As an alternative to a traditional nursing home facility, the U.S. Department of Veterans Affairs has turned to a new program in which those in need of assisted-living care are treated in a more intimate setting.
Medical foster homes place up to three patients, typically veterans, in the private home of a vetted caregiver who is responsible for their care on a daily basis. Additionally, physicians, therapists, social workers and other VA staffer members regularly work with the patients.
Through the Baltimore VA Medical Center, Wanda Williams, 52, runs a medical facility at her Catonsville home. Williams has worked in health services since 1983, when she started her professional career as a nursing assistant. She also cared for her younger brother, who suffered from Down syndrome, until his death in 2009.
"I love making a difference," said Williams, who is caring for two veterans. "I love being able to take care of these people who have given so much."
Her responsibilities include minding her patients' hygiene, providing three daily meals and snacks, coordinating appointments and planning outings. While she finds the work satisfying, she acknowledges that it might not be for everyone.
Williams is still certified as a geriatric nursing assistant. While the VA does not require caregivers to be certified nursing assistants, the home must be licensed by the state as fit for assisted-living care, and is inspected annually by the medical center's social workers. As part of the home license, caregivers complete an 80-hour training before they can accept patients, and additional 20-hour training sessions annually.
Although the VA connects and monitors the housing situations, the veterans pay caregivers, who earn between $1,500 and $3,000 monthly, depending on the level of care.
"The hardest part would probably be not being able to come and go as you please," she said. "But I enjoy being home in my own space and giving them my undivided attention."
Nicole Trimble, a social worker at the Baltimore VA, said the program, which began in 2012, was started to replicate the home environment for patients, rather than the more clinical setting of an institution.
"The individuals are receiving such personalized care," she said. "They're seeing the same faces — not having to constantly see new people — and are able to get much more attention than they would elsewhere."
The program accepts veterans of all ages who require assisted living, with most caregivers having experience dealing with specialized diseases such as dementia and Alzheimer's. In some cases, where illnesses are particularly severe, hospice care is also provided.
Family members of those in the program have been impressed by the level of attention their loved ones receive.
Brenda DeLoach's brother is under Williams' care.
"I'm able to come by any time, and every time I see him, he's happy and looks good," DeLoach said.
So far, there are four medical foster homes associated with the VA in the Baltimore metro area, but Trimble hopes to bring on an additional two to three each year moving forward.
"It's a wonderful alternative for those that need the help but choose to remain in the community as long as possible," she said. "And, for the veterans, they have the chance to be with other veterans. It's something that connects them."
Peter Samaras, a 60-year-old Army veteran, has been a patient at a medical foster home in Edgewood for just over a year. One of his favorite parts of the program is his relationship with his roommate, who also served in the Army.
"We get along good," Samaras said. "He's my buddy, my brother."
Because of the program's relative newness, experts in geriatrics and assisted-living care were uncertain about its long-term potential. But Husher Harris, a longtime volunteer with the AARP who works with the organization's mental health programs and an Army veteran himself, said he supports the initiative.
"Each time that a veteran receives home-like care versus an institution, it's much better," he said.