A gap for those in need

Editors Note:

(this is the second part

in a three-part series on home care needs in the Platte Valley)

“In an ideal world our community desperately needs an assisted living facility. We have a nursing home, and that’s all out, and then we have nothing,” local physician Dr. Dean Bartholomew of the Platte Valley Medical Clinic said during an interview.

There is a gap in services available for those in need of home-based medical care or assistance with daily activities.

An example would be an elderly couple who needs help with their laundry, groceries and housekeeping. That is a service that is fairly hard to get in the Platte Valley according to Bartholomew.

Premium Home Health is a for-profit service based in Rawlins that has a certified nursing assistant (CNA) and can provide in-home care. There are also state-based programs which can be facilitated out of Memorial Hospital of Carbon county. Those programs will be discussed in next week’s article. Bartholomew noted some other resources such as Wyoming Independent Living Rehabilitation which can help patients build handicap accessible features into their homes.

According to Bartholomew there are also private individuals in the area that have CNA training and can work for patients that can afford their services out-of-pocket. These private individuals can be contracted for as many hours a day as the patient needs. Bartholomew says this has helped some people stay out of the nursing home for a period of time, but there are few families in the Valley that can afford this care option.

Actual nursing level care is different. Intravenous antibiotics and other medical care can be provided by a nurse from the state programs like Wyoming Home Services (WyHS), but “I have not seen them be able to come down five days a week or seven days a week,” Bartholomew said.

Some services are provided by the Platte Valley Medical Clinic. They have a nurse that contracts through the clinic to provide in home medical services. “Again, the issue there is the insurance and if the insurance pays for those services,” Bartholomew said.

The clinic actually had to go to Medicare and apply to provide home care. The clinic is now state licensed and approved by Medicare to provide medical nursing assistance to those that meet certain medical criteria such as IV treatments or wound care, however, the clinic cannot afford to send a nurse over for housekeeping.

The needs of the patient have to be assessed on a case by case basis, and the starting point for assessing medical need begins with your provider.

Bartholomew also said he thinks the need does exceed the ability to provide lower level care. CNA-type care where there is an elderly person or an elderly couple who really needs to have somebody in the home that can help them get their medications straightened out on a daily basis, making sure that they are safe and they have groceries.

“I can give you a list of patients who I think are probably unsafe to be at home, but can’t afford to go to the nursing home and so they stay at home. They just get by and get by until there is a crisis and then they have to go to the nursing home, and its really an unfortunate event,” Batholomew said.

According to Bartholomew, in a larger community, that’s where an assisted living facility comes into play. The patient retains much of their autonomy but nursing assistants can help with daily needs and it’s not nearly as expensive as going into a nursing home.

The issue of care types is mainly financial and not a matter of autonomy according to Bartholomew. It’s the fact that intermediate care is not available in the Valley.

“We have had some people in this community in the last couple of years who have had to move out to Laramie.” Bartholomew said. They have moved to Laramie to an assisted living facility when its really too bad because they have lived here all their lives and then suddenly there is no way for them to afford the nursing home and the family moves them out to assisted living.

(Next week’s story will focus on state-based programs and sources of information for potential patients and clients.)