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Canadian moving to Los Angeles

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    Canadian moving to Los Angeles

    Good day,

    I'm a Canadian C3-C4 Quadraplegic looking to move to Los Angeles (Damn Canadian Winters). I was wondering what are my options for my care... Bowel movement (3 times a week), getting up 7 days a week.

    Is there some service agencies specialized for Quadraplegics or some health services?

    I don't mind paying, how much could it be?

    Thank you for your help.

    I assume you already have plans for health insurance, and have a visa that allows you to move permanently to the USA? You would not be eligible for either Medicaid or Medicare as an immigrant.

    You can find home health agencies which will provide these services, but in CA, the agency will require that any bowel care that involves use of a suppository or manual removal or digital stimulation be done by a licensed nurse (not an aide). This would also apply to insertion/changing of a catheter; although an aide could be allowed to empty the bag and provide perineal care. RN care starts at about $60/hr. and goes up from there, while an LVN (LPN) may cost $30-40/hr., and a nurses aide about $30/hr. In addition, the agency often has a minimum shift length requirement (usually 4 hours). The agency takes a cut of this, so these nurses don't actually take home that amount.

    If you have the resources, I would strongly recommend privately hiring and training your personal care attendants instead of using an agency. Even if you use an agency, you will have to train the person as it is rare to find someone (even an RN) who knows how to do SCI bowel care. You can read many messages on these forums about how other members do this; often recruiting through Craig's List or the Penny Saver, interviewing and screening the applicants themselves, and (ideally) developing a written job description and conditions of employment contract. In the Southern CA area, you can find people who will work for $13-20/hr. this way, and they can do any of your needed care. Technically you are responsible for withholding income taxes and Social Security taxes from their pay (although many people don't do this), and giving anyone working for you at least 1 day off every week. This means that most people hire several people to provide their care part-time, and coordinate their own schedules, sick calls, vacations, and family emergency schedule changes as well. Some of my clients employ a bookkeeper who manages the taxes and pays the person under the direction of the employer.

    You might want to use an agency for when you first arrive in CA (you will need a physician's order for the care they provide, so having a physician first will be important) and then proceed to start recruiting your own.

    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.