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The elderly population in the Chicago area benefits from an unusual home care aide program--one in which the aides also benefit: aides are drawn from the population receiving public assistance and given training that offers them a career ladder and opportunity they might otherwise not have had, all while helping others.
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With much to learn in a short time, home care aide students need teachers to maximize learning by conducting a course that is student centered, the way home care is client centered. Standard adult education techniques emphasize recognizing the characteristics of adult learners; they also promote the self-respect of home care aides as they prepare for their increasing responsibilities.
One agency has tapped middle-aged women as resources for home care aides--specifically as personal assistants. This approach has fine results and may prove a good model for addressing the normally high-turnover rate this position accrues.
Family violence affects not only the lives of home care clients, but those of the home care aides who serve them. One organization has developed a program to prepare home care aides for coping with situations of domestic violence.
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Presented here are two case reports of elderly persons with Diogenes syndrome (variously known as senile breakdown, social breakdown and senile squalor syndrome). Diogenes syndrome is often (but not always) characterized by a tendency to hoard excessively (syllogomania). The first patient was diagnosed as having both a schizotypal personality disorder and obessive-compulsive disorders (OCD) while the second was diagnosed as having a schizoid personality disorder. Only the former demonstrated the tendency to hoard rubbish. The Diogenes syndrome in both cases can be hypothesized to be a reaction to stress in elderly people with certain personality characteristics or as the end stage of a personality disorder. The hoarding behavior that was manifested only in the first case can probably be the result of the presence of an OCD. The authors raise the possibility that OCD may be the cause of hoarding rubbish in those cases of Diogenes syndrome in which hoarding exists and cannot be explained by psychotic disorders, dementia or any other mental disorders due to a general medical condition (GMC) or substance-related disorders.
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