Caring for a spouse with a long-term disability almost drove Lucy Warner over the edge.
Her husband, Ernest Warner, 82, was paralyzed by a stroke in 1985. Like many elderly or ill people, the World War II veteran and great-grandfather prefers his four-bedroom East Los Angeles house to a nursing home.
Lucy Warner, 73, has had three spinal operations and uses a walker. Caring for her husband by herself was physically taxing and emotionally distressing.
"People who have strokes have a lot of hostility toward the spouse or person who takes care of them," she says. "He would throw things. He would cuss me out. And here is a man I love. We've been married 48 years.
"I couldn't accept his total disability. I am a person looking forward to retiring. I said, 'Why me?' I was on the verge of saying to heck with it, of committing suicide."
A friend referred Lucy Warner to AltaMed Senior Health and Activity Center in East Los Angeles. It provided a caretaker for her husband for five hours each day.
It also arranged to take Lucy Warner to the center four days a week for counseling, physical therapy and arts and crafts. Most of the services are paid for by Medi-Cal.
"Now I'm able to cope," says Warner. "I got involved with other people's problems in a support group. I can see there are people worse off than I am.
"I know that in the time I'm away, my husband is being taken care of. Then I have the energy to come home and take care of him the rest of the day and the evening."
Services to home care givers range from the comprehensive aid provided to the Warners to more limited assistance.
Los Angeles-area agencies furnish meals, nursing, counseling, adult day care, financial management, legal representation and home-safety improvements. They can also pierce the isolation that some elderly people experience with a daily phone call.
Services are also available to people who have specific diseases. There are groups that deliver meals, wash clothes, feed pets or provide cash grants for people with AIDS. The American Cancer Society furnishes beds, wheelchairs and other equipment for patients at home. It also helps people suffering hair loss, skin problems or other side effects of treatment to feel attractive again by using wigs and cosmetics.
Some agencies charge fees. Others accept only clients who are low income or live in a specific area. And some aren't as effective as others.
"The core of people working in this area is dedicated, caring and ethical," says Wayne Friedlander, deputy director of the Los Angeles Caregiver Resource Center at USC, which offers 2,000 services for home care givers.
"But this also happens to be an area which attracts marginal people who have fallen out of the economy and are trying to get back in," he says. "Minimum-wage personal-care jobs is one way to do that.
"The situation is very much 'buyer beware.' People have to have skills in hiring, checking references and supervising."
Nor is it always easy to find services, particularly from a referral group with thousands of listings.
"You often need to know exactly what you're looking for," says Phyllis Meltzer, education and resource coordinator at the Caregiver Resource Center.
"Suppose a person has a drastic change in behavior and forgets who a family member is. The doctor has recently said the person seems fine, but you think something is wrong. What you really need is a comprehensive geriatric assessment, but you might not know how to ask for that."
Another frustration for consumers is that services change rapidly, Meltzer says. By the time directories are published, many listings are out of date.
For referrals, consumers may call the Caregiver Resource Center, (800) 540-5442, or the 24-hour L.A. County Info Line, (800) 339-6993, which offers numbers for an array of services.