Person-Centered Care

October 15th, 2018

Two months ago, DOORWAYS employee Taylor McCabe transitioned from his role as a social worker at Cooper House to the newly created position as Manager of Person-Centered Care. Person-centered care is based on the concept stating that the individual receiving care is the primary leader of his or her own care, and is treated with dignity, respect, and compassion. The Department of Health and Senior Services regularly conducts audits and inspections to make sure individuals in care facilities are being treated with dignity and respect and receiving quality care. Cooper House consistently meets those standards and has been working for years to provide care beyond those state guidelines. We recently officially confirmed the person-centered care model through creation of the Manager of Person-Centered Care position, and McCabe’s promotion to launch the effort. “We are working towards a place where residents feel the needs they identify are truly being met. This is their home, so we want them to feel genuine care and compassion in every interaction, knowing they can trust us,” said McCabe. “It’s not ‘client’ or ‘tenant.’  We say ‘resident’ just like you would at any apartment building.”

DOORWAYS was founded in 1988 as a hospice for people with AIDS who were alone and homeless. Since then, life for people living with HIV/AIDs has changed. “Cooper House is no longer a final stop for most residents,” explained McCabe. “The goal is to get our residents back on their feet, help them take control of their health, and encourage them to start living independently.” But that path may be different for each person. Cooper House serves a diverse group of men, women, and transgender adults of various ages and races at different stages of health. For this reason, person-centered care is essential, as it focuses on individualized standards of practice:

  1. Presenting residents with choices regarding their care and livelihood.
  2. Recognizing that residents are the leader of their own treatment plans.
  3. Remembering that residents are human beings and treating each resident respectfully.

The first evidence of a person-centered care model is the use of goals created in consultation with each resident. Upon admission of every new resident, Cooper House social workers evaluate the resident’s health and life status, probing to understand their needs, expectations, and desires. Through that discussion, the residents create for themselves a set of goals. Staff use that as a foundational road map to inform the personalized care and support plan, in order to assist them in achieving positive milestones.

For some a first goal might be to reach a healthy weight, reversing the wasting and illness accompanying HIV/AIDS and homelessness. Others may want to commit to a treatment plan to reach viral suppression. For those with more stable HIV/AIDs symptoms, their goal may be to better manage other life challenges, such as mental health or substance use issues. As goals are met, new goals are established to continue the momentum.  “We have a meeting with each resident every three months at which we discuss their plan and help them assess their progress towards their goals,” noted McCabe. “We offer support and additional resources to keep them moving forward, or help them through hurdles when progress is lacking, keeping the focus on what they hope to achieve.”

One example of embracing the person-centered care model occurred in October 2017, when Cooper House welcomed their first openly transgender resident. To be able to care for her in a manner that would create a feeling of support and safety, it was important to understand her needs and expectations related not only to health care but, also, identity care—such as the use of the preferred pronouns and specific personal needs. Recognizing a need for expanded knowledge, Cooper House staff received education and training addressing best practices for working with transgender residents. Sharing information opened new paths of understanding, further enriching the Cooper House commitment to person-centered care. “I have seen a shift in culture within our staff,” noted McCabe. “Many have gone from a lack of knowledge to full understanding of the unique issues related to diversity. Now they are sitting on committees and working towards furthering education on how to care for transgender people.” In fact, Cooper House has developed a reputation for respectful care of transgender residents within the larger community. Since October 2017, the census has included five transgender residents. Management has been contacted by several organizations unaffiliated with HIV/AIDS seeking advice on best practices when working with transgender individuals.  “This is the result of fully embracing person-centered care,” said McCabe.

Person-centered care even begins before admission to Cooper House, and across service platforms. DOORWAYS provides housing to homeless individuals and families affected by HIV/AIDS through Cooper House as well as more independent living programs plus an emergency housing response and a subsidies service. Recently an individual with HIV/AIDS was released from prison into homelessness. She was referred to DOORWAYS by her Ryan White Medical Case Manager and provided with emergency housing. However, she began having seizures and was taken to the emergency room, where doctors were able to stabilize her. However, with an untreated seizure disorder, no income, no health insurance, and no support network, living alone in DOORWAYS’ emergency housing was no longer safe. Following a person-centered care philosophy, when she was discharged from the hospital, she was immediately admitted to Cooper House even before all Medicaid paperwork had been completed. “Person-centered care sometimes requires that we reorder our steps to assure that the patient’s needs are the primary focus of our efforts,” explained McCabe. Since moving into Cooper House, her life has totally changed. She has received much-needed medical care, medications, and treatments. Her seizures have stopped. “She is a bright light for all the residents and the staff. Her move to Cooper House has allowed her to thrive in a safe environment where she can focus on her health, because that’s what we do,” said McCabe. “We create opportunities for residents to make the changes in their lives that can lead them to a better level of health and hope.”

While it may take years of compassionate person-centered care, some residents do reach a point of health and hope that their goal becomes returning to independent living. A philosophy of person-centered care mandates attention to all needs of the individual at every phase of care, so planning and preparing for a life of independence becomes a goal to be achieved.  “When a resident begins planning to move out on their own, we begin practicing the responsibilities that will be needed when they no longer have 24-hour care. While still in Cooper House, we encourage them to manage their medication schedule and even introduce them to a home-health nurse who will stay connected with them after they transition into independent living,” said McCabe. Using his background in education, he is working to develop an expanded exit program that will include topics such as medical literacy, medical advocacy, and a vast array of resources to support them during their move and future life of independence. “Before they are admitted, during their stay with us—no matter how long—and even when they are preparing to leave Cooper House, our goal is to focus on what each resident needs as a unique individual. We want them to have stable health and stable housing for the rest of their lives. We can’t use a process and relationship of only one shape. We need to create a new mold for each person we serve.”

Through support from generous donors, DOORWAYS now celebrates 30 years of service to people in the City of St. Louis and 117 counties in Missouri and Illinois. Last year we provided a new beginning to 3,100 individuals. For more information, contact Karen Carpentier at 314-328-2704 or kcarpentier@doorwayshousing.org.

 

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Never Stop Trying to Move Forward

September 20th, 2018

“Julie” has had many ups and downs in life, but her faith has always given her the strength to keep fighting. At the age of 25, while working in corporate America, she felt a swollen lymph node and visited the doctor to see what it was. To her astonishment, she tested positive for HIV. In seeking answers, her husband received testing. They learned he was HIV+. Together, they began taking the various medications being used to treat this new virus, but they both were having complications. With a more advanced virus, and other difficulties in his life, her husband began experiencing worsening health conditions. He died of kidney failure in 1995.

While mourning the loss of her husband, Julie stopped taking the AZT when it became toxic to her body. She continued working throughout her illness, though, even starting a new job. Her boss was very supportive, providing extra time off with pay when she was ill. After several years, new medications were on the market. Her Pastor, two closest friends, and brothers all encouraged her to try the new drugs. This support network—and her faith that God had a plan for her to survive to help others—carried Julie through the worst of times. Trying times were still ahead.

Ultimately, Julie was too weak to work. After 16 years of full-time employment, she turned to Social Security Disability Insurance (SSDI) as her sole source of income. Her job became taking care of herself, so that she could regain her health and strength.

She first learned of DOORWAYS when she was having difficulty paying her bills. The DOORWAYS Subsidy program provided rent and utility support to prevent homelessness for those affected by HIV/AIDS. “I was so grateful for that financial assistance,” explained Julie. “It is a blessing to have access to services like those offered by DOORWAYS when you are sick and not able to make ends meet.”

Although she was still ill, she was stabilizing and seeing small improvements, but, in March of 2012, she began losing weight and losing hair. A second devastating diagnosis was about to change her life again:  Julie had Stage 4 Lymphatic Lung Cancer, but the doctors were hopeful. Six rounds of treatment should get the cancer under control. Already weakened by HIV, after three rounds of cancer treatment, Julie suffered a mild heart attack and mild stroke. Not even 50 years old, she moved into a nursing home, because she didn’t want to be a burden to anyone.

Julie recalled how sad and hopeless life felt in the nursing home. She had no privacy, no independence, and began feeling depressed. “But God showed me there is always hope. In August 2012 I learned I was cancer free. My Oncologist calls me his miracle patient,” smiled Julie, who was re-energized to continue her fight thanks to that doctor, as well as her infectious disease specialist who remained steadfast with her healthcare efforts.  In fact, after October 2012, Julie received the good news that the HIV virus was undetectable. She then focused over the next three years on her speech therapy and physical therapy, until she realized it was time to leave the nursing home, but she had no money in savings since all of her SSDI income paid nursing home bills. She heard about Cooper House, which is managed by DOORWAYS—a familiar friend that had been there for her before. In 2015, Julie visited Cooper House and was impressed with the 24-hour nursing care, the private apartment-style rooms with their own bathrooms, the 24-hour security, plus the dining and food services. It was also very affordable as an income-based service provider, which would allow Julie to save for a future move to regain her independence. She decided to move to Cooper House as her next step to regain her life.

While Julie felt the facility was wonderful, it was the staff at Cooper House that had the most impact on her. It was clear to her that the goal of Cooper House was to help her transition from the nursing home to independence. “The nursing staff along with trained medicine supply employees working alongside them showed me how to take my medications correctly. They made sure I ate enough and knew the right foods to eat. The social workers, case manager, and many others at Cooper House were very kind and helped me to stay motivated to move forward. I felt everyone really cared about giving me a better future.”

Due to Julie’s personal conviction, she grew stronger and more confident every day. After a couple years, she was ready to find a place of her own, and earlier this year, she did just that. Julie now lives in an apartment and is ready to help others who are struggling without hope. She knows God blessed her in many ways throughout her struggles, and the people in her life were His greatest gifts. She is grateful for her Pastor and his wife, her church family, her beloved three older brothers, her relatives, her circle of friends, plus DOORWAYS and all the other people who have joined her on her journey back to stability, health, and independence.  “I’m here by the grace of God. He has worked so many miracles in my life. I hope telling my story helps people see they should never stop trying to move forward—no matter how many setbacks they have.”

 

Through support from generous donors, DOORWAYS now celebrates 30 years of service to people in the City of St. Louis and 117 counties in Missouri and Illinois. Last year we provided a new beginning to 3,100 individuals. For more information, contact Karen Carpentier at 314-328-2704 or kcarpentier@doorwayshousing.org.

 

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Everything I Do, I Do For My Kids

August 17th, 2018

Mechelle Pierce & KW

KW left Florida eight years ago, fleeing an abusive relationship. They walked away with nothing but what would fit in their car. She and her two children (then age 7 and 10) moved to Troy, IL, where they knew people.  KW also left a job as a CNA in a nursing home. Dedicated to stabilizing her family, she quickly found a day shift job in Troy. They were rebuilding their lives. After six years, their apartment was now their home. The boys liked their school, and KW even began advancing her credentials by starting a Certified Med Tech program, so that she could better provide for her children. A year later, everything changed. The nursing home reduced staff, and KW lost her job. With limited nursing homes in Troy, she needed to look for a job farther away. “I was passionate about finding a job,” said KW. “I worked on it constantly, because I had two kids who depended on me. I didn’t want us to be homeless.”

Unfortunately, her hard work was overwhelmed by life. During her search, her car broke down. Without much public transportation, finding a new job became even more difficult. She had been living on her savings. When the money ran out, she was evicted in November 2017. “I arranged for my boys to stay in Troy to finish school,” she explained. “Then I started thinking of where I could stay.” She had heard of DOORWAYS and called to ask about Emergency Housing. “That same day I got into a motel in Troy. I was so relieved and grateful.” But KW knew this was only temporary housing assistance. She needed to find a job, so she again turned to DOORWAYS’ Employment Specialist, Mechelle Pierce. “I was very impressed with KW’s commitment, qualifications, and work experience,” noted Pierce. “I knew she was qualified, but her location had very few opportunities.” Pierce discussed moving KW out of Troy and into St. Louis where more CNA jobs were available. Focused only on putting her life back together for her children, she agreed.  DOORWAYS moved her to emergency housing in Bridgeton in January 2018. Within a few weeks, she had a job. “Mechelle brought me applications and helped me get to places to apply. By the end of January, I was offered a job, which I started February 1.”

KW’s housing allocation ended late February. She then moved into a shelter for five months while she saved enough money for an apartment for her family. “Besides the money, I had a difficult time finding a place to live because I have an eviction. When I lost my job in Troy and used all my savings, I was evicted. Most people won’t rent to you if you have an eviction,” she explained.  DOORWAYS was able to help by connecting KW to a landlord who agreed to rent to her. “All I can say is that DOORWAYS helps people have second chances,” smiled KW.

She moved into her new apartment early July. Her oldest son graduated from high school, and both boys will be back with her soon. They secured three mattresses, so each has a place of their own to sleep. She is still gathering furnishings to make it a home for her family. “We have a sofa, but no dressers yet. I’m looking for shelving and cabinets for the kitchen to have a place to store things and prepare meals for my boys.” Even though her house is minimally equipped, KW is grateful beyond words. “It’s wonderful having a place where I can have my kids, and that we can call home again. Everything I do is to give my boys a better life. It’s a blessing to have this chance to be back together.”

Through support from generous donors, DOORWAYS now celebrates 30 years of service to people in the City of St. Louis and 117 counties in Missouri and Illinois. Last year we provided a new beginning to 3,100 individuals. For more information, contact Karen Carpentier at 314-328-2704 or kcarpentier@doorwayshousing.org.

 

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Camp Kaya 2018

August 15th, 2018

Through a generous grant from the Norman J. Stupp Foundation – Commerce Bank, Trustee, the DOORWAYS Residential Program was able to offer a five-week summer camp for the children living at the Family Residential Complex. Fifteen children aged 5 to 14 attended the camp, which started on Monday, July 9, and just concluded on Thursday, August 2, running Monday through Thursday from 9 a.m. to 2 p.m.

In addition to a variety of arts and crafts—such as making your own tie-dyed shirts and painting—Camp Kaya also welcomed special guests. Representatives of the University of Missouri Extension/Missouri Botanical Garden taught a class about gardening, seeds, and fruits. Campers planted vegetable seeds and monitored their growth over a two-week period, hopefully gaining an interest in gardening as a fun activity that can create family time as well as fresh produce for the household.

Mad Science of St. Louis, along with their Imagine Arts Academy, collaborated to offer eight exciting hands-on activities to engage imagination and creativity. With their theme of “putting the fun in science,” Mad Science of St. Louis combines education with science-related entertainment to captivate campers while also encouraging exploration and a desire to learn more. Camp Kaya participants learned about the science of magic and illusions, with the chance to perform a Houdini-style escape; tackled the curious cube; and uncovered the source of sounds through sonic waves. Activities included creating vibrations and using sound effects. School supplies and a new bike where incentive to affecting camper attendance. At the closing ceremony, all campers received a backpack full of schools supplies to start the 2018 school year.

Summer opportunities such as Camp Kaya also foster teamwork, encourage personal growth, and enhance self-confidence. For children in low-income, low-service areas without nearby resources, summer camps provide a safe place for fun, socialization, and learning. They also address hunger issues. Camp Kaya included meals and snacks, which helps assure the children have adequate nutrition during the summer—often a time of hunger when school is out. “Summer meals programs across the nation directly address this need,” noted Opal M. Jones, president and CEO of DOORWAYS. “But statistics show that out of the 22 million children receiving school lunch assistance, only 4 million are getting a summer meal due to challenges related to distance, limited transportation, and unsafe neighborhoods, for example. Thanks to the Normal J. Stupp Foundation – Commerce Bank, Trustee, DOORWAYS was able to provide a fun, interactive learning opportunity for the children, and assure they had enough to eat over the summer.”

Through support from generous donors, DOORWAYS now celebrates 30 years of service to people in the City of St. Louis and 117 counties in Missouri and Illinois. Last year we provided a new beginning to 3,100 individuals. For more information, contact Karen Carpentier at 314-328-2704 or kcarpentier@doorwayshousing.org.

 

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A New Beginning

July 20th, 2018

Her only focus was to survive for her children. In 1999 when KC was diagnosed with HIV, she was a single mother of four who had just escaped an abusive relationship. She was young and afraid, but driven to create a good life for her four children. Her first goal was to find a place to live. When her case manager told her about DOORWAYS housing opportunities, KC quickly applied and was approved. “When I got the news, I was so elated, because I felt like this was a new beginning for me and my children,” she recalled. She quickly moved herself and her young children into the apartment.

KC learned that a DOORWAYS apartment not only provides a safe place for those with HIV who are homeless, or at-risk of homelessness, to stabilize their lives, but it also provides access to essential resources. All clients receive an intensive intake assessment to identify critical needs. Those needs are addressed through individual case management with extensive referrals to whatever resources are needed: healthcare, food security, counseling, employment assistance, transportation, schools/day-cares, etc. As KC explained, DOORWAYS also offers self-development workshops:   “DOORWAYS has provided a world of opportunities to me and my family such as providing HIV education, financial literacy classes, nutrition classes, support groups, and even tutors for the children.”

During the early years, she was battling depression and anxiety as her life was filled with such uncertainty. By working with the DOORWAYS staff and utilizing the many resources offered to her, KC was able to regain her stability and begin building a bright future for herself and her children. Her primary focus was to assure her children would receive a good education, so that they would have access to good paying jobs and a life of self-sufficiency. She set an outstanding example by completing an associate’s degree in arts from St. Louis Community College with a focus in human services.  Following her footsteps, her four children have committed themselves to their schooling as well. They graduated from high school, and set their sights on college. KC proudly noted that her daughters just graduated from St. Louis Community College. One is working as a dental assistant while the other is pursuing a bachelor’s degree in business management. Her oldest son graduates from the University of Missouri next year, while her younger son is currently attending St. Louis Community College—with the hope to open his own photography business.

KC and her family are one household living in the 103 apartment units throughout DOORWAYS’ seven permanent housing complexes. In addition to the seven residential complexes for clients who are able to live on their own, DOORWAYS also provides housing to homeless individuals and families affected by HIV/AIDS through a 36-bed care facility for the more seriously ill, an emergency housing program, and an intensive Jumpstart program for homeless single parents with children. Efforts to prevent homelessness are achieved through a subsidies program to assist with rents and utilities.

“Housing is healthcare,” explained Opal M. Jones, president and CEO of DOORWAYS. “HIV/AIDS is treatable. It is no longer a death sentence, unless you are homeless without access to health care, medications, and the stability of a place to call home where you can regain your strength and find your hope for a brighter future.” That’s just what DOORWAYS gave to KC and her family. Housing and a support network provided a firm foundation from which KC could launch her efforts to nurture her family and herself, building a thriving family through hard work, dedication, and hope. “DOORWAYS has been a blessing to me and my family,” explained KC. “My family has received so much help, love, and support from the staff. I know without DOORWAYS’ support and God’s grace, I could not have made it this far.”

Through support from generous donors, DOORWAYS now celebrates 30 years of service to people in the City of St. Louis and 117 counties in Missouri and Illinois. Last year we provided a new beginning to 3,100 individuals.  For more information, contact Karen Carpentier at 314-328-2704 or kcarpentier@doorwayshousing.org.

 

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Click here for more information on the Residential Program.

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CLICK HERE to Make a Donation to DOORWAYS