Legend has it that many (most?) people that start a software business, launch an internet site, or create an app in the modern era are looking for a big payday. That may or may not be true, but I know that, when I set out to create what would eventually become HomeHelpStatus, I did so for one reason: I needed to save my Mom's life.
This sounds like hyperbole, but it's not. As I've written before, my Mom has advanced secondary-progressive Multiple Sclerosis (MS), a degenerative neurological disease that is symptomatically similar to ALS. In my Mom's case, MS has left her quadriplegic with a host of "secondary" conditions, such as limited respiratory capacity.
As her condition worsened over the years, she became more and more dependent upon her home care workers, which we call PCAs (Personal Care Assistants; other terms like Home Heath Aide [HHA] are used as well). This has mostly worked out well; without their help, my Mom would not be able to live at home.
…a caregiver not showing up for their scheduled visit could result in my Mom's death.
The problem is, sometimes things happen. People get flat tires on the way to work. Their child is significantly injured, and they can't come in. Sometimes (thankfully, very rarely) PCAs we've trusted have ended up not being reliable, not showing up for work when scheduled for little reason.
This is generally not a serious problem in other healthcare contexts. For example, a nursing home, clinic, or group home will typically be staffed by a multiple people at any given time; one or two people being absent there will be inconvenient, but usually not an emergency. However, in my Mom's case, she only ever has one PCA scheduled at a time (a constraint understandably enforced by the government agency that thankfully pays for her home care).
So, when someone doesn't show up when they're scheduled, my Mom isn't just inconvenienced: she can't eat; she can't drink; she can't go to the bathroom; she can't take her medications. This last fact is particularly problematic, as some of her medications must be taken rigorously, at the same time every day, or very bad things can happen. There have been times when a PCA not showing up has resulted in an emergency room visit for my Mom...that is, once a PCA shows up for the next scheduled visit, or me or my Dad discover what's happened.
Once I drove over to her apartment after calling a dozen times over the course of an hour or two, only to find that the phone cord had accidentally been yanked out of the wall.
As you can imagine, such situations are horrible experiences. And as terrifying as it might be, it's not hard to think of scenarios where a caregiver not showing up for their scheduled visit could result in my Mom's death.
Knowing this has for years resulted in a sort of mild, gnawing worry: around the times caregivers were supposed to be arriving, I'd look at the clock and wonder, "Are they going to show up?" I'd debate with myself about whether to call over and confirm. Sometimes I would, and sometimes the phone would just ring and ring. Are they just a little late? Are they busy? Did my Mom send them to the store for something? Or, are they not going to show up at all? Once I drove over to her apartment after calling a dozen times over the course of an hour or two, only to find that the phone cord had accidentally been yanked out of the wall.
Earlier this year, I knew I had to do something, but no obviously good options presented themselves:
- Caregiver check-in services did exist, but they were built for organizations like home care agencies that had dozens of staff, and cost $1,000's just to get started. I found nothing suitable for individual and family use.
- Informal check-in services also exist, but they're largely intended for families, e.g. so teenagers can let parents know where they are. While we aim to hire trustworthy people, I wanted to know for sure that caregivers were actually at my Mom's apartment, and not checking in from their phone from wherever. Trust, but verify is an apt proverb.
- Emergency call services like Lifeline are available, but my Mom simply isn't able to operate the switches or even blow tubes you can use to trigger them. Also, we don't need EMT calvary rolling in when a caregiver doesn't show up; knowing that that's going to happen actually discourages the use of things like Lifeline.
What I wanted seemed very simple:
- A way for caregivers to check in from my Mom's apartment in a verifiable way (by phone using caller ID or maybe using a mobile app that used GPS to verify presence).
- When a caretaker doesn't arrive within some minutes of when a visit is scheduled, I want to get a text message or phone call so I can do whatever is necessary.
I don't have to worry anymore about whether she's being cared for.
Thankfully, being a reasonably competent software developer, I built this. It's worked wonderfully for my Mom for some months now: when a PCA has very occasionally been running late, I get a text message, and my Dad gets a phone call. PCAs now also check in when they're departing at the end of their visit, so a nice side benefit is that I now have access to a complete in/out log that I can use to verify their pay (and thus protect the hours of care that my Mom is allotted).
I don't have to worry anymore about whether she's being cared for. And, if I do feel a flutter of paranoia, I can just go look at the checkin log in 10 seconds and be reassured. More subtly, my Mom doesn't worry about what will happen the next time someone is late or doesn't show up.
But, most importantly, I know my Mom will never be in danger again, when someday a PCA really doesn't show up again. It's not glamorous, and it's not technically boastful, but the code and system that enables this may be the most important I've ever written.
Other people, maybe many others, could get the same benefit from it that I and my family have. I know I wish I had had something like this when my grandmother was getting some minor home care some time ago: she remains in good health, but is the sort of person will say "I didn't want to bother you!" when you find out that the aide didn't show up the week before, but didn't call anyone.
So, I've done what I can to make it as easy to use as possible; this is what HomeHelpStatus is today. Please pass it along if you know someone that might find it useful.