HOMEMAKER

HOMEMAKER A. Definition and Purpose Homemaker services are supportive services provided in the home by a trained homemaker that involves education and/or provision of home management duties to assist in strengthening family life, promoting self sufficiency and enhancing quality of life. The purpose of homemaker services is to assist functionally impaired older persons to remain in their home by providing assistance with the activities of daily living, housekeeping, laundry, meal planning, marketing, food preparation, and other types of home management tasks. B. Eligibility Individuals 60 years and older with a level II score of 22 or above on the Consumer Information Form who cannot perform simple housekeeping tasks or need assistance in performing these tasks. Individuals 60 and older who have either functional, physical, or mental characteristics which prevent them from providing the service for themselves and who do not have an informal support network capable of meeting their service needs. C. Unit of Service One (1) unit of service equals one (1) hour of direct service to, for or on behalf of the client. D. Minimum Program Requirements All providers of homemaker services under Title III, SSBG or other funds through contractual agreement with an Area Agency on Aging must adhere to the following minimum program requirements: • All clients are to be entered into the State Approved Client Tracking System no later than 10 working days. 1. Service Activities - the homemaker shall perform the following services: a. Household Management - Assist with activities of daily living such as dusting, vacuuming, sweeping, washing dishes and clothes, bed making, and other simple housekeeping tasks to ensure a healthy environment. b. Menu Planning and Meal Preparation – Work with the client and primary caregiver to find out what foods and menus the client needs; prepare a shopping list, plan the meals for a week, purchase groceries, prepare and serve the meal if needed, and put away groceries and other food items. The homemaker must know the basic food groups and what constitutes a nutritious meal. c. Consumer Education - Assist the client in getting the best buy for the dollar; selecting good quality meats, vegetables and other foods; comparing prices, buying merchandise in the size or quantity to meet the needs of the client and family; choosing the most economical products; clipping coupons, and watching for newspaper or store ads and in-store sale items. d. Human Growth and Development - Be knowledgeable of the aging process to assist the client in understanding his or her aging process and the changes that occur as he or she ages. e. Dressing - Assist the client in finding, preparing and putting on or taking off clothes. f. Toileting - Assist the client to understand the importance of regular elimination of body waste and assist client in using the commode, urinal or bed pan. g. Oral Hygiene – Assist the clients with mouth and denture cleaning procedures. h. Bed Making – Change bed linen as necessary. i. Sleeping and Rest Habits – Be aware of the sleeping patterns and rest habits of older people and encourage clients to take frequent rest periods. j. Safety – Be aware of the overall protection of the household from predictable hazards and do everything possible to ensure a safe environment for the client, which includes being knowledgeable of: 1) Basic first aid and CPR; 2) Proper cleaning techniques; The effects of medication on clients; 4) Ways to prevent burns, falls and fires and the types of accidents to which elderly clients are prone; 5) The phone numbers to contact emergency personnel; 6) Ways to recognize the signs of abuse, neglect and exploitation, and the proper reporting protocol; and, 7) Diseases such as AIDS, tuberculosis, pneumonia and other infections, communicable or contagious diseases and proper disease prevention techniques. k. Health: Encourage healthy lifestyles with good habits of eating, dieting and exercising. The homemaker should be aware of the leading causes of death among the elderly such as cancer, strokes, diseases of the heart/heart attacks and others. Evidence suggests that heavy smoking, alcohol abuse, poor nutrition, improper exercise, and the lack of regular medical check-ups are associated with a variety of poor health conditions later in life. l. Substandard Housing - The homemaker should have a basic knowledge of existing county and city housing codes and be aware of telephone numbers and process for making referrals for clients residing in substandard or inadequate housing. 2. Location of Service Homemaker services are provided in the client's home. 3. Access to Services a. A client may enter the service system at any point through an appropriate referral. b. Priority shall be given to serving clients with the greatest need for the service. . Delivery Characteristics The following guidelines represent the basis by which homemaker services shall be provided. These guidelines serve as minimum instructions. a. Volunteer Contributions - Allow client to voluntarily contribute to the cost of the service. However, services will not be denied due to a client's inability to contribute. b. Gloves and Masks - Homemakers shall wear safety items such as gloves and partial facial masks when needed to prevent the spread of infections or diseases. c. Service Hours - Homemaker services shall be available five (5) days a week, preferably between 8:00 a.m. and 5:00 p.m. d Uniform - Homemakers shall wear uniforms which consist of a smock op, a hospital scrub suit, lab jacket, apron, or whatever has been designated by the provider agency as a uniform. The uniform must be the same in color, style, and design for all homemakers. It is left to the discretion of the service provider to supply the uniform or have homemakers to purchase one (1). A homemaker in a proper uniform has a professional appearance that makes the client feel more secure and enables the client to distinguish from other para- professionals entering the client's home. e. Badges - Homemakers shall wear an Identification (ID) Badge or picture ID which contains agency name, and homemaker's name and title. It is left to the discretion of the provider to determine how the badge is designed or obtained. f. Confidentiality - Homemakers shall maintain confidentiality of client information as indicated on the Consumer Information Form. g. Case Record - The homemaker client case record shall consist of: 1) Consumer Information Form which contains Confidentiality and Authorization Release; 2) Service Plan/Care Plan (the care plan may be used in lieu of the service plan for case managed clients only); 3) Record of Contact (used for documentation of visits and other pertinent information); and, 4) Homemaker Activity Sheet. h. Back-up System - The homemaker, provider, or supervisor shall establish a back-up system when a homemaker is absent for reasons such as vacations, long periods of illness or death. The back-up system is a substitute homemaker, or an alternate means to ensure that the client is provided the service as outlined on the service or care plan. i. Reporting - Homemakers shall report abusive behavior or situations to their supervisor immediately. Also, such behavior by a client must bedocumented in the client’s case record. j. Harassment - Homemakers shall not permit or be subjected to sexualharassment or advances by clients. This kind of behavior should not be tolerated. The homemaker must firmly state to the client or family member in the home that such behavior is not acceptable. If such behavior occurs, the homemaker should tell the client that such behavior will be reported to their supervisor and walk away. However, the homemaker shall handle the situation with diplomacy and tact but always refuse to participate in any sexual misconduct with the client. k. Jewelry - Homemakers shall limit the amount of jewelry worn into the client's home. A watch is the most appropriate piece of jewelry to wear. Dangling jewelry such as earrings, necklaces and bracelets should not be worn; they can catch on bedding and furniture, or the client may pull on them and injure the homemaker. A ring may scratch the client or become lost during tasks in the home. If items are lost or damaged, the service provider or client is not responsible by the provider or client. l. Liability - The most important protection from liability for the homemaker is to do exactly what has been prescribed on the care or service plan or instructed by the homemaker supervisor. When the homemaker follows the care or service plan or instructions, the provider agency assumes responsibility for the homemaker’s actions. m. Documentation - The homemaker shall write down on the record of contact any and all factual observations, contacts or visits with the client and actions or behaviors displayed by the client. This documentation is essential in determining if changes should be made in the care or service plan. It is also essential to show that certain tasks were performed on certain dates and time. Furthermore, the case record documentation is a valuable source of information in the event of legal action. n. Waiting List – A waiting list consists of screened clients. Each Area Agency on Aging (contracted or direct services) shall develop policy to ensure the provision of homemaker services to those eligible individuals in the greatest need waiting to receive assistance. o. Screening of Non-Case Managed Client – All homemaker clients shall bescreened. p. Transportation - Homemakers shall have access to reliable means of transportation, automobile insurance, if vehicle is owned by the homemaker. q. Coordination with Case Management - The homemaker supervisor shall maintain regular and on-going communication with the case management rovider regarding case-managed homemaker clients. Such communication will keep both the homemaker and case manager abreast of the client status and helps in deciding whether to continue or terminate services. 1) The case manager shall develop the care plan for case-managed clients that are referred for homemaker services. 2) The homemaker shall share copies of the Homemaker Activity Sheet on case-managed clients with the case manager. r. Termination of Homemaker Clients - Clients receiving homemaker services shall be terminated based on the following criteria: 1) Death; 2) Relocation out of state or Planning and Service Area; 3) Increased informal or formal support, or a relative moving in to care for client; 4) Improved health status or condition; 5) Client becoming abusive and belligerent, including sexual harassment; 6) Client refuses service; 7) Client reports that he/she no longer needs the service and is able to manage activities of daily living; 8) Client is placed in a long term care facility; and 9) Services are duplicated (e.g. homemaker and home health aide are providing the same service on the same days). Any situation involving the above criteria must be reported to the homemaker supervisor and documented in the client's case record. s. Cleaning Supplies -The homemaker provider agency shall purchase for the homemaker a generic cleaning supply kit that can be carried to each home. However, these supplies will only be used if the client cannot purchase supplies due to financial restraints. t. Homemaker Categories - The role of the homemaker falls into twocategories, household care and personal care. However, if personal care is required, see the personal care standards. u. Routine Tasks - The homemaker shall perform the following tasks but notbe limited to: 1) Assist with mouth and denture care; 2) Shampoo/hair care; 3) Assist with bed bath (partial or complete) and shower or tub bath; 4) Assist with dressing, bathroom use, bed pan or urinal as requested; 5) Make or change occupied bed; 6) Light housekeeping to assure that rooms are clean and in order; 7) Prepare shopping lists and run errands; 8) Purchase and store groceries; 9) Prepare and serve foods; 10) Do laundering, ironing, sweeping, light mopping, dusting; and 11) Clean and operate equipment in the home such as vaccum cleaner, stove, washer, dryer, and other small appliances. 5. Staffing a. The homemaker provider shall ensure that the agency has an adequate number of full-time and part-time staff to cover the counties where homemaker services are available. b. There shall be at least One (1) supervisor for every twenty full-time equivalent (FTE) homemakers. c. The person responsible for supervision of homemaker services shall have the following qualifications: 1) A Bachelor's Degree in Social Work, Home Economics, or a related profession. 2) Licensed Registered Nurse or Licensed Practical nurse, or 3) High school diploma and two years of experience working with the elderly or aging programs and some supervisoryexperience. 6. Training a. The homemaker provider agency is responsible for assuring that all homemakers and homemaker supervisors are trained and certified using an approved curriculum. b. The homemaker supervisor shall observe and evaluate the homemaker performing assigned tasks in the client's home annually. c. A homemaker or supervisor who has been trained and certified through another approved homemaker program using the approved Mississippi Homemaker Curriculum or a comparable curriculum is exempt from participating in the 40 hour curriculum training. However, the homemaker shall take and pass the standardized examination administered at the end of the 40 hour curriculum training. d. All homemakers and supervisors who are not certified upon employment with the agency must attend and complete the 40 hours curriculum training including taking and passing the standardized examination. A certificate shall be issued upon successful completion of the aforementioned requirements. e. The homemaker provider agency shall provide on-going in-service training that consists of a minimum of eight hours per year. Such training can be conducted in intervals most convenient for the agency and homemaker staff and can consist of workshops, conferences, academic course work related to the homemaker program or the agency designated training material. f. All homemakers and supervisors shall receive orientation training provided by The agency prior to performing any assigned tasks relating to the homemaker program. Orientation training shall consist of: 1) introduction to the agency and organizations in the aging network; 2) introduction to community resources; 3) review of the agency and Division of Aging and Adult Services policies, procedures and applicable service regulations; 4) overview of the program history, intent, funding source and target population; and, 5) homemaker responsibilities and tasks. g. Before arranging the 40 hours curriculum training, the provider agency or designated individual must seek curriculum approval from the Division of Aging and Adult Services. i. The curriculum training shall include lecturers, class discussions, demonstrations, handouts, films, charts, graphs, other written or audio visual instructional material which relates to the services and care of the population targeted for services. j. The provider agency shall assure that all homemakers have satisfied the requirements to perform the tasks needed in the program. This can be documented with a certificate, CNA license, etc. k. Homemakers may be employed when the 40 hour curriculum training is not available, but only with the provision of at least two weeks of in home training with a homemaker or homemaker supervisor who has completed the training. However, this does not replace the training which can becompleted when the classes are scheduled or at a time scheduled that is convenient for the homemaker and agency. 7. Case Record Retention a. All client records shall be retained for four years after a client has been terminated from the program. b. If a client has been terminated and re-enters the system within four years from the date of termination, the previous case-record shall be retrieved, updated and used. c. All case records shall be maintained in an area that will protect confidentiality of information, protect from damage, theft and unauthorized inspection or use. 8. Monitoring, Evaluation and Reporting a. The DHS Office of Audit and Evaluation shall monitor the Area Agency Homemaker Program annually with periodic reviews at the discretion of the Division of Aging and Adult Services. b. The Area Agency on Aging shall monitor the homemaker service provide semi-annually. 9. Prohibited Service Activities The homemaker may be faced with problems while caring for a client, and may be asked in the work place to perform tasks that are not part of the job description The following activities are prohibited: a. Using the client’s car; b. Consuming clinet’s food or drink; c. Using client’s telephone for any reason other than an emergency Homemaker related activities; d. Engaging in the discussion of own personal problems, religious or political beliefs with clients; e. Breach of client’s confidentiality; f. Accepting gifts or tips; g. Bringing friends, relatives, or other guest to the client’s home; h. Engaging in consumption of alcoholic beverages in the client’s home; i. Smoking in client’s home; j. Soliciting money or goods from the client; k. Engage in yard maintenance; l. Engage in pet grooming; m. Engage in home repairs; n. Administering medication or giving injections; o. Using illegal drugs; p. Wearing high or spiked heels when working; q. Using abusive languaghe in the client’s home; r. Engaging in sexual misconduct with client; s. Cleaning up after anyone except client or client’s spouse if he or she cannot do so; t. Engaging in heavy cleaning; u. Hanging or laundering curtains; v. Waxing hardwood floors; w. Carrying firewood or containers of coal and ashes; x. Lifting or carrying large full garbage cans; or, y. Moving heavy furniture.