An elderly woman pulled herself slowly to her feet, using her metal walker, to tell of the homemaker aide who stole $165 from her and quit the next day.
A frail woman told of the frequent times her home aide fails to show up, forcing her to make trips to the drugstore alone, fearful that she will have another seizure on the way.
Louise Brown, 77, the president of the residents council at the Judiciary House complex for the elderly in Shaw, told stories about handicapped elderly persons in her building who sometimes wait for weeks or even months before they get home aides to help them cook, clean, and shop. When aides do arrive, she said, they often are untrained and incompetent.
The three were among 50 elderly persons who met yesterday with Department of Human Services (DHS) officials to discuss problems they have with the city programs that provide home care to the elderly and the handicapped. The programs are aimed at enabling the elderly and disabled to stay at home and avoid more costly nursing home or institutional care.
Yesterday's meeting, at the Garfield Terrace Senior Citizens Housing Project, 2301 11th St. NW, was organized by Washington Inner City Self Help (WISH), a church-supported community organization. The focus was on past cutbacks that have reduced service, delays that elderly persons have in receiving home care after they leave hospitals, and the lack of training for some home aides. DHS officials said most of the aides, who generally are lowly paid, provide valuable services and perform well. But they also acknowledge shortcomings in the programs and said they are seeking to remedy them.
Under the city's three programs for homebound persons, which have a total annual budget of $6 million, care is provided to roughly 2,700 people yearly. About 800 of these are Medicaid-eligible disabled persons who receive visits from "personal care attendants" who bathe, feed, and otherwise assist. Under the two other programs, roughly 1,900 people yearly are visited by "chore aides" who cook, clean, and shop for elderly persons, or by homemaker aides who handle a wider range of household tasks, including budgeting, child care and personal grooming.
While personal care is provided only to those who earn less than about $350 monthly, city officials said, the homemaker and chore programs have higher income limits: service is provided to persons earning up to $692 monthly or couples earning about $1,000 monthly.
With the elderly population rising and with the federal contribution to human services shrinking, the home care programs are faced with increased caseloads that are beginning to outstrip the city's budgets and capability, according to Patricia Yates, director of DHS's social service division and Louise Erlbeck, chief of the home care services bureau.
Because of declining federal grants, Yates said, the homemaker and chore programs were cut by $624,000 in fiscal 1982. After protests from advocates for the elderly, she said, the City Council has restored the cut for the new fiscal year.
"But that still puts us in 1983, back at our 1981 funding level," she said. Meanwhile, the caseload of the program has grown by several hundred, while funding remains the same, she said.
Yates, whose office runs the homemaker and chore programs, acknowledged that the city sometimes takes several months to line up home aides, a situation that she said "should not happen." Sometimes, she said, the reason is that city hospitals fail to inform DHS soon enough when elderly or disabled persons are about to be discharged.
Other times, she added, the delays are caused by the growing caseload. The city receives between 100 to 200 new applications monthly, she said. Private firms that provide the services under contract with DHS are often unable to quickly work new clients into their system, she said.
Cheryl Fish, a representative of Legal Counsel for the Elderly Inc., said that as a result of cutbacks, DHS has reduced the number of hours that many elderly persons receive the care.
Yates acknowledged that the city's 400 chore aides, who earn $3.50 hourly through federal Medicaid funding, receive no supervision or training. She said the city was legally prevented from training and supervising them because under city and federal regulations they are considered "private contractors" rather than city employes.
To remedy the problem, she said, the city is considering a plan to hire private firms to run the chore service, and that would include the training and supervision of the aides.
Yates said she also wished that chore aides, in particular, could be paid more so that the city might attract better workers. "One of the real sadnesses in human services is that the people who spend the most time with patients often make the least money," she said.
Brown, who said many Judiciary House residents complain about laziness and theft on the part of aides, also criticized their lack of skill. "I have seen elderly people have meals prepared for them and, honest to goodness, it was not fit to eat. My lord, I have seen these things for six years in my builidng. Dinners that would be all dried out and black and unfit to eat."
"But these people are afraid to report these things because they would lose their home aide," she said.
Both Yates and Erlbeck, who commended the WISH Home Care Coalition for its advocacy work, said that the elderly should feel free to complain and that untrustworthy aides would be replaced.