Plumbing, Advocacy and House Calls

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Denver, CO – I don’t know why I thought it would be a good idea to call the Plumbing Contractors of America but I did.  I was batting around this idea that we could train people in the trades on whom to call if they visit someone who needs more than just home repair help.  It could also be that I’ve always thought I would make a good plumber.

Plumbing -- as compared to social work -- always makes sense.  The rules are clear: if you fix it right, it doesn’t leak. As one friend told me, to be a plumber, you must remember three things: 1.) Friday is payday; 2.) water, among other things, flows downhill; and 3.) don’t bite your fingernails. 

So I get on the phone with the Plumbing Contractors of America.  A woman answers. I tell her I have a question and I don’t know where to start with finding the answer.  This, by the way, is my favorite way to do research and works for a multitude of other administrative tasks, ie. finding out where your Medicaid application is at with the Department of Human Services.  If you’re working in any kind of big system, start with what you don’t know and admit that you are fully at the mercy of the person on the other end of the line.

I tell the woman that I work with people in their own homes to provide counseling and connect them to services.  I tell her that sometimes I even recommend handy-persons and I have helped with more than a few repairs before. She listens but I can tell this does nothing to raise my street cred.

“So,” I ask her.  “What kind trainings are out there for plumbers to tell them what to do if their client needs more help…like food or help around the house?  What if the plumber is the only person someone sees all week?”

Now there’s a fine line between being at someone’s mercy and making them feel comfortable if they don’t have an answer.  I err on the side of making her perfectly comfortable because she tells me yes, my question is, in fact, strange.  As it turns out, I would need to be a member of their national organization in order to teach.  I decide I’ve done enough research for the day but it does make me think about how the only way to do plumbing is in someone’s home.  

In the Denver metro area, we have several helping professions who are shifting the paradigm of what it means to care for others and going back to the original “house call” model.  Dispatch Health led the way by literally figuring out how to send an ER-trained Physician Assistant or Nurse Practitioner plus an EMT to your home for those times when you don’t need an emergency room but need medical care.  Kaiser evidently has a program that offers similar services.  And if you have a chronic condition and difficulty leaving your home, it's worth checking to see if your Medicare supplement covers palliative care.

Another organization that's doing great work is Senior Reach.  Originally modeled off a pilot program that took place in Spokane, WA, mental health providers in some areas of Colorado now visit people over the age of 60 in their own homes to offer counseling and a little bit of case management. 

If you're curious about other industries that will come to your home, know that there are attorneys, computer-fixers and hairstylists who will come to you -- and if they do, thank them...they are definitely the exception in their fields.  I’m missing others who could be part of this list. (I’d love to hear if anyone knows a good veterinarian who will make house calls. How great would that be?!)

It also takes a lot of trust to let someone come into your home.  I’d be remiss if I didn’t say we also need to consider things like background checks, having someone you trust know when a new provider is coming into your home, and building a social network so that you’re looking out for your neighbors and they’re looking out for you.  And once you have that in place, there are other questions to ask: how can technology augment house calls so that we can keep services affordable?  Or: if you can get care in your own home so that you don’t have to leave your dog, does that make life better?  Now that’s something to push for.

In-home care providers have always understood the art of caring for people in their environment and we’re thankful there’s an industry that already gets this concept.  Plumbers (who will always inspire me) understand this on a different level and, the ones I’ve met, care a whole lot about helping us too.

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