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I can not find home care for my 85yo Mom. Mom is an Alzheimers patient (still recognizes family, pleasant, needs redirection) has a 15 year old colostomy, resides with her husband, her daughter-me, and my husband. Needs all ADLs, ambulating and transferring. Planning was done to be sure Mom would be comfortably cared for. A LTC Insurance policy has been enforced.



I have reached out to numerous private local home care agencies and actually was told by one agency if Mom’s appliance pancakes/leaks their PCA-Personal Care Aide would need to send Mom to the ER to have a new appliance replaced on Mom. I was stunned!! Is this a little dirty secret that I have uncovered? The ER or Long Term Nursing Center?? Or wait for a nurse to arrive 1 - 5 hours after the call, with poo all over you??



I do not understand or accept, patients like Mom, are being discriminated within the Home Care Industry. The Center for Medicare and Medicaid Services states emptying and/or changing an ostomy pouch does not require continuous nursing care of skilled care. Any service that could be safely done by a non-medical person (or by self) without the supervision of a nurse isn’t considered skilled care. Mom was managing her colostomy, and I would assist on shower days (it’s really not rocket science if managed correctly) until November 2022. Mom was quite ill and had 4 hospitalizations from November 2022 - January 2023.



I have PCAs (from a local agency who I have had numerous meetings/conversations regarding Mom’s care plan) coming 7 days a week, averaging 6.5 hours a day, a couple of them are unwilling to be trained, emptying or changing the pouch. I’m exhausted and frustrated.





Are there Home Care Agencies out there and I just have not found them? I am becoming a VERY motivated advocate. This is inhuman, cruel and catastrophe of unmentionable portions to our helpless loved ones.

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Call the State Health Departmemt to learn what the state requirements are for providing that care. I bet a LPN or RN license is required for that care. If the care agency provides a service they are not licensed to perform they lose their certification and they may not have appropriately licensed staff. Or they can decide what services they will not provide.
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You might do better hiring someone directly and training them yourself.

That said, I've had CNA's on the job who have mentioned they have done this in the past.
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Each state has a acope of practice. She may need a skilled nurse
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You are running into a problem that’s happening because you chose to keep mom at home. Now you’re learning that it isn’t always possible to get the care they need to come to the home. Please reconsider and investigate care facilities. They should have the professionals who can do it.
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Good luck with that. I know when my late husband had a supra pubic catheter put in, the Home Health Care agency we had at the time said they didn't think that they had any nurses on staff that knew how to change it, and that we would have to take him to the urologists office to have him change it, which I did.
Then when my husband was under hospice care in our home, there was only one nurse(and she was a LPN)that said she was comfortable changing his catheter, and hospice asked me if I wanted to learn how to change it, and that she would teach me.
Of course I said NO, but I also said that perhaps she should teach the rest of nursing staff so they had more than just one person on staff who knew how to change a supra pubic catheter.
To my knowledge she never did, as anytime it needed to be changed, she was the one to come change it.
I don't know if your mom was in a nursing facility if that would make a difference or not, but I wish you well in finding help.
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Drama queen alert.

You’re really crying discrimination because someone not trained in medicine isn’t willing to conduct a medical procedure? If she needed open heart surgery would you complain that the home care aid wouldn’t do that as well? "Catastrophe of unmentionable portions", give me a break.

Grow up.
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The State probably does not allow anyone but an LPN or an RN to change a bag. I understand that Mom always did her own and anyone can be trained on doing it, but CNAs are not medically trained. In no facility are they allowed to do this. When its leaking, it is now Hazardous, is the only word I can think of. Your Mom could have hep B or C and transfer it to an aide.

Sorry, but even private agencies are overseen by the State.
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I have little to no experience with colostomy bags and the changing of them, so this is just a shout in the dark.

A colostomy bag is a real step above a person in an incontinence brief that must be changed, I would imagine.

Is your mom able to do anything for herself? Help out with the change, or does she sit back and let others perform this task for her.

Probably, and again, a guess--you need someone with more of a care level ability than a 'basic trained' person. As a CG years ago, I would not have been 'allowed' to change a colostomy bag. And I really didn't want to have that skill anyway--so any clients who needed that aid, I couldn't 'take'.

I'm sure you will be able to find an agency that can help you.

While changing out a colostomy bag may be not a big deal to you, it may be a task that a lot of CG's won't do.
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Bright star might as they actually have lvn and e
rn on board.
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