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Thread: question about a PCA -help, SCI nurse?

  1. #1
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    question about a PCA -help, SCI nurse?

    I'm looking for a PCA or nurse or home health aide to get me into bed at night, do my bowel routine, clean me up, and get me up/dressed the next morning (no overnight stay would be required). this would be only an occasional need (once a month to once a week). I checked Craig's list but could not find a category for this. What exactly are the laws in my state (Indiana) regarding who can and cannot do bowel routines (would a PCA have to have certain training to be a PCA and do this?)
    "courage is fear that has said its prayers"

  2. #2
    Finding good aides has been our biggest problem.
    If you are paying out of pocket I believe you can hire whoever you want.
    Some states do consider it a nursing skill, so if you went through an agency it might be different.

  3. #3
    Senior Member Jonna's Avatar
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    Hi JennyP

    I have no idea about the laws in Indiana but hopefully a few helpful suggestions for you ~

    I would think for your own protection and safety you would want someone who has had some training and a state certificate or license (as for example a CNA). You wouldn't want anyone helping you with transfers for example, who wasn't trained in how to maneuver a paralyzed body/body part. A neurological injury is not an orthopedic injury, so someone with knowledge of only orthopedic care, IMO, is not sufficient or safe. Similarly, you wouldn't want an untrained person helping with personal hygeine, especially an evening B & B routine, again for your safety. (You don't want to be injured by someone who is well meaning, but doesn't really know what they are doing.)

    Having said that, you might be best served (if available to you in Indiana) contacting your local Visiting Nurses Association (VNA) and/or Center for Independent Living (CIL) and asking for assistance from them. Your local hospital may also have a "home health care" department that can hook you up with some home care.

    I'm no expert by any means and I bet there are more options that other CC members are aware of. Lots of wisdom and expertise in this Community so I'm sure you'll get some good info as others weigh in.

    Oh, and don't be shy about advocating for what you need and what works best for you.

    Best, Jonna
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  4. #4
    Senior Member zillazangel's Avatar
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    Don't bother with an agency or certifications, it is prohibitively expensive and by no means yields someone who knows what they are doing (trust me on this!!). Private pay, train the aide yourself, anybody can learn transfers and bowel programs, cathing, showering, etc. That's what we do as do all of my friends who have paralyzed spouses/loved ones. Post your own ad, under medical/health. However, if it's as infrequent as once a week (or worse, once a month) then it will be virtually impossible to find someone, sorry to say. You'll probably have to guarantee that person X hours per week for it to be worth their time, and you the bother of training them.

  5. #5
    I know someone in Indiana and now that I think about it it does have to be a nurse for bowel programs.

  6. #6
    Senior Member zillazangel's Avatar
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    Quote Originally Posted by LindaT View Post
    I know someone in Indiana and now that I think about it it does have to be a nurse for bowel programs.
    Only has to be a nurse if you go through an agency. You can private pay anyone you want.

  7. #7
    We don't search Craig's List for PCAs. We place our own ad, with a very specific job description, including the information that we check references and that a background check prior to hire is mandatory. I have posted a sample ad here before. The last 3 times we did this (all in the last 2 years) I had more applicants than I could handle and started taking a waiting list after I had 10 interviews set up. This all occurred within 24 hours after placing the ad.

    We do an initial phone screen, then an off-site interview, and I only take those who I pre-screen back to the house to meet my mother. I use a friend who is a private investigator to do our background checks (less than $100 each).

    In CA, where we are, you can hire anyone to do this type of care. Agencies will normally not allow bowel care, dressing changes, medication administration, or catheterization except for licensed (RN, LVN) staff. In CA, an RN has to supervise agency aides, and it is illegal in this state for an RN to delegate any care that "invades an internal body organ" to an unlicensed person (HHA, CNA are "certified", not licensed). If you are wealthy, you can hire an RN or LVN from an agency to do your care, but keep in mind that this type of care is nearly always considered "maintenance" care, so not covered by most insurances, including Medicare. Even then you will have to train them. For example, most RNs/LVNs have little or no training in transfers or ROM, nor in doing a bowel program.

    Some of our applicants are HHA, some CNAs, some even RNs (foreign trained but not CA licensed yet), and some with no formal training. Of those we have hired who really worked out well, about half have any type of formal training. Some had prior experience as family caregivers, although not for someone with SCI. Our top priorities are reliability, willingness to learn and follow directions, and trustworthiness. Given that, we can train anyone to do the care my mother needs (which includes catheterization, bowel care, transfers, ROM, skin inspection, dressing, bathing, etc.).

    (KLD)

  8. #8
    Senior Member zillazangel's Avatar
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    Quote Originally Posted by SCI-Nurse View Post
    We don't search Craig's List for PCAs. We place our own ad, with a very specific job description, including the information that we check references and that a background check prior to hire is mandatory. I have posted a sample ad here before. The last 3 times we did this (all in the last 2 years) I had more applicants than I could handle and started taking a waiting list after I had 10 interviews set up. This all occurred within 24 hours after placing the ad.

    We do an initial phone screen, then an off-site interview, and I only take those who I pre-screen back to the house to meet my mother. I use a friend who is a private investigator to do our background checks (less than $100 each).

    In CA, where we are, you can hire anyone to do this type of care. Agencies will normally not allow bowel care, dressing changes, medication administration, or catheterization except for licensed (RN, LVN) staff. In CA, an RN has to supervise agency aides, and it is illegal in this state for an RN to delegate any care that "invades an internal body organ" to an unlicensed person (HHA, CNA are "certified", not licensed). If you are wealthy, you can hire an RN or LVN from an agency to do your care, but keep in mind that this type of care is nearly always considered "maintenance" care, so not covered by most insurances, including Medicare. Even then you will have to train them. For example, most RNs/LVNs have little or no training in transfers or ROM, nor in doing a bowel program.

    Some of our applicants are HHA, some CNAs, some even RNs (foreign trained but not CA licensed yet), and some with no formal training. Of those we have hired who really worked out well, about half have any type of formal training. Some had prior experience as family caregivers, although not for someone with SCI. Our top priorities are reliability, willingness to learn and follow directions, and trustworthiness. Given that, we can train anyone to do the care my mother needs (which includes catheterization, bowel care, transfers, ROM, skin inspection, dressing, bathing, etc.).

    (KLD)
    ^^ what she said

    I totally agree - make sure you interview NOT at your house the first time because some people prey on the disabled and use these ads to discover good places to break into, knowing there is someone disabled there.

    Also, we can't afford a $100 background check so we do it ourselves, I pull a credit report, I search crime databases and require 3 solid references (which I call).

    Even with all of that you'll still find 10 bad ones for every 1 potential. Maybe even 20:1! Don't mean to be negative, but realistic.

  9. #9
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    Off location interview was excellent advice.

  10. #10
    Any suggestions on where to do an off site interview? Coffee shop, restaurant, park bench?
    Do you suggest have a PCA present during the interview? For me, she would also be doing the training.

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