Providers of Home Care in Budget Pinch

Mary Burse can hardly remember when she first met Georgia Logan, only that it was about 30 years ago on a Sunday. Back in the days when Logan was the newest member of Zion Baptist Church in Compton, and Burse was a young congregation member who wanted to make her feel welcome.

They taught Sunday School together, and after Burse was in a bad automobile accident 15 years ago, Logan helped her back to health, deepening their friendship. Now, with Logan, 82, weak, nearly blind and alone, it is Burse, 58, who is there to help.

Burse is Logan’s home health care worker, one of approximately 40,000 men and women in Los Angeles County who provide care and companionship to the elderly and disabled. They dress the blind, dispense medicine to the sick, bathe, cook and shop for the weak and perform a myriad of other tasks--all for the state minimum wage of $4.25 an hour. They can earn a maximum of $1,202.75 per client per month--less if the client is not severely disabled.

Poor Helping the Poor

They are often the middle-aged taking care of the elderly, the poor taking care of the poor. According to home care union and program officials, 95% of Los Angeles County home care providers are women, 90% are black or Latino.

Their jobs are the result of a decade-old state program designed to provide services to the poor and infirm who would otherwise have to be institutionalized at tremendous costs to the state, said Julia Takeda, In-Home-Supportive-Services program deputy for Los Angeles County. State and county officials point out that it is less costly to provide home care workers for disabled people than to pay for nursing home care.

Recently, about 15,000 home care workers in Los Angeles County have made headlines by forming a union and pressing their fight for health insurance, sick pay and the right to negotiate for raises.

But before they can attain a pay increase, the workers must forestall a proposed $64-million state budget cut to the in-home services program, a cut that would be achieved by freezing their pay at California’s minimum wage and limiting their work hours.

They also need an employer. Supervised by the county but paid by the state, they are workers with no one to bargain with or get benefits from. The 1 1/2-year-old home care workers union is preparing to go to court for a second time to try establish the county as their employer, or to have the court recognize the county and state as joint employers, said Kirk Adams, chief organizer for the union of home care workers in Los Angeles County.

Health care experts praise the home care workers for providing companionship as well as care and credit them for enabling the infirm to maintain some dignity and independence.

“They are lifesavers,” said Dr. Monika White, assistant director of the Senior Care Network at Huntington Memorial Hospital in Pasadena. “Most people want to live at home, no matter what the home is like . . . you can always say, ‘At least I’m not in a nursing home.’ Dignity is very important.”

Slightly more than half the home care workers in Los Angeles County are taking care of their relatives or close friends, Takeda said. Ann Kreibaum is one, a woman who had to give up a $30,000-a-year job as a data entry operator to care for her son, severely disabled by a stroke in 1981. The rest are paid to take care of strangers. Many of them stay with the often-demanding work because they develop close bonds with their clients or get a sense of personal satisfaction from helping others, especially the elderly.

The relationships are not always easy. “The older generation is very resistant to help,” White says. “You’re talking about people who lived through the Depression, who pulled themselves up by their bootstraps.”

Georgia Logan was one of those people. A teacher in her youth in the South, she worked as an Avon Lady most of her life, selling makeup until she became legally blind. Her bedroom dresser is covered with jars and bottles, long empty of any perfume, that serve as reminders of the days when she drove the streets of Los Angeles peddling cosmetics.

“She loves her keepsakes,” said Burse, smiling as she made up “Miss Logan’s” bed one Wednesday morning.

It was 11 a.m., and Burse had just finished preparing a plate of sausage and eggs for Logan. “She loves to eat,” Burse said, chuckling and washing off fruit in the kitchen.

Soon, the two women sat eating fruit at the dining room table while Logan knitted an afghan and Burse read the newspaper. Despite their apparent concentration, each of them was following a TV drama.

“She’s falling for that con man,” said Logan, shaking her head over “The Young and The Restless.”

“She sure is,” replied a disapproving Burse.

The young woman in the drama suddenly told her handsome suitor, “I want you to meet my dad,” and both women, like schoolgirls watching a horror movie, yelled in unison “No, you don’t!”

Their days are often like this, the two women say. Between Burse’s cooking and cleaning, there are chats about the news, giggles over commercials with dancing raisins, trips to the Carson shopping mall with Burse guiding Logan through store aisles--and an occasional gentle scolding, as when Logan leaves her electric blanket on too long or loses a bill. The hours go well beyond the 96 per month Burse is paid for.

“I don’t know what I’d do without her,” said Logan, a widow with one daughter she doesn’t see very often. “She’s closer than a sister or a daughter because when I need her, she’s there.”

“I been around (nursing) homes, seen how people were treated,” she said. “I don’t want to go there.”

Jane Allen, another elderly woman dependent on her home care worker, knows exactly what Logan is talking about.

One recent Wednesday afternoon, Allen, 73, sat in a wheelchair at Alden Terrace Convalescent Hospital where she was recovering from a stroke. She puffed away on Marlboro cigarettes as she waited for her home care worker, Claudia Johnson, to visit. “This is bunk,” she said. “I have my own house.” She gave a cold stare and an icy reply to a visitor who asked if she had made any friends in the hospital: “Hell, no.”

But when Johnson arrived, Allen’s eyes lit up and her scowl changed to a smile. Johnson, said Allen, “is my best friend. Without her, I’d do nothing. Just sit in the house.”

Johnson, who also cares for another elderly woman, went to work for Allen 3 1/2 years ago. But as they gossip and giggle over mutual friends and events in their South-Central Los Angeles neighborhood, they act like they have always known each other. Johnson, usually Allen’s only visitor, can look at a tray of hospital food sitting before the elderly woman, see that she is not eating, and instantly know why: “Must not be any salt on it.”

Johnson, 54, is not paid for the time Allen is in the hospital because she is not officially performing her home care duties. But it doesn’t matter. She makes the 30-minute drive every other day for two-to-three-hour visits with Allen, who is never ready for her to go.

“It makes you feel good when you do something for a person and they appreciate it,” said Johnson, who gave up a better-paying job as a hairdresser to do home care work full time.

But Burse and Johnson say there is another reason they do this work, despite the low wages. When they look at the weathered faces of their clients they see their own elderly relatives--or themselves in 20 years.

“She’ll be 83 on Sept. 4,” Burse said of Logan. “The same age my mother would be if she was living. She could have been the same way. She could have lost her sight. I used to ask her to come live with me, but she wouldn’t leave her house in Arkansas.”

Said Johnson: “I think about how I’m getting older and you don’t ever know what’s going to happen in your life. And if I was sick or down, I would want someone to see about me. I wouldn’t want to be shoved somewhere.”

A Drive for Lunch

And they find rewards for what they do. For Johnson, it comes from driving Allen down to a local lunch counter for her favorite lunch--a plate of spaghetti and a cup of coffee.

For Burse, it comes with the memory evoked when she looks at a decorated candle that was a dying gift from her last client.

“I saw her going down,” said Burse, remembering the woman, who had suffered from cerebral palsy. “The 23rd of December she was gone. But she had already bought me a Christmas gift, a beautiful candle, and when she passed, her daughter gave it to me.”

“You know I still got it?” she asked, her eyes misting over. “I keep it on the little archway in the door, and I look at it and love it because she gave it to me.”

Things like that candle, she said, make her proud to be a home care worker.