Medical foster home provides options

ELK POINT – When long-time health care worker Rose Lenz's son first told her about Veterans Administration Medical Foster Homes (MFH), she was not receptive to the idea.

"He called me last spring and said, 'Mom, this is just the thing for you. You wouldn't have to travel in the snow and go out at night. … This would be ideal. I think you should look at this.' 

"I vetoed it," she said with a laugh.But her son was persistent, and eventually convinced the 70-year-old Elk Point resident to discuss the program with the VA directly."I told him I would do that, and when I did, I was impressed," Lenz said.

MFH is a type of Community Residential Care home chosen by a veteran who is no longer able to live independently. The homes are not owned and operated by the VA, but by a live-in caregiver who will provide 24-hour supervision and personal assistance.

"These homes provide meals, supervision and help with reminders to take medications, help with keeping up of their room and that kind of thing," said MFH Coordinator Kris Breitag. "It's an alternative to another more institutional setting, like assisted living."

According to Breitag, the program was established about 10 years ago in Little Rock, AK. A similar program was founded several years later in Tampa, FL, and Puerto Rico, and in 2008, the VA passed an initiative to expand the program to other locations, as well.

"There are close to 40 VAs that are accepting applications for homes and for veterans," Breitag said. "There are some VAs that are working on getting to the point where they can develop homes and offer this option."

There currently are five homes in the Sioux Falls area participating in the MFH program, and programs are also being developed in the Black Hills and Omaha.

"They're small programs, but I think for the veterans that have chosen this option, there has been a good level of satisfaction," Breitag said.

This also is true for those associated with the veterans, said Clay County Veterans Service Assistant Cynthia Aden.

It offers "a lot of peace of mind for the veterans' families and loved ones," Aden said. "Here we have an opportunity for them to be taken care of in a facility where somebody's watching over them. It's not an institution, so there's a lot more flexibility for veterans and their families. It's something great for our community that people don't have to go out of our communities. They can stay close by. "That's the biggest thing, just being able to have your veteran close at hand so you can stay connected with them," she said.

There were a number of factors that made the program appealing to Lenz, who has been a home health care worker for the past 30 years.

"I go into peoples' homes and take care of them, and what is bringing me home to do this, mainly, is I do not have to lift them," she said. "They have to be up and able enough that you don't have to lift anybody. Right now I'm taking care of somebody that I have to lift all the time throughout the night. …"

I don't mind cleaning and cooking, but lifting gets a little tough," she said.

While she has made it her career, providing this type of care also has been a big part of Lenz's personal life.

"My husband was sick for 12 years, and the last two years were really tough on him," she said. "So I've dealt with that type of thing, and it's just in my heart to do it. 

"I really feel sorry for the young boys that come back in pieces. They go over ready to conquer the world. They don't know the world might conquer them," she said. "So I guess I have a lot empathy in my heart for that."

Lenz felt her house would be ideal for the MFH program, primarily because it is one level. She has two bedrooms that are ready to be filled, and has completed an intensive process of inspection and certification.

Breitag said each home under consideration for the MFH program undergoes inspection for fire safety, accessible exits and wide hallways. A special fire alarm system must be installed, and fire drills must be completed several times a year.

A dietician inspects food storage and sample menus, and a nurse looks at how medications are going to be stored, Breitag said.

"I had to go through a lot," Lenz said. "My neighbors have been wonderful about helping me to get everything up to code."

Lenz said her primary role will be "keeping the house clean and making sure (the veterans) are OK. I'm here 24/7."

As for the veterans themselves, they must undergo a screening process before they can live in one of the MFH houses.

"Basically, we look at if their medical needs can be met in this type of setting," Breitag said. "We do have a home-based primary care team that goes to the homes and monitors the medical status of the veterans, and that team for this new home will be from Sioux City, IA. The team consists of an RN, a nurse practitioner and we can also involve dieticians and physical therapists when needed."

To make sure the veterans are receiving the proper care, the VA inspects the home on a regular basis.

Breitag said some of the veterans may even be able to leave the homes unattended for short periods of time.

"Much will depend on their abilities and whether they're able to be out and about. We ask that they let the caregiver know when they're leaving and approximately when they'll be back," she said.

Family interaction is also encouraged.

"If the family is available and wants to have them come for a meal or go for a drive, that's great," Breitag said. "The caregivers also sometimes take the veterans on a ride or take them to do their shopping for their personal needs. It's tailored to the individual needs of the veteran."

Lenz said visits from family members are one of the things to which she is most looking forward. She encourages others to visit, too.

"I want the community to be involved, and I want them to come and have coffee or tea," she said. "I'll have some goodies on the table at 10 a.m. and 3 p.m., Monday through Friday."

If visitors let her know in advance, Lenz said they are also more than welcome to join the veterans for a meal.

"I want (the veterans) to feel that everybody is welcome here, that it's an open home," she said. "I don't want them to feel that they have to stay in their bedroom. I don't want that at all. I want mingling, and for them to feel at home here."

Breitag said MFH is a good addition to the programs offered by the VA.

"When we visit with veterans, it's another option to offer them," she said. "Some veterans will choose other options, such as assisted living or a nursing home, but there are some that prefer a home-type setting, and this is one way that they can live in a home, maybe have a little more individual schedule."

Individuals who are interested in participating in the MFH program either as a provider or a resident may contact Breitag at (605) 333-6861.

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