and disabled individuals under age 60, who were unable to safely manage their care needs on their own, have found the care and supervision they need in a home environment. In the Adult Family Care program, individuals who are eligible for MassHealth and have a medical condition that limits their ability to care for themselves receive daily care or supervision from a qualified caregiver.
Those who participate in this program may live in the home of their caregiver or their caregiver may live in their home. All caregivers must go through a careful screening process, including a criminal background check and medical clearance from their physician. There is also a safety evaluation of the home where the care is to be provided.
In 2006, shortly after Thanksgiving, Dorothy Vallieres was hospitalized for congestive heart failure and hyperglycemia. A lifelong North County resident, she was still unable to return to her home alone even after a stay at a local nursing home where she received rehabilitation. Then Vallieres’ daughter Pauline Longtin and her family invited Dorothy to move in with them. She had no hesitation and was doing well in her new home until she was hospitalized because of a stroke that affected the right side of her body.
When she discharged from the hospital, Vallieres once again returned to her daughter’s home. The local visiting nurse association (VNA) provided short-term skilled services to Vallieres. The VNA also made a referral to Elder Services to see what help and support the agency could provide to Vallieres and her family. Elder Services’ Client Services Coordinator Jennifer Boland, LSW visited the home and took note of all the day-to day-care Longtin was providing to her mother. Boland decided they would be a natural fit for the AFC program.
Dorothy Vallieres has been an AFC program client since May 2007 with her daughter as her caregiver. An Elder Services team consisting of a registered nurse and social worker visit their home monthly to provide education and support to both women and to monitor Vallieres’s overall health and well-being.
When asked about her case manager Jennifer Boland and her nurse, Cindy Danforth, R.N., Vallieres smiled, “I like them very much. They are swell; everyone who comes here is swell. I would recommend this program to anyone.”
Due to her complex medical condition, Vallieres requires her daughter’s daily assistance with bathing, dressing, personal hygiene and toileting. She also manages her mother’s medications, makes her doctors’ appointments, cooks her meals and does her laundry.
About her living situation, Vallieres says her biggest challenge living in her daughter’s home is not eating too much, because Pauline is “such a good cook, and I always want more.”
For the first time in the program’s history, family members, with exception of a spouse or legal guardian, are considered eligible caregivers for the AFC program. This has allowed family caregivers to receive a monthly tax-free stipend as well as on-going education and support. As her caregiver, Pauline Longtin receives a monthly tax-free stipend.
Not only are Dorothy Vallieres’s physical needs met by living with her daughter, her emotional and spiritual needs are met as well. She attends the Adult Day Health Program in North Adams four days week, where she is able to socialize with the other people who attend. Most important, she continues to paint landscapes by taking part in the weekly art classes at the center. Many of her pieces of work decorate her daughter’s home. When Dorothy was complimented on her obvious talent, she just shrugged her shoulders, eyes twinkling, and said “I guess they are alright. We have a very good teacher.”
She also continues to have a close relationship with each of her 14 children, all of whom live in the Berkshires. One son stays with her on Fridays. On Friday nights, two of her daughters take her to a weekly Bingo game at the Elks Lodge in North Adams where the attendees still call her “Ma V,” a neighborhood nickname from when she was raising her children in town. Another son visits on Saturdays to allow Longtin to run household errands. And still another son picks up his mother each Sunday morning to take her to church and then back to her former home for a visit. Two of her sons have been approved as AFC respite care providers to give a Longtin the option to leave the home for an occasional overnight break. These respite care providers also receive a stipend in Longtin’s absence.
Longtin feels strongly about Elder Services’ AFC program. From the caregiver’s perspective, she notes she has received a lot of support from program staff. “I can call anytime. I can ask questions and have received a lot of support. It’s been very beneficial to us all.” When asked if the monthly payment is helpful, Pauline replied, “Of course.” The monthly stipend to AFC caregivers is based on the medical complexity of the client’s needs. Reimbursement begins at $23.50 per day and can be as much as $49.69 per day.
The AFC program is also a viable option for disabled individuals under age 60 and their families. With the inclusion of family members as eligible caregivers, parents or siblings of a disabled adult could qualify as care providers, receiving the same support and compensation as Vallieres and her family. The only exception is for family members who are also the client’s legal guardian.
The Elder Services AFC program can serve many more in this unique program. Do you know someone who benefit from this program? Call Elder Services’ Housing Programs Manager Maureen Tuggey at 499-0524 or 1-800-544-5242 ext. 718 for more information.
Maureen Tuggey is Elder Services’ Housing Programs Manager.
