Evergreen In-Home Care Services, a Bend company that connects caregivers with seniors in Central Oregon, is not the same operation as when it started. Looking back to its opening almost 30 years ago, Nancy Webre, the CEO has a long list of ways in which the business and industry have changed.
The needs of the elderly have shifted because they’re growing older now. Children of the elderly want more services for their parents. Client count has fluctuated. And, yes, the cost of in-home care has changed.
Webre founded the company with her husband, John, in 1982, after having worked together at the Central Oregon Council on Aging. While he got the business up and running, she worked in Eastern Oregon as regional director of the American Lung Association. She joined Evergreen after about four or five years into the life of the company, she said.
Today, she oversees day-to-day operations, and he keeps on top of behind-the-scenes matters as facility management.
They own the Old Mill District building in which the office is located and lease out space in it to other companies. In Evergreen’s early days, it was run out of an office on NE Greenwood Avenue in Bend, according to a 1982 Bulletin article.
Back then, Nancy Webre said, Evergreen was the only such company in the region. Now, several other companies offer in-home care to seniors in Central Oregon. The average out-of-pocket cost of care has more than tripled. In 1982, according to the Bulletin article, it was between $5.75 and $6.75 an hour. Minimum wage in Oregon then was $3.10 an hour.
Now, with the state minimum wage at $8.50 an hour, the out-of-pocket cost for service ranges between $17 and $27 an hour; the average is around$20 an hour.
In the past, if all the caregivers were busy, Nancy Webre said, she herself used to offer assistance to a client. No longer; other employees in the office can do that now. Webre, 60, serves in a more administrative capacity today, making sure all departments are working properly.
Despite the many changes Evergreen has enacted or seen, Webre said the company has always been passionate about providing services to seniors in Deschutes, Jefferson and Crook counties.
Q: Evergreen started in 1982. What was the situation?
A: It was very depressed economy in Bend, and all of Oregon, but a lot people were actually leaving Bend at that time. And the economy, as I look back now, I would say it’s probably worse now than it was then, but there were no other businesses like ours, private businesses that were providing services for seniors.
Q: Were there people saying, “I’d be willing to pay for services”? Or how’d you get the idea (that there would be demand)?
A: Just started talking to a lot of people. People did say that their parents needed help, or even parents…said, you know, “We’re interested. “ and the feedback a lot of connections in the elder care community, the feedback from people that I talked to was real positive, saying that there was a huge need. So we just grew slowly, and it’s kind of evolved ever since.
Q: At that point, how were people paying you? Was it with insurance at all, or was it strictly out of pocket?
A: We had three (main) sources. One was Medicaid through the state of Oregon, and another was through OPI (Oregon Project Independence, in the state Department of Human Services). We had a contract with the Council on Aging, and that was for Oregon Project Independence funds…. And then private pay…it’s all based on income. The funds that the Council on Aging was getting at that time a lot of money available for in-home care services, as opposed to now, the funds have really been cut.
Q: Was it a progressive (cut)?
A: It’s been progressive. It’s been over the years. But I think I’ve seen the biggest impact in terms of cuts in the last eight to ten years.
Q: (What about) the other two (sources of payment)?
A: We still have a Medicaid contract. We still have a small one with the Council on Aging for OPI. And the we also have one we do—we provide services with the (U.S. Department of Veterans Affairs) as well. Another change in terms of payer sources is we are continually seeing more and more people who have long-term insurance policies, which help them pay for our services.
Q: What were the services in the 1980’s? What has been added and subtracted since then?
A: The focus was more on homemaker services, because those were the kinds of services that more people were requesting. Older people had a hard time pushing a vacuum, that kind of thing. They needed more assistance with homemaking. And then, over the years, I think we’ve just seen a greater need for assistance with activities of daily living. People monitoring medications is a huge service that we provide in the home, and oftentimes just having someone come in and provide that one service makes a huge difference whether or not they can stay in their own home. So I think…we do more of that than we did then.
Q: What are some of the things that might go on now?
A: Helping with bathing. More hands-on kinds of things. Many times we do a lot of hospice, end-of-life care, more now than in years past, and many times we’re there once that person has a diagnosis of hospice. We will be there till the very end, where we’re providing round-the-clock, 24-hour care to that person.
Q: What about clientele? How has the number of clients changed over the years?
A: It’s increased, of course, over the years. What I’ve seen with clientele is people are living longer. So is used to be years ago our older clients were maybe 80 to 85, and now, you know, that’s young, and really we’ve got more clients from maybe 90 to over 100. More clients that are over 100.
Q: What age is the oldest one now?
A: Well, we just lost one that was 102, I think. Right now, upper nineties.
Q: Does that mean they stay with you longer?
A: Yes, many times…. another change that we see…is we have a lot of couples we provide services to that have been married many, many years I think that’s going to become a thing of the past. You know, younger marriages aren’t lasting longer, and we’re beginning to see, even now, some of our clients that are maybe in their eighties are in the their second or third marriage, and that brings to the table a whole other set of issues, because you have really two families that you’re dealing with, and not just one family. And when families get involved…many times it requires more care coordination and more management on our part to make sure that the families are on the same page we are, but also always have the best interests of the parent in mind… Many times what I see is the kids are advocates for the parents.
Q: What is changing?
A: Years ago, it was the parents that would call and set up services for themselves. Now we’re seeing more of the kids set services up, and pretty much it’s the baby boomer age that we see, that’s, you know, the advocates for the parents. But it’s really a lot more family involvement than we saw in the past.
Q: What do you think might be the future for the company?
A: Well, one thing that we are doing that’s a new niche, and I think this is the future also, is we do a lot if geriatric care management…Helping people coordinate services. Different resources in the community. Sometimes just coming up with innovative ideas of what it can take to keep people together in their home. Sometimes families need assistance. Sometimes families are feeling guilty about, you know, have a hard time dealing with a parent’s care needs increasing… There’s times when we can help with that process and make suggestions.
As seen in The Bend Bulletin: Evergreen In-Home Care Services nears 30 years in Bend
June 2011