SELF-DIRECTED ATTENDANT CARE

MEMBER INFORMATION

SDAC MISSION AND VISION

Self- Directed Attendant Care (SDAC) is a new model of service delivery for attendant care. Members choosing SDAC will have:
•	More options in deciding who their Attendant Care Workers are
•	The ability to choose how/when services are delivered
•	More control over services received
•	Greater responsibility in managing personal health.

Members have the right and the ability to make decisions about how to best get their needs met, including who will provide the services and when the services will be provided. SDAC allows members to make decisions about the services they want and how to receive them.  With the SDAC service option, members will hire, train, supervise, and (if needed) fire attendants.

The mission and basic philosophy of this service option is tied to the ALTCS guiding principles.  SDAC is based on the idea that members best know their own individual needs and how to address them.  SDAC promotes choice, dignity and independence. SDAC’s purpose is to improve the quality of life by empowering members and promoting in-home community living.

Terms You Need to Know

SDAC – Self Directed Attendant Care: The program this manual is about.

Member – This is you; the person who is participating in the ALTCS program, living in your own home and wanting to hire your own Attendant Care Worker (ACW).

ACW – Attendant Care Worker: This is the person you will be hiring to provide the care that you need.

FEA – Fiscal Employer Agent: This is the agency that will help you take care of all taxes, payroll withholding and paychecks for your ACW.

SELF DIRECTED ATTENDANT CARE

F What is Self Directed Attendant Care?

Self Directed Attendant Care (SDAC) allows a member to make decisions about the services he or she wants and how to receive them. A member best knows his/her own individual needs and how to address them.  SDAC allows a member to assess their own needs, decide how and by whom they are met, and define what quality is.  Members choose which services to receive and the dates and times they receive the services.   Members can hire the attendant they choose including family members, friends, and neighbors (with the exception of spouses, parents of children 18 and younger and legal guardians who are overseeing the care).  Members are also responsible for supervising and firing attendants.   Attendants can assist members with personal care needs.

F How does the Self Directed Attendant Care Service Option work?

The SDAC option allows the member living in their own home to manage their own care.  The member is able to recruit, hire, supervise and fire, if necessary, his/her own Attendant Care Workers (ACWs).  These workers can assist with tasks such as bathing, driving, housework, cooking and other in- home tasks. They can also do some skilled nursing tasks. Just like Attendant Care services received from an agency, members, together with their case managers, develop their service plans, including the number of hours per week they will receive help.

F How is Self Directed Attendant Care different from other program options?

SDAC  puts  the  member  in  charge  of  his  or  her  services  (interviewing, training, directing, managing and dismissing workers as necessary).  Other major differences include:

•	Member decides which services best meet individual needs
•	Member hires and supervises Attendant Care Workers (ACWs)
•	Spouses cannot be hired under SDAC.  If a member wants his or her spouse to be the paid caregiver, the spouse must be hired by an agency.
•	Member rates the quality of services
•	Training, technical assistance and support are available

•	A Fiscal Employer Agent takes care of all taxes, payroll withholding, and paychecks.
•	An attendant care worker (ACW) under the SDAC service option can perform some specific skilled nursing tasks as part of their duties, while an ACW employed by an agency cannot do these types of
tasks.

F Will help be available if needed?

Yes.	If the plan the member has developed does not work, contact the member’s case manager.  If any part of this service does not work, contact the case manager.

F How will the Member work with the Case Manager?

The member will still receive case management services from the case manager. The member will work with the case manager to decide:

•	What help the member will need.
•	How much help will be needed each day.   The member may still receive	other  services  such  as  Home  Health  Nursing,  medical equipment and supplies, home modifications, and emergency alert systems as they always have.

F An Attendant Care Worker has been chosen. What next?

Once the member hires an Attendant Care Worker (ACW), the member will meet with him/her.   The case manager can help the member talk about his/her needs if necessary.  The member will sign a Self Directed Attendant Care Member/Attendant Care Worker Agreement (refer to Forms section) between him/herself and the ACW. The agreement will list what the ACW will do for the member and what the work schedule will be.  It will also say what the ACW will be paid to perform the duties.

The ACW will not be able to begin helping the member until both have completed and signed all the necessary forms.  The ACW will also have to communicate with the agency that will be taking care of all the taxes and withholding, referred to in this manual as the Fiscal Employer Agent (FEA). The FEA will also get the timesheets the member sends in and make up the ACW’s paycheck.  It is important for the member to complete all the forms because the worker cannot be paid until the forms are signed.

F What is the first step for the member to start to direct his/her own services?
ƒ	Ask the case manager.
ƒ	Complete a Self Directed Attendant Care Agreement (found in the
Forms section of this manual).

Self Directed Attendant Care
ROLES, RIGHTS, AND RESPONSIBILITIES

THE MEMBER

F MEMBER ROLES

•	Interview and hire Attendant Care Worker(s) (ACWs)
•	Work with the Fiscal Employer Agent to have all paperwork signed by the member and each attendant hired
•	Participate in the development of the service plan
•	Prepare an outline of duties for ACW(s)
•	Develop an emergency back-up plan made up of ACW(s) and/or an agency that can assist if a regular ACW is not able to come at the time he/she is needed.
•	Schedule the ACW(s)
•	Train the ACW(s) in the way the duties should be performed
•	Direct the care received from the ACW
•	Complete and sign timesheets and send to  the Fiscal Employer
Agent, as arranged
•	Supervise ACW(s), including letting them go if necessary

F MEMBER RIGHTS

All adults, no matter what age or limitation, have the right to:

ƒ	Make his/her own decisions
ƒ	Direct his/her own life
ƒ	Live where he/she chooses
ƒ	Access all the opportunities in his/her community

In addition to the rights that all ALTCS members have, members who choose the Self Directed Attendant Care (SDAC) service option have a right to:

•	Be safe
•	Be treated with courtesy, consideration, and respect
•	Confidentiality in care
•	Privacy
•	Set their own house rules
•	Trust their instincts
•	Refuse service if it does not meet their needs

•	Voice complaints/concerns
•	Be free from mental, physical and emotional abuse
•	Change their worker
•	Make their own decisions
•	Know about any changes in SDAC, in a timely manner
•	Request a new assessment if their needs have changed
•	Leave the SDAC option and get attendant care services from an agency
•	Have access to information (forms, training, etc.) in a language and format that best meets their needs

F MEMBER RESPONSIBILITIES

In addition to the responsibilities expected of all ALTCS members, members who choose the SDAC service option have the responsibility to:

•	Recruit, hire, train and supervise their ACW(s)
•	Make sure that all required paperwork is sent to the Fiscal Employer
Agent, in a timely manner
•	Review their ACW’s timesheet to make sure it is accurate and does not exceed the authorized hours
•	Report any gaps in services to their case manager
•	Fire an ACW by following Federal and State laws, if the ACW is not doing a good job
•	Notify their case manager of any change in their health or situation
(hospitalization, declining health, etc.)
•	Manage their own health
•	Make sure that they are receiving quality service and report any problems or concerns to their case manager
•	Communicate clearly and openly with their ACW and their case manager
•	Be considerate and respect the limits of others
•	Direct the ACW to perform duties per the approved care plan

THE ATTENDANT CARE WORKER

F ATTENDANT CARE WORKER ROLE

The role of the Attendant Care Worker (ACW) is to provide attendant care services outlined in the service plan while maintaining a safe and comfortable environment.   The member and the case manager are responsible for creating the service plan.  An attendant care worker (ACW) under the SDAC service option can perform some specific skilled nursing tasks as part of their duties, while an ACW employed by an agency cannot do these types of tasks.

F ATTENDANT CARE WORKER RIGHTS

An ACW in the Self Directed Attendant Care option has the right to:

•	Receive	a	clear,	well-defined	set	of	expected	tasks	and	time schedule
•	Receive requests for any additional tasks or schedule changes with as much advance notice as possible
•	Receive clear, step-by-step instructions for doing tasks
•	Be told ways of doing task(s) that are logical and time/effort efficient
•	Receive instructions and other communications in a clear and direct manner
•	Be provided with equipment and supplies that are adequate for performing assigned tasks
•	Be	provided	with	the	wage	information	prior	to	accepting	the position and be paid for all services rendered
•	Perform tasks in a safe working environment
•	Negotiate	additional	tasks	requested	by	a	member,	including requesting additional training
•	Receive from the member the confidentiality, respect and dignity as a human who has personal thoughts, values, beliefs, relationships,
activities and a personal life outside of providing attendant care
services
•	Express reasonable concerns regarding working conditions
•	Express feelings about work expectations

F ATTENDANT CARE WORKER RESPONSIBILITIES

An Attendant Care Worker (ACW) in the Self Directed Attendant Care services option has the responsibility to:

•	Know his/her own skills and limitations and to discuss them with the member
•	Be dependable – to arrive on time and be ready to go to work
•	Notify the member as soon as possible when they know that they will be late or unable to work
•	Give a two-week notice if s/he will be quitting (unless s/he is in danger if work is continued). An ACW may quit for any reason.
•	Provide reliable, safe, high quality services as directed, in a thorough and caring manner
•	Respect the member’s dignity, privacy, property, religion, and culture
•	Leave personal problems at home!
•	Report any suspected abuse, neglect, or exploitation of a dependant elderly or disabled person
•	Complete and submit time cards as instructed; timecards should be accurate and completed in a timely manner
•	Keep personal information about the member and/or their family confidential
•	Complete training as instructed by the member
•	Communicate	clearly	and	honestly	about	feelings,	needs	and routines
•	Report emergency situations to the proper authorities
•	Not work more hours than are authorized for the member
•	Report hours worked accurately and honestly on the time sheet

THE CASE MANAGER

F CASE MANAGER ROLE

The role of the case manager is to inform, educate, empower, and support the member’s right to independence.  The member and case manager will work together to develop a service plan that best meets the member’s needs.

The case manager will continue to help the member get the healthcare he/she needs. The case manager will still visit the member in his/her home every 90 days.

F CASE MANAGER RESPONSIBILITIES

•	Inform and educate all members about the Self Directed Attendant Care
(SDAC) services option

•	Refer members to other resources for further information about SDAC
services

•	Help with enrollment with the Fiscal Employer Agent

•	Refer to training resources based on the member’s training needs

•	Verify that the member understands his/her own role and responsibilities in the SDAC option

•	Facilitate any transition from SDAC to receiving services from an agency and vice versa

•	Monitor members having skilled care tasks done by their ACW to ensure they continue to be medically stable.

F HOW TO CONTACT THE CASE MANAGER

The case manager will still be available by phone during business hours Monday through Friday (except for holidays).  If you need help after work hours or on weekends, you can still call the case manager or the after hours on-call staff that can assist you.

F WHEN TO CONTACT THE CASE MANAGER

•	If there are any changes in your health or situation.
•	If you are admitted to the hospital or another care facility.
•	If there are any gaps in your care that you are unable to fill with your backup plan.
•	If you experience any type of abuse, neglect, exploitation or feel you are being treated badly.
•	If you have questions about the SDAC services option
•	If you need copies of any of the SDAC forms

THE FISCAL EMPLOYER AGENT

F FISCAL EMPLOYER AGENT ROLE

•  The Fiscal Employer Agent (FEA) provides financial services that are required of employers on behalf of the member

•  The FEA monitors the number of hours Attendant Care Workers (ACWs)
are paid, making sure that no more than the hours authorized are used.

F FISCAL EMPLOYER AGENT RESPONSIBILITIES

•	Establish members as employers

•	Prepare and distribute ACW hiring packets

•	Review and verify ACW new hire paperwork

•	Perform all employer payroll duties

•	Pay ACWs on a bi-weekly schedule

•	Withhold, deposit, and file payroll taxes

•	Handle year-end employer filing requirements

•	Submit claims to the health plan for the member’s SDAC

•	Perform background checks as requested

•	Help members and case managers track ACW services provided through monthly statements that report hours used and hours remaining.

•	Contact	case	managers	and/or	members	about	over-	and	under- utilization of services or problems identified with time sheets, etc.

•	Provide reports to Program Contractors regarding service utilization

•	Provide toll-free customer service assistance to employers and ACWs on all FEA activities.

APPEAL AND GRIEVANCE RIGHTS

Under Self Directed Attendant Care (SDAC) the member has the same appeal and grievance rights as they have with any other service they receive as an ALTCS member.  Given below are short summaries of these rights and what to do.  The Program Contractor Member Handbook explains in detail how to go about filing a grievance or an appeal.

A grievance is a statement from the member that he/she is unhappy with any part of the care they are receiving from ALTCS.  The member can call or write their case manager.  The case manager has up to 90 days to take care of the issue but will usually resolve grievances within 10 days.

If the member has chosen SDAC but their doctor and/or their case manager decide that this is not the best way for the member to receive care, the case manager will send the member a written Notice of Action.  If the member receives a Notice of Action and does not agree with it, he/she can tell the case manager that he/she wants to file an appeal.

The member must tell the case manager that they want to file an appeal within 60 days of getting a Notice of Action Letter.  A health care provider or someone else the member chooses can help him/her file an appeal if needed. During the appeal process, the member will still receive SDAC.

NEEDS AND SERVICE PLANNING

DECIDING WHAT IS IMPORTANT TO YOU

Reviewing your lifestyle will help you understand your own needs and preferences so that you can work with your case manager to develop a service plan.  It will also help you clearly communicate your needs to your Attendant Care Worker (ACW). Here are some questions to help with this:

•	What is really important to you?

•	What do you value most about your lifestyle?

F RATING YOUR PRIORITIES

•	Knowing  what  is  really  important  to  you  and  what  you  cannot compromise on can help you find an ACW who will improve your quality of life.
•	You should think about what qualities you are looking for in an ACW
that will help make the quality of your life better.
•	Once you have determined what qualities are especially important to you in an ACW, you may want to discuss these qualities during employment interviews.
•	In addition, you may want to pay close attention to any information a prospective ACW shares that relates to these qualities.

Fill out the Rating Your Priorities form (in the Forms section) to help you figure out what is important to you in your lifestyle.

After you have completed the Rating Your Priorities form, take note of the things that you find more important as you look for ACWs, interview them and train them.

DETERMINING YOUR NEEDS AND DEVELOPING YOUR SERVICE PLAN

F IDENTIFYING NEEDS AND HOW TO ASSESS NEEDS

The “What Do I Need?” Checklist (found in the Forms section of this manual) was designed to help you identify how much help you may need in each area of daily living.  Use the checklists to help you decide what you will want your worker to do.

Activities of Daily Living are personal things you do on a daily basis.  Some examples of daily living are:

•	Meal Preparation	y	Grooming	
•	Bathing/Showering	y	Housekeeping	
•	Toileting	y	Moving Around	
•	Dressing/Undressing	y	Transportation	

You may also need help with some skilled nursing tasks. These include:

•	Bowel care, including suppositories, enemas, manual evacuation and digital stimulation
•	Bladder catheterizations (non-indwelling) that does not require a sterile procedure
•	Wound care (non-sterile)
•	Glucose monitoring
•	Glucogen, as directed by the health care provider
•	Insulin; subcutaneous injection only if you are not able to self-inject.
Sliding scale dosing for insulin
•	Permanent gastronomy tube feeding
•	Additional services if approved by AHCCCS and the Arizona State
Board of Nursing.

Note:  If you wish to have your ACW do the above types of skilled services for you, a registered nurse must visit you and the ACW before these services are provided so that the nurse can assess, educate and train you both and make sure that the ACW demonstrates the skill to perform these services for you.

You may find some of these tasks hard to perform on your own due to your physical limitations.   Take time to assess your need in each area on the “What Do I Need” Checklist.  You can talk to your case manager and your ACW about how much help you will need with each task.

NOTE:   You should be aware that there is equipment available to help improve your ability to perform some of the tasks on your own. Examples of equipment include:  walkers, grab bars, shower chairs, etc. The goal is to help you remain as independent as possible.

USING YOUR “WHAT DO I NEED?” CHECKLIST

When you fill out your “What Do I Need?” Checklist, be sure to take your time. Be honest with yourself about how much help you may need. The checklist is located in the Forms section of this manual. Below are some ways the checklist can be helpful to you.

•	You can use the “What Do I Need?” Checklist to help when you and your case manager develop your service plan.

•	You can use your completed form during employment interviews as you discuss your needs with a prospective ACW.

•	You and your ACW can also use the completed forms as you create daily and weekly activity schedules.

•	You can use the form to train and manage your ACW.

WHAT ARE MY TRAINING NEEDS?

You will use many different kinds of skills while participating in Self Directed Attendant Care.   You are the person who can best decide what kind of training you need.  Your case manager will help you set it up.  There is a form called Training Needs Checklist For Members in the Forms section of this manual that will help you determine what skills you need as a member in Self Directed Attendant Care.

If you wish to have your ACW do skilled services for you, a registered nurse must visit you and the ACW before these services are provided so that the nurse can assess, educate and train you both and make sure that the ACW demonstrates the skill to perform these services for you.

DETERMINING MY HOURS

The number of hours your Attendant Care Worker (ACW) will be able to work each week will be decided in this way:

•	You and your case manager will talk about your situation and what tasks you need help with.

•	You and your case manager will work together to determine how much time each task you need help with takes.

•	Together  the  two  of  you  and  any  other  people  you  want  to participate will decide on the number of hours your ACW can get paid to help you do the tasks you need help with.

•	The case manager will authorize the hours determined necessary.

•	The  case  manager will  let  the  Fiscal  Employer Agent  know  the number of hours authorized.

•	The Fiscal Employer Agent will notify the case manager if the ACW
sends in a time sheet with too many hours.

•	It is very important that you keep track of the hours your ACW works each week.  If he or she consistently goes over the hours authorized, you may be asked to leave this program and return to getting help from an agency ACW.

FINDING AND CHOOSING AN
ATTENDANT CARE WORKER

HIRING AN ATTENDANT CARE WORKER

JOB DESCRIPTION

The first step in the hiring process is to write a job description.  See the example Job Description at the end of this section.  A well-written job description makes supervising easier for you because the duties are clear to you and the Attendant Care Worker (ACW).

•	A written job description helps give you a snapshot of the type of person you are looking for.
•	It helps you decide what qualifications and previous work experience your ACW should have.
•	It will help you to develop questions you will ask during screening and interviewing.
•	It can be used to write a newspaper ad, a bulletin board flier or to describe the job during a telephone interview.

F PARTS OF THE JOB DESCRIPTION

1.  Job Title - The job title should identify the type of work to be done: most likely it will be Attendant Care Worker or some other words you would like to use (i.e., Caregiver)

2.  Job Summary - The duties listed in the job description are specific tasks that the ACW must know how to perform before being hired or be trained to perform upon hiring.
•	A brief description of you, as the employer, and your physical limitations
•	A short list of the main duties
•	A brief outline of the work schedule

3.  Qualifications and Qualities of the Attendant Care Worker –
State what the ACW must have to become your employee
•	Pre Employment Requirements
o CPR Certification
o First Aid Certification

•	Required for Employment
o Proof of citizenship or legal residency
o Social Security card
o Two forms of valid identification
•	Suggested Requirements – It is recommended that you require
these things, especially if you are hiring someone you do not know.
o Criminal background check
o References from previous employers
o Driver’s record and proof of insurance (if the ACW will be
driving you)
o Tuberculosis (TB) Screening (the ACW can contact the local
Health Department to get more information on this)
•	Also include anything else you want in an ACW. This may include:
o Reliability: work as scheduled, or call as much in advance as possible when unable to work
o Promptness:  Be on time or call when delayed more than 10 minutes
o Cleanliness: keep a neat and clean personal appearance, while working
o Flexibility:  be able to change the schedule, tasks, etc. if you need to
o Willingness to talk about and resolve employment-related problems

4.  Duties to be Performed – These are the list of tasks with which you need assistance.  This could be a listing of the broad areas you need help with.  If you have a complicated routine, you might want to attach a more detailed task checklist to the job description.  You can use the “What Do I Need?” Checklist for a very detailed list.

Invite the ACW to take the job description home to review and list any questions that occur to them. Make sure they are comfortable with the duties before you hire them.

5. Work Schedule and Comments – This is where you state the specific days and times that you expect your ACW to work, including number of days, hours, and weekends (if required).

SAMPLE JOB DESCRIPTION

Job Title: Attendant Care Worker 	Date:  	

Position Summary:  An Attendant Care Worker performs or assists with performing routine tasks of daily living for an individual with a functional disability as per the employer’s instructions.

Qualifications:

•	Caring individual who is willing to perform required tasks with confidentiality, dependability, flexibility, and sensitivity
•	18 years of age or older
•	U.S. Citizen or permanent resident
•	Physically able to accomplish required tasks
•	Must have two valid forms of I.D.
•	Able to travel to and from employer’s home
•	Must have a valid Social Security Number
•	Must be able to provide personal and/or professional references
•	Must submit to a criminal background check
•	Must have CPR and First Aid certifications

Job Duties:

•	Housekeeping: Laundry, cooking, shopping, cleaning
•	Personal Care: Bathing, grooming, transfers, help with dressing
•	Other: Accompany to doctor’s appointments, help with medication set-up

Schedule: Monday and Wednesday – 8:00 am to 4:00 pm; Saturdays – 9:00 am to 1:00 pm

FINDING WORKERS/ADVERTISING

If you do not have someone already in mind for the job, you might want to advertise or get the word out.  Below are some suggestions for places to advertise:

•	Friends and neighbors	y	Employment agencies	
•	Churches	y	Library and community bulletin	
•	Local newspapers		Boards	
•	Local hospitals or nursing	y	Organizations for people with	
homes		disabilities	
•	Local medical clinics	y	Local colleges	
•	Your doctor			

F ADVERTISING

The first step is to put together an ad.  It is best to make the ad short and to  the  point.    Give  just  enough  information to  catch  the  eye  of  an interested applicant.  Include your telephone number or email address, but not your address.

Here are the main ways to advertise for ACWs:

Bulletin Boards

•	You can post flyers, posters or 3x5 cards on bulletin boards
o Check rules for posting
o You may wish to make your flier with a tear-off section at the
bottom that has your name and contact information
o Choose bulletin boards where many people will walk by:

ƒ	College dorms
ƒ	Malls
ƒ	Churches
ƒ	Apartment complexes
ƒ	Health facilities
ƒ	Supermarkets

Newspaper Ads

•	Tend to be expensive
•	Review the types of newspapers in your community and pick one you think will reach the most people
•	Check for special rates for weekend editions
•	The ad should be short. You will pay by the word.

F SUGGESTIONS ON WHAT TO INCLUDE:

•	Catchy help wanted headline
•	Brief personal profile
•	Live-in or out
•	Duties and requirements (i.e.: driver’s license)
•	Prior experience, if desired
•	Gender preference
•	Location – general area- Do not include your address.
•	Hours and days needed
•	Perks – if any (i.e.; travel)
•	Preferences – non-smoking, non-drinking, etc
•	Contact information – time to call
•	References required

HELP WANTED
Woman with a disability seeking assistance with personal care, light housekeeping and meal prep. PT/Flexible hrs. Call 555-5555,
10AM –4PM.

Man with disability looking for assistance in my home in Casa Grande. Help needed with some personal care, light housework, and cooking. Part time, $9.50/hr. Must be reliable.  Call Jim at 555-5555, 9AM-8PM.

PROS AND CONS OF HIRING

F	HIRING FRIENDS OR NEIGHBORS

Pros
•	You will know them before you hire them
•	A neighbor will live close by so it will be convenient for him/her to work the hours that you may need

Cons
•	Might be hard to keep as an ACW
•	The possibility of losing a friend if the job does not work out

F	HIRING FAMILY MEMBERS

Pros
•	The loving care of a family member
•	You may feel more comfortable asking for what you need

Cons
•	Keeping an employer/employee relationship may be hard

F	HIRING PEOPLE YOU DO NOT KNOW

Pros
•	It	may	be	easier	for	you	to	establish	an	employer/employee relationship
•	You may find someone who has experience working as an ACW

Cons
•	You do not know anything about the person or their character except for what turns up with a reference or background check

SCREENING, INTERVIEWING, REFERENCE AND BACKGROUND CHECKS

F SCREENING CANDIDATES

When someone calls you, it is best to check out some basic information by phone before setting up an interview.  Be ready and organized for these phone calls. This is your first impression for being the employer. Make it a good one!

•	Give a short job description; include their duties, the times you want them to work, and the amount of money and payment schedule.
•	Ask questions that are most important to you.  Take notes. You can refer back to their answers if you need or want to.  Some examples of questions you might want to ask.

o Ask for their name, address and phone number
o Have you ever done this type of work?
o Tell me a little about yourself.
o Briefly tell me about your work experience and
education
o Do you have reliable transportation?	Do you drive?
o Can	you	lift	and	transfer	(put	number	of pounds) pounds?
o Can you be at my home at 6:00 am?
o Do you smoke or drink?
o Are you willing to fill out an application, give
three references, and have a background
check?
•	Give them detailed information about any  special care you  may require (i.e., bowel or bladder care).   Describe any situations that may be embarrassing or uncomfortable for an Attendant Care Worker
(ACW).
•	Explain special job requirements (CPR and First Aid certification, etc.)
•	Explain any special requirements you may have (skilled needs, lifting, etc.)
•	You may want to go ahead and set a time to meet with the person if they sound like they may be right for the job.  You should meet them
at a public place or have someone at home with you when you meet.

•	If not, tell the person you will be returning calls to applicants you feel are right for the job, say within a week, to schedule an interview.
•	Thank them for calling.

Another great way to screen applicants is to have each one fill out an application for the job.  When you read over job applications, you want to determine if the candidate has the necessary qualifications to meet your needs.

The job application is more than a list of jobs and job references. Here are some things to look for:

•	Is it neat? Is it covered with grease spots or coffee stains?  This may be a clue about how they will do your work – sloppily.
•	Did they follow directions?	Did they answer all the questions?
This may tell you how well they follow directions.  It also may show how much attention they give to detail.  This is important if you have a complicated routine.
•	Does  it  raise  any  questions that  you  should ask? Did the applicant have jobs similar to attendant care work?  Did the applicant do	totally  different  work?    Why  does  he/she  want  to  change positions?
•	Did the applicant provide the references you asked for?   If not, why not?
•	Some simply will not be suitable and you will eliminate them as your possible ACW.

A sample job application is found in the Forms section of this manual.

F INTERVIEWING

After screening your pool of applicants, you need to set up some times to do interviews. Take notes during the interview.  If you have never done an interview, the following are a list of things that might help you:

•	Write down your questions.
•	Ask everyone the same questions.
•	Ask open-ended questions. (See the Communication section for information about open-ended questions.)

•	Do not interview alone. Have a friend or family member sit in with you. Often another person will notice things you don’t.
•	For security reasons, if you live alone you may want to pick a quiet, public place to do the interview.

The first time you do an interview, it can be a little scary. Remember you are the one who has the job to offer and the applicant is at least as nervous as you are.

•	Make sure you introduce yourself.
•	Start out by asking them to complete the forms you need:
o Self Directed Attendant Care Application for Employment (with references and authorization to check them)
o Background Check Consent Form (get from your case manager)
•	Allow them time to do this without interruptions.

F ADDITIONAL INTERVIEWING TIPS

•	Take time to go over the information with the applicant to make sure they filled everything out correctly.
•	Have a pen and paper to take notes as you do the interview.
•	Remember  that  your  first  meeting  is  an  important  one,  so  be organized. Have questions and information ready.
•	Discuss the job in detail.	Use the “What Do I Need?” Checklist and your Job Description. Be specific about bowel care, shower care, or
any other areas of care that may have special instructions.
•	The work done by an ACW has a lot of personal contact. It is best to state	openly  that  it  is  O.K.  to  feel  a  bit  uncomfortable  when discussing some of the job duties. Just be honest, say so, and move on.
•	Discuss hours, rate of pay and time off.	Let the applicant know how and when they will be paid.
•	At the end of the interview, thank the applicant for coming and ask them if they have any questions.
•	Let the applicant know when you will be making a choice on who you will hire.	For example, by the end of the week or the first of the
month.

REMEMBER!
If you do not know the applicant, it is best to wait until after you check references and/or conduct a background check before you offer him/her the position.  Even if you like the applicant, it is best to wait until you have more information.

F GOOD INTERVIEW QUESTIONS

•	Ask the applicant again about their transportation and whether they can drive you to medical appointments or shopping if necessary.
•	What are the applicant’s strengths and weaknesses?
•	Ask the applicant what interests them about this job
•	Ask the applicant about previous jobs – what was the best part of the job? The worst?
•	Ask the applicant why they left their last job
•	Ask the applicant to tell you about a time on the job when they made a mistake, and how they handled it.
•	Ask about availability for back-up.

F LEGAL/ILLEGAL INTERVIEW QUESTIONS

Subject	Illegal Questions	Legal Questions	

National Origin/ Citizenship	
Are you a U.S. citizen?	Are you authorized to work in the United
States?	
	Where were you/your parents born?	What languages do you read, speak or write fluently? (This is an ok question as long as this ability is relevant to the job.)	
	What is your native "tongue"?		

Age	How old are you?	

Are you over the age of 18?	
	When did you graduate from high school?		
	What is your birthday?		

Marital/ Family
Status	
What is your marital status?	Would you be willing to relocate if necessary?	
	Who do you live with?	Would you be willing to travel as needed by the job? (This question is okay as
long as ALL applicants interviewed are asked it.)	
	Do you plan to have a family? When?		
	How many kids do you have?	Are you willing to work overtime? (This question is okay as long as ALL applicants interviewed are asked it.)	
	What are your child care arrangements?		

Affiliations	
To what clubs or social organizations do you belong?	Do you belong to any professional/ trade groups or other organizations that you consider relevant to your ability to perform this job?	

Personal	How tall are you?	
Are you able to lift heavy objects?	
	How much do you weigh?		

Disabilities	Do you have any disabilities?	
Based on the job, can you perform these essential functions?	
	Please complete the following medical history.		
	Have you had any recent or past illnesses or operations? If yes, list and give details.	
As part of the job process, you are required to pass a medical exam.	
	What was the date of your last physical examination?	

Can you demonstrate how you would perform the following job-related function?	
	How's your family's health?		
	When did you lose your eyesight?		

Arrest Record	

Have you ever been arrested?	Have you ever been convicted of
?  (The crime should be reasonably related to the performance of the job in question.)	

Military	
If you have been in the military, were you honorably discharged?	In what branch of the Armed Forces did you serve?	
		What type of training or education did you receive in the military?	

F REFERENCE CHECKS

If you are going to check references for the job applicants, you need to have them complete and sign the Self Directed Attendant Care Application for Employment in the Forms section of this manual.  The application form has space allocated for three references. When you call the reference, introduce yourself and tell them that you are considering hiring the individual. Ask the following questions:

•	How long have you known the applicant?
•	Is the applicant responsible and honest?
•	Did the applicant come to work on time?
•	What are the applicant’s strengths and weaknesses?
•	Would they recommend this person to be an Attendant Care Worker?
•	If this is a previous employer, ask if they would hire the person again.

F BACKGROUND CHECKS

As an employer, you have the right to have a background check done on the people who apply to work for you. A background check can include a nationwide or local criminal history check. It may include a credit check.

If you want to have a background check done, contact your case manager to get the Background Check Consent Form.  Have the person you want to hire sign this form. The Fiscal Employer Agent will conduct the background checks for you.

F DECIDING HOW MUCH TO PAY YOUR WORKERS AND JOB BENEFITS

This will be determined by your ALTCS Program Contractor.   Your case manager will talk to you about the pay and any benefits available for the ACW.

CHOOSING A QUALIFIED PERSON(S) FOR THE JOB

Now it’s time to decide which applicant(s) you will hire. If you have screened applicants carefully, interviewed thoroughly, and checked references, you probably have “gut” feeling about the applicants.  As you review your list of candidates, you might want to consider the following:

•	Were you satisfied with the answers that the reference gave you?
•	Was the applicant on time for the interview?
•	Were you comfortable with each other in the interview?
•	Did the applicant give you the number of references you asked for?
•	Do you think the applicant has the skills and personality to do the job?
•	Does the applicant seem healthy, strong, energetic and pleasant?
•	Was the applicant clean, neat and presentable?

F GENERAL GUIDELINES

Here are a few general guidelines you can use to help you decide:

•	Trust your “gut” feelings and intuitions about the person
•	Hire someone you feel is trustworthy and who has respect for your privacy
•	Hire someone who is pleasant and has a positive attitude
•	Hire someone with good references

You have the option of having more than one Attendant Care Worker.   If there are a couple of good candidates that are available at different times or have different skill sets that would benefit you, you may choose to hire more than one ACW.

DON’T HIRE SOMEONE:

•	Who makes you feel uncomfortable
•	You don’t like, out of desperation for assistance

F PRE-EMPLOYMENT REQUIREMENTS

There are two certifications that your Attendant Care Worker (ACW) must have before ever being hired by you.  Those are CPR and First Aid.  A description of each can be found below.  It is important to remember that both types of certification have to be renewed every two years.  It will be your responsibility to make sure that your ACW renews his or her certification in a timely manner, as needed.

•	Cardio-pulmonary Resuscitation (CPR):   This training will teach your  ACW  what  to  do  if  your  heart  stops  beating  or  if  you  stop breathing.   The ACW will need to show you and the Fiscal Employer Agent proof that he or she has finished this training.

•	First Aid:  This training will teach your ACW what to do when accidents or emergencies happen.  They will learn what to do if you choke, cut yourself and start bleeding, get a burn, have a seizure, and much more.

F OFFERING THE JOB

Once you have narrowed down your choices, list them in the order you prefer. Once your number one choice has passed all the screenings (reference and background checks), offer the position to your number one choice.

When offering the job, let your prospective Attendant Care Worker (ACW)
know:
•	When and where to report to work.
•	What must be kept confidential when you offer the job. It is a good idea not to discuss personal matters until you know them better.
•	That they must meet with the Fiscal Employer Agent to complete all their employment paperwork.
•	That they can be let go at any time if it is not working out.

Once you have made a choice and the ACW has accepted the job:

•	Call the other applicants to let them know you have made a choice
•	Keep names, addresses and phone numbers of people you decide not to interview as possible back-up attendants.
•	Proceed to the next section of this manual for further direction on what to do next.

AFTER HIRING AN ATTENDANT

Once you have decided on an ACW you want to hire, you need to call your case manager to get things started.  The case manager will make a referral and authorize services from the Fiscal Employer Agent (FEA), who will handle all the paperwork to get your new ACW hired and ready to get paid. You may already have a packet from the FEA to give to the worker to fill out.

If you will be having your ACW do skilled nursing tasks for you, be sure your case manager knows this so s/he can arrange for a registered nurse to train and assess you and the ACW on those tasks before the ACW begins to do them.

F ORIENTATION MATERIALS

To help your new worker understand Self Directed Attendant Care (SDAC), it is important to give him/her the TRAINING MATERIALS AND OTHER RESOURCES FOR THE ATTENDANT CARE WORKER section of this manual. You can use any of the materials in that section to train your ACW.  You might want to give your worker copies of some of the pages or have him/her read through sections that you feel are important.

It is all up to you.
You are the one directing your own care.

EMPLOYMENT AGREEMENT AND SCHEDULE

It is important that you have a signed Self Directed Attendant Care Member/Attendant Care Worker Work Agreement (found in the Forms section of this manual) so that both you and the worker understand:

•	What the worker will be doing (give your ACW a copy of your “What Do
I Need?” Checklist)
•	What the worker’s schedule will be, including the start date and the number of hours authorized
•	What the pay will be (subject to change if rates are changed)

F WHAT YOUR ATTENDANT CARE WORKER WILL BE HELPING YOU WITH

Give your ACW a copy of your “What Do I Need?” Checklist.  You want to be sure that the ACW does the things that you need help with and does not use up the time doing things that you can do yourself.  Remember, you and your case manager have developed a service plan that describes what your worker will do and how many hours a week have been authorized to get those things done.

FISCAL EMPLOYER AGENT (FEA)

The Fiscal Employer Agent, also known as the FEA, is the agency that will handle all the paperwork and financial part of being an employer.  The FEA will get you signed up to be an employer.  This agency will also make sure that your worker is legally able to work for you and that he or she signs all the forms and paperwork needed to be your worker.  The FEA will handle all the withholding required for taxes, Social Security and anything else that needs to come out of your worker’s paycheck.

The FEA will give you timesheets to use to keep track of your worker’s hours. You will be responsible for sending signed timesheets to the FEA on the agreed upon schedule. The FEA will issue the worker’s paycheck at least every two weeks.  The FEA will also check that the hours are not more than they should be and let your case manager know if there is a problem.

If you have questions or need help, the FEA will have a toll-free number to call.

TRAINING YOUR ATTENDANT CARE WORKER

A very important part of hiring someone is training that person for the job.  Many problems that occur between employer and employee are due to a lack of training.

Generally, how much you train your Attendant Care Worker (ACW) is up to you.  However, there is some training that is required.  This is to make sure that whoever  you  hire  knows  what  to  do  in  case  of  an
emergency, an accident, if your heart stops beating, and how to keep you and your home sanitary.  Some training is required and other training is optional. Refer to the TRAINING INFORMATION AND MATERIALS FOR THE MEMBER section of this manual for the orientation schedule and the TRAINING MATERIALS AND OTHER RESOURCES FOR THE ATTENDANT CARE WORKER for training materials.

If you know your ACW well and he or she knows you and what you need well, you may not have to do much training at all.  Below are some general information and suggestions about training.

•	It is important that you explain what you need.

•	Be specific about what you need.  Do not expect your ACW to know this information!

•	Ask your ACWs if they understand your needs and if they know how to do the tasks. Have them show you how they would do things.

•	Be sure to take the time to train.  Use this manual or ask your case manager to arrange training you want your ACW to have that you can’t do yourself.

•	Work together to train each other, so you both will know what to expect about the tasks of the job.

•	If you wish to have your ACW do skilled services for you, a registered nurse must visit you and the ACW before these services are provided so that the nurse can assess, educate and train you both and make sure

that the ACW demonstrates the skill to perform these services for you. Your case manager will arrange for this to be done.

•	Before you start training your ACW make sure you know what you will expect from your new employee.	Look at your “What Do I Need?” Checklist and the schedule on the Self Directed Attendant Care Member/Attendant Care Worker Agreement.

•	Even if your ACW is a friend or family member, it’s still a good idea to train them. Just because someone knows you, doesn’t mean they are going to know how you like things done in your day to day life.

You can use the materials in the TRAINING MATERIALS AND OTHER RESOURCES FOR THE ATTENDANT CARE WORKER section of this manual if you want to do the training yourself.  If you want someone else to do the training, call your case manager.

F HOW TO TEACH SOMEONE NEW TASKS/A NEW ROUTINE

You need to be as patient and flexible as possible during the training period. Training time will depend on the difficulty of the tasks and how quickly the ACW learns.   Training time may be shorter if you have another ACW demonstrate the more difficult tasks.   Remember:   each person learns differently.   Some may take longer than others to get your routine the way you want it. Training time can vary from a few hours to a couple of weeks.

If you have a complex routine that requires special attention to detail, you may want to have an experienced ACW help you in training your new ACW. One of the best methods to teach a new ACW is by demonstration.  You may want to consider having a family member or friend make a video tape of appropriate parts of your routine.  Another consideration would be to write down the details of the task to be completed and review that with your ACW. This would give the ACW something to refer back to if necessary.

F ACW SKILLS CHECKLIST

There are some skills that are necessary for your ACW to have in order to provide you the service(s) that you need.   Those skills are outlined in the Attendant Care Worker Skills Checklist, found in the Forms section of this

manual.  Be sure to complete this form, keep a copy for yourself, give a copy to your ACW, and forward a copy to the Fiscal Employer Agent.

BEING A SUCCESSFUL EMPLOYER

GENERAL INFORMATION

Many of the problems that occur between employers and employees are due to inadequate training and poor communication.

•	Don’t assume your Attendant Care Worker (ACW) knows how to do something without having been given proper training.
•	Explain your routine in detail; if necessary write it down.	You can use your “What Do I Need?” Checklist.
•	It usually takes a couple of weeks to establish your routine with a new
ACW.

As a good employer, you should:

•	Help the ACW feel good about work
•	Know which tasks you can do yourself
•	Communicate your needs clearly, assertively, and respectfully
•	Encourage respect and trust
•	Compliment the ACW for doing a good job
•	Be patient when the ACW makes a mistake
•	Give suggestions for improvement politely but firmly
•	Keep your home a safe place to work

F THINGS TO REMEMBER

•	Make the job rewarding for your ACW.
•	It is very important to praise your ACW when they are doing a good job.
This can be as simple as saying:
o	“You have done a good job”
o “I really appreciate the job you are doing!”
o “I appreciate your help.”
•	By telling the ACW what you like about how they are doing the job, the
worker will find the job more satisfying. They will stay with you longer.
•	Even if your ACW is a friend or a family member, do not forget to let them know they are doing a good job.
•	If a task is not being done the way you like it, tell your Attendant Care
Worker right away. Tell them how you want it to be done.

•	Clearly explain your routine and home care needs in detail.	This will help make you a good employer.
•	Use your “What Do I Need?” Checklist.

Taking the time to talk to your Attendant Care Worker will be the key to your success with Self Directed Attendant Care!

F OTHER IMPORTANT THINGS TO REMEMBER

•	If you every feel uncomfortable with your ACW or how they are treating you and your property, call your case manager.
•	Always protect yourself, no matter how nice your new ACW appears to be.
•	Always track your money, medications, mileage, and telephone calls.
Lock up your jewelry, and ask for receipts when your ACW buys things for you.

EVALUATING YOUR ATTENDANT CARE WORKER

Another important part of managing your Attendant Care Worker (ACW) is giving them regular reviews of how they are doing the job.   Even if you have hired a friend or family member you should still do a review.

You can use the Evaluation Form in the Forms section of this manual to note your ACW’s performance.

NOTE: Do not wait for a formal review to let your Attendant Care Worker know if they are not doing something the right way. Tell them right away.

POINTERS ON SUPPORTIVE FEEDBACK

Feedback gives us a chance to change what we are doing until we get it right. You cannot expect your Attendant Care Worker (ACW) to correct mistakes unless he/she knows about them.   It is critical that you give feedback, whether positive or negative, as soon as you see the behavior. Experts tell us that behaviors become habits in about 30 days.

If you wait to give feedback, your ACW may have already developed bad habits that are hard to break.    When you give feedback, you prevent the ACW from learning the skill the wrong way. They will continue doing it in a way that doesn’t match your wishes.

F GIVING FEEDBACK

•	How you give feedback is as important as what you say.
•	Always keep your criticism respectful of the person.
•	Keep it focused on the task at hand.
•	Be direct and specific.
•	Remember you want to bring out the best from your ACW.
•	To get the best, give your best!

Strengthen positive actions you like through comments that are:

•	Timely (right after the observed behavior, if possible)
•	Specific (exactly what went well or what didn’t)
•	Respectful (focused on the how the task was done, not the character of the person)

LETTING YOUR ATTENDANT CARE WORKER GO

NEVER use termination as a threat if your Attendant Care Worker (ACW) isn’t doing a good job! When you talk about termination, you should mean it.

F STEPS TO TERMINATING AN ATTENDANT CARE WORKER

1. Set a date for the termination

2. Make sure you have someone else present, either a family member, friend, or your case manager.

3. Have your signed Self Directed Attendant Care Member/Attendant Care
Worker Work Agreement out at the time of the discussion.

4. Make a list of anything the ACW may have, such as keys to your home.
Ask for them at the time of termination.

5. Have your backup system ready to go before the termination.

6. Let the ACW know the job is not working out as you had hoped and you no longer need their services.

7. If they ask you “why”, refer to the documented discussions and your Self Directed Attendant Care Member/Attendant Care Worker Work Agreement. DO NOT ARGUE WITH THEM!!

8. Tell them when they can pick up their last check.

9. If they become angry or offensive, ask them to leave immediately and call the police, if necessary.

BOUNDARIES

F A BOUNDARY IS THE:

•	Emotional and physical space between you and another person.

•	Limit or line which you will not allow anyone to cross because it will not be emotionally healthy and will cause you physical and mental discomfort.

•	Emotional and physical space you need to behave like the real you without the pressure from others to be something that you are not.

•	Healthy emotional and physical distance you can maintain between you and another so that you do not become trapped and/or dependent.

•	Clearly defined limits within which you are free to be yourself with no restrictions placed on you by others as to how to think, feel, or act.

•	Set of traits which make you a unique, independent person who has the freedom to be a creative, original problem solver.

F		BOUNDARIES AND A RELATIONSHIP WITH YOUR ATTENDANT CARE WORKER

Since personal care is so personal, it is important to be aware of the potential issues that may arise as you work toward developing comfortable boundaries with your Attendant Care Worker (ACW).  Take some time to look at what a boundary is and then look at the “signs” of healthy boundaries.

Keep in mind that it is always important for you to be aware of your own behavior and what it might be saying to your ACW.

Signs of healthy boundaries include:

•	Appropriate trust
•	Deciding whether you want to be friends with your ACW or keep your relationship on a professional level
•	Be sure you protect yourself by making a clear defined boundary in the area of personal touch
•	Keeping personal values despite what others want
•	Noticing when someone else displays inappropriate boundaries
•	Noticing when someone invades your boundaries
•	Saying "NO" to food, gifts, and things you don't want
•	Asking a person before touching them
•	Respect for others--not taking advantage of someone's generosity
•	Self-respect--not giving too much in hope that someone will like you
•	Not allowing someone to take advantage of your generosity
•	Trusting your own decisions
•	Knowing who you are and what you want

ENSURING QUALITY SERVICE

QUALITY SERVICE

The Arizona Long Term Care System (ALTCS) requires that anyone providing care to you provide quality care that meets your needs and is done in a safe and respectful way.   Since you will be in charge of your Attendant Care Worker (ACW), it will be up to you to make sure that the quality of the services you receive from that ACW is high and meets your needs.

You are the supervisor. You need to make sure that:

•	The care you receive is what you need
•	That your ACW really works and takes care of you
•	That your ACW doesn’t work hours that the case manager has not authorized
•	That your health or quality of life does not decline because your ACW
isn’t doing the job right or well.

If you are not able to do this, your case manager will talk to you about what might help you.  Training can be made available to you to help you discuss your needs and teach you how to make sure they are met.  You may also consider using traditional services if you would prefer to use an ACW from a local agency.

F QUALITY IN HEALTH CARE MEANS:

•	Getting the care you need
•	Three balanced meals a day that includes vegetables, fruits, and protein and any special diet required by your doctor
•	Exercise, stretching, range of motion, walking, or as recommended by
your doctor
•	Cleanliness of body including bathing and grooming (hair, nails, teeth)
•	Skin free from sores or pressure area
•	Enough to drink (water, juice, etc.)
•	A home that is safe and clean
•	Medications available when ordered and taken as directed
•	Member satisfaction
•	Religious/spiritual and/or social activities are met as desired

CREATING AND MAINTAINING A BACKUP PLAN

Having backup Attendant Care Workers (ACWs) is very important to your quality of life.  Backups are people who are willing to assist you when your regular ACW is suddenly unavailable.

Sometimes ACWs get sick or they have car trouble or their children are sick. Suddenly finding yourself without help can be a very upsetting situation.  You will need to plan ahead to set things up so that if your ACW cannot come, you will still get the help you need.

Since your ACW may at times become unavailable, it is up to you to have a backup plan.  You will need to work with your case manager to develop your backup plan.  Your backup plan can include a family member, friend, another ACW, or an ACW from an agency.  It will be your decision on who you want for your backup ACW and how quickly you want a replacement.  Your backup plan is a formal document that will be signed by you and your case manager.

F SUGGESTIONS ON HOW TO PREPARE FOR A BACKUP:

•	Keep your backup plan that you developed with your case manager readily available.
•	Develop a list of people who are willing to serve as emergency backup
ACWs for you.	Use the Backup Attendant Care Worker List form in the
Forms section of this manual. Find out their schedules, when they could and could not come.
•	If you already have several people working for you, ask one of them if they are willing to work an extra shift for a short time during an
emergency.
•	Talk to family, friends, former personal attendants, church volunteers, job interviewees that you didn’t hire, etc. to see if they would be willing to fill in.

•	If your backup ACWs need to be paid, make sure they have registered with the Fiscal Employer Agent.
•	Keep your list current by updating it every six months or so, and keep it close at hand.
•	If  your  regular ACW  does  skilled care  tasks  for  you,  your  backup caregivers may also have to do these tasks for you.  In order for the
backup ACW to be paid to do skilled care, they also have to be assessed and trained by a registered nurse and be able to demonstrate the skill to
do those tasks.	It would be wise to get this done for your backup caregivers before you need to use them.

It may be a good idea to prioritize your needs using your “What Do I Need?” Checklist. In an emergency you may only be able to get your essential needs met.

If your ACW is not able to come as scheduled, it is up to you to decide what to do:

•	If you decide you can get by until the next time the ACW is due to come, call your case manager and let them know your ACW could not come.

•	If you need someone before the next time your ACW is scheduled to come, you will need to refer to the backup plan your case manager helped you with.  Call your case manager and let them know you had to use a backup ACW.

•	If you can find no one to help you and you need help right away, call your case manager.

•	If your backup ACW has not been trained and certified by a registered nurse to provide your skilled care, call your case manager and ask him/her to arrange for a Home Health nurse to come and provide those services for you.

PLANNING FOR EMERGENCIES/KEEPING SAFE

F EMERGENCIES

It is very important to discuss what to do in case of an emergency with your Attendant Care Worker (ACW) as part of his/her orientation.  Additional information on Fire Safety and Prevention is located in the GENERAL INFORMATION FOR MEMBERS AND ATTENDANT CARE WORKERS section of this manual.

•	Discuss routine emergencies such as first aid for cuts and burns and if you have any specific requests, allergies, etc.
•	You may want to map out a plan for any type of emergency that you may face. Be sure to include information that relates to your disability.
•  Take time to practice your emergency plan with your ACW.

Make sure your ACW knows:

•	What to do in case of a fire
•	What to do in case of a medical emergency
•	What medicines you are allergic to
•	Where your medical supplies are located
•	Who to contact in case of an emergency
•	The	location	of	your	home	phone	and	the	following	emergency numbers:
o Doctor/ Pharmacy o Ambulance service o Fire department
o Close relatives or friends

See the Emergency Plan form in the Forms section of this manual to help you develop your personal emergency plan.

FALL PREVENTION

Many falls occur in or around the home. Older adults and members with physical conditions that impair vision or mobility are at a high risk of falling. Falls are a leading cause of injury, hospitalization, and death.

F TIPS TO MAKE LIVING AREA SAFER AND REDUCE FALLING RISKS

•	Be Active.  Regular activity and stretching exercises keeps muscles and bones strong.
•	Have Regular Health Check-ups. Changes in your vision, hearing and muscles could lead to a fall. Visit your doctor regularly.
•	Do A Home Safety Check.  Basic home safety features include secure handrails, well lit stairs, night-lights, non-skid bath mats and grab bars
for tubs and next to the toilet.
•	Light Up  Your  Path.    Use  night-lights  to  brighten  dark  hallways, bathrooms and stairways. Improve lighting throughout the home.
•	Secure Rugs.	Small rugs or mats could easily slide or bunch up and
cause someone to trip. Remove throw rugs. Bare floors are best.
•	Remove Clutter. Clear objects from stairs and traffic areas.
•	Create Safe Stairways.	Install sturdy handrails on both sides of stairs.
Keep steps in good repair and make certain that carpets are firmly attached. Have good lighting at top and bottom of stairs.
•	Stay Indoors During Icy or Snowy Conditions.  Have friends, family or neighbors help you with shopping and errands. Exercise indoors.
•	Use Walking Aids Correctly.	Fit canes or walkers to your height. Adapt
cane for icy sidewalks.
•	Don't Rush. Rushing increases your risk of falling. Take your time.
•	Use Alcohol Wisely.   Moderation is the key. Don't mix alcohol and medications. Remember that the effects of alcohol can change as you age.
•	Use Medication Safely.	Some medications including "over the counter"
ones	can	make	you	drowsy,	dizzy	or	unsteady.	Check	with	your pharmacist or doctor.
•	Keep Emergency Numbers by All Phones for Easy Access.  Getting help quickly after a fall can prevent a hospital stay. Keep a telephone within
reach of the bed for emergencies.

•	Make Time for Friends.  Seniors who are able to enjoy time and have fun with friends and family are less likely to have a fall. Check on your friends regularly.

FRAUD, ABUSE, NEGLECT, AND EXPLOITATION

Fraud, Abuse, Neglect, and Exploitation are all very serious crimes.   You should not have to suffer from any of these actions.  Information on how to recognize these issues and how to protect yourself can be found on the following pages. For more information on these topics, please refer to the “TRAINING  MATERIALS  AND  OTHER  RESOURCES  FOR  THE  ATTENDANT CARE WORKER” section of this manual.

WHO TO TELL IF YOU SUSPECT FRAUD, ABUSE, NEGLECT OR EXPLOITATION

•	If you are in immediate danger you should call 911 for assistance

•	Call your case manager

•	If you are over 18, you may call Adult Protective Services at
1-877-767-2385

•	If you are under 18, call Child Protective Services at
1-888-767-2445

F HOW TO RECOGNIZE POTENTIAL ABUSE

If you answer “yes” to any of the following questions, there may be potential for abuse:
•	Do you sense that your ACW is deliberately ignoring your instructions and requests?
•	Does your ACW make mistakes and then blame you or other people?
•	Does your ACW ask personal questions unrelated to your case, such as how you manage your finances?
•	Does your ACW make unwanted comments about your appearance, weight, clothing, speech, eating habits, disability, etc.?
•	Do you sometimes find less money in your wallet than you expected?
•	Are there unfamiliar charges on your checking or credit card accounts?
•	Is your ACW eager to access your car or credit card?
•	Does your ACW want to work all of your shifts?
•	Does your ACW want to control your choices such as what you wear and what you eat?
•	Does your ACW place items you need just out of your reach?

•	Does your ACW try to isolate your from your family and friends or restrict your contact?
•	Does your ACW make unwanted comments about your friends, family or choice of activity?
•	Does your  ACW  look  around your  home or  through your  personal belongings without your permission?
•	Does your ACW use your computer without your permission?
•	Are you uncomfortable asking your ACW to do routine tasks?
•	Does your ACW take naps, watch TV or talk on the phone instead of providing your care?
•	Are any of your medications missing?
•	Has your ACW tried to gain access or control of your medications?

F TIPS ON PREVENTING INJURY, ABUSE, EXPLOITATION AND NEGLECT

•	Remember:  YOU ARE THE SUPERVISOR! You have the authority to fire your ACW if necessary.  You are responsible for creating a professional relationship with your ACW.
•	With anyone – ACW, friend, family member, or stranger – you ALWAYS have the right to say NO or STOP if they do anything wrong or uncomfortable.
•	Carefully screen potential ACWs.   Require references and check them before hiring.
•	Do not become overly dependent on any one ACW.
•	Do not allow your ACW to make choices for you, such as what to wear or what to eat.
•	Trust only those people who earn your trust.
•	Connect with family members, friends and other people directing their care for support in addressing and preventing critical incidents.
•	Seek help or advice if you suspect a situation may be harmful.
•	Make a list of personal belongings such as jewelry, antiques, silverware, and other valuables.
•	Inventory controlled medications after each ACW leaves.
•	Do not leave cash or medication around.
•	Use a password to restrict access to your computer.
•	Find a local self-defense class, and talk with the instructor about the possibility of adapting the class to your disability.

HOW TO MINIMIZE YOUR RISK1

F PREVENTING IDENTITY THEFT

Identity theft is a crime in which an imposter obtains key pieces of personal information, such as Social Security or driver’s license numbers, in order to impersonate someone else.   The information can be used to obtain credit, merchandise, and services in the name of the victim.  In addition to running up debt, an imposter might provide false identification to the police, creating a criminal record or leaving outstanding arrest warrants for the person whose identity has been stolen.

•	If you use a signature stamp, keep it with you at all times and do not allow it to be taken or used without your authorization.
•	Do not leave cash or credit cards out in the open.
•	Keep important documents in a safe place.  Only allow a limited number of trusted individuals to know where they are and have access to them.
•	Never put computer passwords where others can see them.
•	If you need to carry documents with sensitive information, carry the documents in a close fitting pouch or in your front pocket if possible.  If you need to carry these documents on your wheelchair, make sure they are hidden and secure in a place you can observe.  Sensitive documents include driver’s license, credit and debit cards, checks, car registration and anything with your Social Security Number.
•	Do not carry your checkbook in public – carry only the checks you need.
•	If possible, remove anything from your wallet containing your Social Security Number (may include driver’s license, Social Security card, Medicare card, and military ID).   You do not want to carry these documents unless absolutely necessary.
•	Call your bank and credit card customer service lines and ask to “opt out”	of  ALL  marketing  programs,  including  “convenience”  check mailings.
•	Contact the Credit Card Offer Opt Out Line to reduce the number of credit	card   solicitations   you   receive,   at   1-888-567-8688   or www.optoutprescreen.com.
•	Destroy pre-approved credit card offers, convenience checks and any document containing sensitive information, by cutting, tearing up, or shredding.

1 Information taken from CDAS: Emergency Backup and Critical Incident Management manual

•	When sending mail containing checks, go to the Post Office.  Do not put mail  with  checks  in  your  mailbox  or  in  street  corner  post  boxes. Consider using automated payment plans, if possible.
•	Do not keep your auto registration, insurance card, checkbook receipts, or other identifying information in your car.  Do not leave your car or van unlocked or unattended.
•	Check your earnings record at least annually and more often if you suspect your Social Security Number (SSN) has been compromised. It is free and there is no limit to how often you may request it.  Contact the Social Security Administration at 1-800-772-1213 and ask for Form SSA-
7004, Request for Earnings and Benefit Estimate Statement.
•	Monitor your bank accounts for any activity you do not recognize, such as withdrawals from ATM’s, cleared checks, and credit card charges.

F PERSONAL PROPERTY TIPS

•	If you entrust your car to anyone to do errands for you, request that the keys be returned to you as soon as the errands are completed.  Record mileage before and after each use.
•	If you need your ACW or other people to be able to enter your house when you cannot get to the door, consider mounting a lock box on or near your door so that you do not have to distribute copies of your
house key.
•	If you do have a lock box, change the combination about every six months and change it if you terminate an ACW.
•	When you advertise for new ACWs, never put your address in the ad.
Screen carefully before you invite an applicant to your house for an interview.  If at all possible, hold interviews in a public location rather than your house. Ask for and check references.
•	Keep track of your property, who comes into your house, and when.

F PREVENTING LEGAL EXPLOITATION

•	Do not sign papers if you do not know what they are.
•	Do not change title of your house or car to include your ACW. Do not make a will that names your ACW as the beneficiary.

MEDICAL DECISIONS

ADVANCE DIRECTIVES

Advance Directives are written legal papers that state the type of medical treatment someone wants or does not want when he or she can’t speak for themselves.

F Two kinds of Advance Directives are:

1.   Living Will: This is  a legal paper that states the medical care someone wants or does not want if he or she is unable to make decisions.	These legal papers provide written proof of someone’s wishes rather than making others guess what they want. A Living Will must be done while someone is still able to make decisions.

2.   Medical Power of Attorney: This is a legal paper that names an “agent” or “proxy” to act in making medical decisions for someone if he or she is not able to.  Having a Medical Power of Attorney means that the Doctor knows who can make medical decisions for the member for things that are not covered by the written Advance Directive.

A person does not have to have both of these documents. A Living Will can be done without a Medical Power of Attorney.  In Arizona the forms do not have to be notarized.

DNR’S:	DO NOT RESUSCITATE

DNR means Do Not Resuscitate. This means that if someone stops breathing or if their heart stops, they do not want anyone to try to bring them back. DNRs are also known as the “Orange Form”. This form says that if the heart stops beating or breathing stops, the person does not want to receive cardiopulmonary resuscitation (CPR) under any circumstance.   This special form, which is bright orange in color, lets the paramedics and emergency medical services people know what to do.

This “Orange Form” should be placed where the paramedics will be able to see it.  Such places would be the refrigerator or next to the front door.  It is important for your ACW to know if you have these legal papers and what to do in an emergency.
Advance Directives information can be obtained from: Health Care Decisions
www.hcdecisions.org
(480) 966-2674

Office of Arizona Attorney General www.ag.state.az.us (602)542-2079

GENERAL INFORMATION FOR
MEMBERS AND ATTENDANT CARE WORKERS

The  information found  in  this  section  of  the  manual is  meant  for  both members and Attendant Care Workers (ACWs).  The topics provide general information on Communication, Stress Management and Fire Safety and Prevention.

COMMUNICATION

COMMUNICATION SKILLS

Communication is one of the most basic skills we learn in a lifetime. From the time we are infants into our old age, we communicate with others in a variety of ways.

•	Communication is the link between the member and the Attendant Care
Worker (ACW).
•	Communication frequently involves talking, but listening and observing are also required.
•	Even when we are quiet, we are communicating.

Communication can be difficult, but everyone can learn to be a better communicator.

LISTENING

Hearing is the first step in listening, but listening is more complicated.

What’s the difference between hearing and listening? The following story may help you understand the difference:

Imagine you are riding on a bus. You are tired and not really paying attention to things going on around you. You do hear some sounds like a horn honking, the bus doors opening and closing, and a child laughing, but it doesn’t really sink in. This is hearing.

Suddenly, you notice two people you know sitting in the seat behind you. They are enjoying a lively conversation, and you quickly become curious about what they are talking about. You concentrate trying to overhear their conversation. Now, you are listening!

Learning to listen well requires practice. Practice the following good listening techniques in order to become a better listener.

F GOOD LISTENING TECHNIQUES

1. Focus on the speaker, giving him/her your full attention.

2. Pay attention to nonverbal communication.

3. Ask questions to clarify.

4. Be patient and avoid interrupting the speaker.

5. Participate	as	you	listen	by	nodding	in	agreement,	asking questions, and repeating key ideas.

ASKING QUESTIONS

The  member  and  the  ACW  need  to  ask  questions  in  order  to  obtain information from each other.  There are two types of questions:  close-ended questions and open-ended questions.

Close-ended questions:

•	Can be answered with a yes or no or a single word.
•	Can be used when information is needed immediately.
•	Can be used when a simple choice needs to be made.
o Examples:
ƒ	Did you eat breakfast today?
ƒ	Are you feeling okay?

Open-ended questions:

•	Must be answered using more than one word.
•	Are best used when clarification is needed.
•	Are best when feelings are important.
•	You can use the  following words to  help you develop open-ended questions: Who, What, When, Where, How
o Examples:
ƒ   What did you have for breakfast today?
ƒ   How are you feeling today?

NONVERBAL COMMUNICATION

Another important part of becoming a good communicator is understanding nonverbal communication.   This is also called body language.  It is believed that 90% of communication is nonverbal and only 10% is verbal.

You should be aware of your own body language. You should also be aware of other people’s nonverbal communication.

Nonverbal communication can be divided into several categories:

•	facial expressions
•	head movements
•	hand and arm gestures
•	physical space
•	touching
•	eye contact

•	physical postures

Examples of Nonverbal Communication:

•	A thumbs up sign

•	Several wide yawns while someone else is speaking
•	Shrugging your shoulders

Read the following examples of nonverbal communication and think about what they mean to you.

•	Extending a hand in a handshake	•	Frequent yawning	
•	Frequent eye contact	•	Smiling	
•	Tapping the foot	•	Slumped shoulders	

Nonverbal communication can easily be misunderstood. Make sure you take the time to understand other people’s body language. Also make sure you are being clear about your own body language.

MANAGING EMOTIONS

Another important aspect of good communication is managing your emotional responses.

When a conflict occurs in any relationship, it is a good idea to take the time to ask oneself what may be contributing to the situation.

For example:
•	Could some of my own past experiences be contributing to my bad feelings about what may have been said or done?
•	Could I be feeling bad and reacting outwardly?
•	What do I need in order to let go of the angry/hurt/frightened feeling?
•	Whose problem is this, really? How much is mine? How much is theirs?

F FOUR GOALS FOR COMMUNICATING YOUR EMOTIONS PROPERLY

1. Try to avoid the desire to blame or punish.

2. Take a timeout to help prevent over-reacting or becoming defensively aggressive.

3. Try to avoid repeating the same situations.

4. Try to improve the relationship and increase communication.

CONFLICT MANAGEMENT

Conflict is to be expected in any relationship. Conflict can lead to change and improvement, as well as increased respect and trust.

Not talking about a problem can make it worse.

The situation can continue, resentment can build, and you can overreact at an inappropriate time and place.

F DISCUSSION TIPS

1. Use listening techniques discussed earlier in this manual.

2. Let the person know that what he or she says is important.

3. Do not respond with anger or become defensive.

4. Try to see it from the other person’s point of view.

5. Try to understand your own feelings before starting.	For example, if you feel angry, think about where this feeling is coming from.

6. Be clear about what you hope to do. Do you want to:
•	Problem-solve?
•	Express feelings?
•	Make a request?

7. Choose an appropriate time and place for the discussion.

8. Open the talk with a positive statement.

STRESS MANAGEMENT

STRESS AND ANXIETY

Stress is a response of the body to any demand placed on a person to change, adapt, or modify their existing sense of balance in life.

Anxiety is an emotional and physical reaction to stressful situations.   Even though the physical reaction is related to stress, it is real and should be treated as any other medical condition.

Anxiety attacks can resemble a heart attack or high blood pressure.   They should be treated with the same seriousness and sense of emergency.  Stress can also contribute to other conditions such as migraines.  When the  stress  level  is  manageable  or  when  we  have developed effective coping mechanisms, the impact of stress on our lives is minimal.

Recognizing the signs and learning to cope with stress is necessary, not only to be effective at home and in the workplace, but to protect your health.  The benefits to you will be:

•	A positive attitude	y	More energy	
•	Looking forward to getting up every day	y	Feeling “lighter”	
•	The ability to make better decisions			

F SIGNS OF STRESS

•	Crying	y	Depression	
•	No Energy	y	Anxiety	
•	Not Sleeping	y	Stomach Pains	
F UNHEALTHY APPROACHES TO STRESS MANAGEMENT

Unhealthy coping strategies cover  up  the  problems, providing temporary rather than long-term help in managing stress.  Unhealthy coping can include abuse of drugs, alcohol or cigarettes.

F HEALTHY APPROACHES TO STRESS MANAGEMENT

•	Exercise regularly and eat a well-balanced diet

•	Visit an old friend

•	Participate in a hobby

•	Take a hot bubble bath

•	Accept a friend’s invitation

•	Rent a funny movie

•	Slow down

•	Keep a journal

•	Read a favorite magazine or book

•	Take a class to learn something new

•	Play a game with someone

•	Listen to music

•	Go out to eat at a favorite restaurant

•	Learn to meditate or do yoga

•	Laugh

•	Practice relaxation techniques

•	Take a nap

RELAXATION TECHNIQUES

Relaxation techniques can help you manage your stress.	To continually manage your stress you should practice them on a regular basis.

F DEEP CONTROL BREATHING

•	Take a deep breath of air through the nose and slowly release the air through your mouth. Good air in, stressed air out.

•	Get in a comfortable position.  You can do this either sitting or lying down.  When lying down put your hand on your stomach.  Take a deep breath through your nose and then let it out through your mouth.  Let your hand feel your abdomen go up and down while taking the deep breaths.

F Progressive Muscle Relaxation

•	Get in a comfortable position.  If possible lay down.  Let your whole body relax gradually.

•	Breathe slowly through your nose.  Feel the cool air as you breathe in and out.    Let your awareness turn away from your daily cares and concerns.	Close your eyes and let your awareness turn inward to the physical sensations of your body.

•	Tighten the muscles of your face.  Feel the tension in your face.  Hold for ten seconds. Release. Feel the tension flow outward.

•	Tighten your eyebrows by squeezing them.   Feel the tension in your eyebrows.	Hold for ten seconds.    Release and feel the tension flow outward.

•	Clench your jaw tight.   Feel the tension in your jaw.   Hold for ten seconds. Release. Feel your jaw drop. Allow your jaw to drop.

•	Squeeze your neck muscles and hold for ten seconds.  Release.  Feel the tension leave your face. You feel relaxed. You are relaxed.

•	Take a deep breath and hold. Feel the tension in your chest from holding your breath.  Exhale and feel the tension leave your body. Repeat.

•	Tighten your fists or your arms.  Feel the muscle tension.  Hold for ten seconds. Release and feel the tension travel down your arms.

•	Open your fingers on you hands and feel the tension slip out from your fingers. You are feeling so relaxed. You are relaxed.

•	Stretch and tighten your toes.  Hold.  Release.  Feel the tension leave your toes.

•	Squeeze your legs together and feel the tension in your legs.  Hold for ten seconds.  Release and feel the tension leave your body.  You feel relaxed. You are relaxed.

•	Breathe in through your nose and slowly say, “I am”, exhale through your mouth and say, “Relaxed”.

F IMAGERY

Sit  in  an  armchair  with  your  head,  back,  and  arms  in  a  comfortable, supportive position.  Try to be as relaxed as possible.  You can also lie down with your head supported, legs about eight inches apart, toes pointed slightly outward, and arms resting comfortable at the side of you body.  Close your eyes.   Let your mind be like a quiet pool, with no thoughts rippling the surface.

Say the following phrases to yourself.  Repeat each phrase slowly, three or four times.
•	My head is heavy and calm
•	My face is warm and relaxed
•	My eyelids are heavy and warm
•	My shoulders are heavy and warm
•	My chest is relaxed
•	My breathing is calm and regular
•	My stomach is calm and relaxed
•	My body feels quiet and comfortable
•	My mind is quiet and refreshed
•	I am relaxed and refreshed

F GUIDED IMAGERY

Guided Imagery is fun to do.   Go to your own private happy place.   Be relaxed! For example:   Pretend you are on the beach. Say and picture these things:

•	It is a perfect day at the beach
•	The sand is warm
•	You can feel the gentle breeze caress your face
•	You can even feel the warm sand run
through your fingers
•	You hear the waves gently lapping onto the shore
•	You can see the water as if it was diamonds sparkling in the sun
•	As you look at the ocean, you see the endless horizon
•	This is real. This is real. This is real.

Focus on your special place and feel every aspect of your happy place.

HOME AND FIRE SAFETY

FIRE SAFETY

If there is a fire: Get out and stay out!

•	Leave the home as soon as possible.
•	Do not try to gather personal possessions or attempt to extinguish the fire.
•	Stay low because the air above the flames can be extremely hot. Crawl and stay under the smoke if you are able. If not, try to cover your nose and mouth to avoid breathing toxic fumes.
•	Do not use an elevator if there is one.
•	Once out, do not go back inside. Call the fire department at 911 from a cell phone or a neighbor’s home. Tell them if someone is missing. The fire fighters are trained to perform safe rescues.

If you are in immediate danger from flames or smoke: Get out and stay out.

F HOW TO USE A FIRE EXTINGUISHER: P.A.S.S.

•	Pull the safety pin.
•	Aim low, pointing the nozzle at the base of the fire.
•	Squeeze the trigger or handle.
•	Sweep the extinguisher from side to side, aiming at the base of the fire.

FIRE PREPAREDNESS

F	HOW TO BE PREPARED FOR A FIRE

•	Identify the nearest emergency exit and be familiar with the escape route.
•	Have an emergency plan and practice leaving the home. Practice the plan in
darkness or using blindfolds.
•	Install smoke alarms on each floor of the home and next to sleeping areas.
•	Check the batteries in smoke alarms monthly and replace them every six months.
•	Have  a  fire  extinguisher and  know
how	to	use	it.	Keep	it	near	the kitchen and any other room at risk for fire.
•	If someone uses a wheelchair, consider mounting a small personal use fire	extinguisher	on	the	wheelchair	and/or	keep	a	flame-resistant
blanket nearby.
•	Live or sleep near an exit; try to sleep on the ground floor.
•	Keep a phone by your bed or wheelchair.

If any part of you catches on fire, STOP, DROP and ROLL on the ground.

F IF YOU ARE TRAPPED

•	Close all doors between you and the fire.
•	Fill cracks in doors and cover all vents with a damp cloth to keep smoke out.
•	If possible, call the fire department at 911 and tell them where you are located.
•	Signal rescuers from a window with a light-colored cloth.

FIRE PREVENTION

F COOKING

•	Never leave the stove unattended. If you have to step away, turn it off or carry a large spoon with you as a reminder that food is on the stove.
•	Do not use water to extinguish a grease fire. If food or grease catches fire, smother the flames by sliding a lid over the pan and turning off the heat. Keep salt next to stove; you can pour salt on a grease fire to try to extinguish it.
•	Keep towels and potholders away from flames and hot surfaces.
•	Make sure the stove is kept clean and free of grease buildup. When deep-frying, never fill the pan more than one-third full.
•	Turn pot handles away from the front of the stove so they cannot be knocked off or pulled down.
•	Never put foil or other metals in the microwave.

F SMOKING

•	Never smoke in bed and make sure that you are alert when you smoke.
•	Don’t smoke near oxygen or an open flame.
•	Don’t	smoke	when	you	are	taking	medications	that	can	cause drowsiness or confusion, including alcohol.
•	Don’t leave smoking materials unattended.
•	Check	around	furniture,	especially	upholstered	furniture,	for	any discarded or smoldering smoking materials.

F HEATING

•	Keep space heaters at least three feet away from anything that can burn. Turn them off when you leave the room or go to sleep.
•	Make sure kerosene heaters are never run on gasoline or any substitute fuel.
•	Have your heating systems and chimneys checked and cleaned annually by a professional.
•	Never store fuel for heating inside the home. Keep it outside or in a
detached storage shed.

F ELECTRICAL SAFETY

•	Never use an appliance with exposed wires. Replace all cords that have exposed or broken wires.
•	If an appliance begins to smell suspiciously or you see smoke, unplug it immediately.
•	Don’t overload outlets or extension cords by plugging in several items.
•	Keep extension cords out of traffic areas.
•	Turn off heating pads before you go to sleep.
•	Electric blankets and heating pads should have overheating protection.
•	Use only UL-listed electrical appliances.
•	Give space heaters space: at least 3 feet from furniture, clothes, or people. Do not use heaters or other heating devices to dry clothing.

F USING OXYGEN

•	Oxygen should not be flowing near open flames or a heat source.
•	Don’t  smoke  near  oxygen.  A  member  using oxygen should not smoke with tubing in place and oxygen on.
•	Oxygen should be at least 3 feet from a space
heater.
•	Put up signs stating that oxygen is in use and asking visitors not to smoke.
•	Secure tanks so that they cannot be knocked over or be bumped into.
Strap the tank to a closet wall or into the backseat of a car in an upright position.
•	Don’t knock over, bump or roll an oxygen tank. If the valve is damaged, the tank can act like a torpedo.

ADDITIONAL HELP AND INFORMATION

ADDITIONAL RESOURCES FOR MEMBERS AND ATTENDANT CARE WORKERS

1) Arizona Resources

•	AZ Links is Arizona’s Aging and Disability Resource Center (ADRC), which was created to help Arizona seniors, people with disabilities, caregivers and family members locate resources and services that meet their needs.

Visit: http://www.azlinks.gov/

•	The Arizona Department of Economic Security offers information and support programs for caregivers.

Visit:	www.azdes.gov/aaa/programs/care/default.asp

ƒ	People’s Information Guide contains information on a variety of no-
cost/low-cost programs and services available to low-income individuals or families. Some services have income eligibility requirements, some do not. The Guide is intended to assist individuals in obtaining resources needed to prevent a person or family from falling deeper into a crisis situation.

Visit: http://www.azcaa.org/azcaa-peoplesInformationGuide.html

•	Area Agencies on Aging provides resource guides, member and caregiver training, and educational forums. Contact the Agency nearest you.

Area Agency on Aging, Region One
Inc.
1366 East Thomas Road, Suite 108
Phoenix, Arizona 85014 www.aaaphx.org
Client Intake: 602-264-4357

Pima Council on Aging (PCOA)
Area Agency on Aging Region II
8467 East Broadway Blvd. Tucson, Arizona 85710-4009
www.pcoa.org
Client Intake: 520-790-7262

Northern Arizona Council of
Governments (NACOG)
Area Agency on Aging Region III
119 East Aspen Avenue Flagstaff, Arizona 86001-5296 www.nacog.org
Client Intake: 928-213-5254 or 877-521-
3500	Western Arizona Council of
Governments (WACOG)
Area Agency on Aging Region IV
224 South 3rd Avenue Yuma, Arizona 85364 www.wacog.org
Client Intake: 928-782-1886 or 800-782-1886	
Pinal/Gila Council for Senior Citizens
(PGCSC)
Area Agency on Aging Region V P.O. Box 10530
8969 W. McCartney Road
Casa Grande, Arizona 85230-0530 www.pgcsc.org
Client Intake: 520-836-2758 or 800-293-
9393	SouthEastern Arizona Government
Organization (SEAGO)
Area Agency on Aging Region VI
118 Arizona Street
Bisbee, Arizona 85603 www.seago.org
Client Intake: 520-432-5301	
Navajo Nation
Area Agency on Aging Region VII P.O. Box Drawer 1390
Window Rock, Arizona 86515 www.navajo.org
Client Intake: 928-729-4498	Inter Tribal Council of Arizona, Inc.
(ITCA)
Area Agency on Aging Region VIII
2214 North Central #100
Phoenix, Arizona 85004 www.itcaonline.com
Client Intake: 602-258-4822	

2) Training

•	AZDIRECTCARE.org has a variety of caregiver information.

Visit:  http://www.azdirectcare.org/

•	Gateway Community College (Phoenix) offers Caregiver Career Development and Placement Services and a course in the Principles of Caregiving. For more information, visit www.compassionatecareers.org  or call 602-286-8153.

GateWay Community College
www.gateway.edu
108 North 40th Street
Phoenix, Arizona 85034-1795
Phone: 602-286-8000

•	Pima Community College (Tucson) offers courses for direct care professionals
(Attendant Care Workers). Visit www.pima.edu.

Downtown Campus	Northwest Campus
1255 North Stone Ave.	7600 North Shannon Road
Tucson, AZ 85709-3000	Tucson, AZ 85709-7200 (520) 206-7171		(520) 206-2200

3) National and Local Organizations with Resources & Tips on
Caregiving, Stress, and Support Services

Arizona Alzheimer's Association	www.alzdsw.org/
1028 E McDowell Rd
Phoenix AZ 85006
Phone: 602.528.0545

Center for Personal Assistance Services
www.pascenter.org

Department of Social and Behavioral Sciences
School of Nursing, University of California
3333 California Street, Suite 455
San Francisco, CA 94118-0612
Toll free: 866-727-9577
Phone: 415-502-7190

Statewide Independent Living Council
www.azsilc.org
Statewide Independent Living Council
2400 North Central Avenue Suite 105
Phoenix, Arizona 85004
Phone: (602) 262-2900
E-mail: azsilc@qwest.net

Administration on Aging
www.aoa.gov/

Centers for Disease Control and Prevention
www.cdc.gov/

4) Information and Handbooks

Tips for First Responders
http://cdd.unm.edu/products/tips_web020205.pdf
A 25-page booklet with tips for handling emergency situations.

The Caregiver’s Handbook
www.acsu.buffalo.edu/%7Edrstall/hndbk0.html
Care techniques, legal issues, nutrition, record keeping.

Direct Support Professional Training Curriculum California Department of Developmental Services www.dds.ca.gov/DSPT/DSPT_guides.cfm
Student Guides include information on illnesses, communication, safety, nutrition, and exercise.

Northwest Parkinson’s Foundation Training
http://www.parkinsonseducator.org/toc.asp#
Lessons on activities of daily living, communication and more, specifically for persons with Parkinson’s Disease.

Fire Prevention
www.cdc.gov/ncipc/factsheets/fireprevention.htm

Fall Prevention
www.cdc.gov/ncipc/duip/preventadultfalls.htm

Emergency Preparedness
www.ready.gov
The “Ready America” section of this site offers information and a planning checklist for older individuals and persons with disabilities.

5) Regional Resources, Training, etc.

[TO BE COMPLETED BY PROGRAM CONTRACTOR]