Job Description

I seem to be in a fog as to what is going on with some consumers I work with, and the care plan agencies that administer these plans. On Friday, a scheduled day off, I spoke with a care planner who has set up their home care agency home evaluation. Mind you, the date of discharge was set for 1 November and this eval was happening on the last possible day. Further, I called (on my day off) the planner who advised that the apartment might not allow for a ‘safe’ discharge.

I was polite, but thinking all along: the person is question uses a manual wheelchair, and yet I have been in the apartment with my power wheelchair, so I can’t imagine the safety being an issue. I spoke with the management company and they installed a 17” high toilet and bathtub cut – both for issues of safety, and I am cognizant about making safe transfers from a ‘chair.. I am annoyed at the way this sounded. Okay, it was Friday – forget the job until Monday and be prepared for a delightful or disappointing day then. It gnaws at me  how the details are not attended to by everyone else…

Which yellow brick road to take?

The directions can be opaque, and never crystal clear. I am sure about not wanting to continue with the work that I do, yet I do continue to do so. 

The transition coordinating has its oddities and share of complications. You might think that I relish the challenge and have just enough ego to rise to said challenge - a conquering hero of sorts (a well-worn cliché). But it all seems tiring and a never ending challenge.

The cone as sundial - or is it a compass needle I am to follow?? Photo by Ralph

I am working with a person who was discharged recently. She has the PCA waiver, in which (unnamed) pays for the services of the assistants, while the discharged client acts as an employer. This is a tough task for many persons as in a nursing home, a dependency is fostered where someone shows up to do this or that for you. The longer one stays in a skilled nursing facility (the formal term in use that I would never use to describe these places...), the more dependent one becomes.

So this person has five PCAs in her schedule. Contrary to Independent Living preferred practice, I did a lot of the work for the consumer - advertising and locating potential, arranged for the interviews by the client and when approved, I created a schedule. Independent living really dictates that the client really do all the work - although the client needed help. so supergimp Ralph jumped into the hiring fray. 

The client can be demanding after being provided all services in the home. So far, one PCA has resigned, one more (I hear this in third person) may. Yet, I have to spring into action, the other day checking by geography potential recruits. Based on a phone call, and an e-mail of documents, there may be hope for another PCA. I hope...

Discharged clients who end up back in these facilities can make things difficult for the coordinators. As I work for a contractor the state (unnamed) cannot dictate  what constitutes an offense that can lead to dismissal. Yet, terminating my position could have a happy ending. I say could, because there is a lot of downside to being asked to leave, especially in a society that views the disabled as failures of sorts anyway. So failure is not an option. Yet, from many directions, outcomes are not guaranteed. So I ask as I have been, am I bold enough to resign and take my chances on income on my terms?

It’s not who you know, It’s what...

It has been a week since my last post. Yet I remain committed to a change while events keep me on the track I have been on and missing the switches that offer a spur line into change. The train metaphor is apt as the heavy locomotive moves along with inertia, and thus keeps on going despite the application of the brakes - what I need to at least consider.

Yet, during the past week , I see a bit of confidence in my approach, perhaps there is hope that I can use the bit of intellect that I possess. In this case, perhaps it is as (noted before) a disability consultant.

The non-profit I work for had its fund raiser this morning. Referred to as the 2010 Wheel-a-Thon, there were two obstacle courses whereby teams mounted manual wheelchairs, and team pledges were added up and team elapsed times were tallied for winners, and a cook-out lunch was provided. A fun time near Long Island Sound on a beautiful day.

Yet I had no real responsibilities for the day. I didn’t even receive the loud yellow Staff Member tee-shirt. So an observer I was. Yet there were two women who corralled me, perhaps as they had a few questions that a wheelchair driver could answer. Which was the case. It was an older mother and her younger daughter. The questions at first had to do with the power wheelchair for the husband of mom:

Q - How much did your (wheelchair) cost?

A - A basic power chair (Pride Jet) like mine is about $4000 new. I bought this chair like new through my company for $700

Q - Can you take your apart for travel

A - No, and I don’t think the units that can be broken down are ideal - you would probably get tired of trying to lift the heavy batteries every time you travel.

So, I asked a couple of questions that were pertinent: Does your husband have Medicare? If approved, it would be a 20% co-pay, so the $4000 would be a co-pay of $800

Next I asked if he could walk. Apparently he can stand and move for short distances with a walker - he needs a wheelchair. So then I mentioned that a van would be optimal. Would you like to see mine to get an idea? They would. I was able to explain how the wheelchair works well with this type of modified minivan. Except these are expensive. 

Q - Is there anybody that can help in getting one?

A - I suggested that Social Security maybe through Medicare, although I don’t think so. What about a used one? His wheelchair can be easily tied down in the van, so no battery lifting would be needed.

I suggested that they contact the place where my van was modified, Advanced Wheels in East Granby near the Hartford Airport. All they do is modify wheelchair vans, and ask for John, Christian or Jason to see if they have anything used or any ideas. I have their phone number committed to memory and the daughter took all the info down on her I-Phone (I am merely a satisfied customer of this company, not a paid shill. My 2008 Grand Caravan is the third vehicle I own that was modified by them, and they will get answers for you). They left satisfied with the answers.

The point I am trying to make is that I know these issues. Two people were apprehensive about their plight, and by my knowledge, experience and manner, I was able to take the edge off the women’s fears. Perhaps I was able to erase the answer we so often see - the easy to say words ‘No' or ‘Never' are often what we say. Hopefully I was able to allow them to see the possibilities, the harder to say ‘Maybe' or even ‘Yes' just might be the outcome. I spoke as naturally as I do, with a command of the facts and possibilities that were not considered. This is the third time in the past week where my knowledge of wheelchairs and egress answered questions that seemed daunting at first. I know what I speaketh, and can present it well.

A disability consultant? Why not??

Finger pointing exercise

The term ‘transition coordinator’ seems innocuous enough, you coordinate others who perform the duties that they are assigned, and all works out in the end, a safe discharge the result.

Pointing the way??

That’s the theory, anyway. 

The ‘responsibility vs. authority’ argument seems pretty clear here. I am the point person, the visible one who has to be certain the care plan is adhered to by the various care planners. I am merely an administrator. So the discharge on Monday occurred, with an interesting mix of problems that indicate a lack of focus by others - that I have to address and hopefully fix. Not my job? So there!

Lets start with the facility person who arranges the discharge. As medications will be needed, an appointment with the consumer’s physician is needed. Given that this person doesn’t drive, a method of transport to the doctor’s office is to be determined.

So the  appointment was made for the following day at 3:45 PM. I set up the PCA schedule, and can you guess - there was not a PCA scheduled who could drive the consumer then! Call it a mistake, but hey, why ask me what a good day might have been since I only created the schedules. Thanks...

Exit stage left??

The bigger issue is that after a call to the doctor, there were no other times available this week and there is a finite supply of meds. The transport for Title XIX (Medicaid) requires 48 hour notice. A fabulous sales job by me (30 minutes) convinced them to schedule a pickup for the appointment in <24 hours.

Let’s follow the what-ifs:

• the meds run out
• the consumer was unable to get to the doctor to get a new supply

Who has the ultimate responsibility here? You’d think the nursing home personnel, who have to provide a safe discharge, might have sweated the details a tiny bit. Au contraire! Any problems fall onto me. I am not averse to work, but where ought the blame ultimately be placed? There are a few other sidebars to this story I’ll ignore, but you get the idea...

Let’s not be silly Ralph - the blame is to fall on you! Responsibility vs. authority. It is a simple enough concept that I get it. What about the other players?


So much behavior here seems so old. Change can be good for the soul, my mantra should be change is good, change is good, etc. Wheelchair or not...

Spam to the left, spam to the right

The search continues. Photo by Patti

I recently created an ad on craigslist for a position wanted for myself. Interestingly, I received the following reply, which is spam. Why I chose not to continue is the syntax, as the structure and text is not American English. But where from: India? Bahamas? Jamaica? Or perhaps the place of Mass scams, Nigeria. I see many oddities, can anyone else?

ATTN: Sequel to your resume on (Craigslist.org),your resume have been reviewed by our company (------ ---- Inc) and our hiring officer will like to conduct an online interview with you to discuss more about the Job Position that you are yet to occupy. Set Up a Screen name with the Yahoo Instant Messenger or if you have a yahoo or msn or hotmail, you can use it and add up Mrs Mcjenny Mayne:  On Comprehensive online training shall be provided as this is work from home.

I am not used to adding up anybody, and the name of the contact? Thanks, but no thanks…Opportunities exist, and in general I like craigslist, but really, I don't speak their style of English, and thus will skip the reply...

Knowledge Base

Is the wheelchair a blessing or a curse? Since my foray into this method of moving about (17 November 1995), I obviously have come to the practical limitations of the ‘chair, often its use, care and feeding (and if things break on the chair, repairs cost $$$).

The upside? Well, I am a ‘quick study’, having to pick up strategies and such on the fly (such as can I get into this building with my wheelchair?).

I would prefer to start with side jobs, simple or not to establish a bit of credibility. What do you need, I can offer this, etc. How to sell your abilities and how to locate these opportunities??

The following is a brief look at my resume describing myself briefly – it ought to sell says I:

“Varied skill set from organizations from manufacturing to consulting to non-profits the areas of:

- Sales administration, including estimating

- Purchasing and inventory management systems experience

- Home accessibility and knowledge

- Writing and editing

- Adaptive equipment consulting”

I know my abilities. I know my limitations. And a need to apply both of these to an income producing organization…

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My last post might sound a bit confusing about various agencies and what might be construed issues of competency. My purpose here is not to slight the non-profit I work (part-time) for a small advocacy non-profit in Connecticut - this being a competent (if underfunded) organization.

I actually meant much of the state government who we work as a contractor for…