Att F1_HC Handbook

Caring for yourself
while caring for others

For more information and to request copies of the handbook contact:
Public Authority for In-Home Supportive Services in Alameda County
Training Program at 510-777-4202 or www.ac-pa4ihss.org
Service Employees International Union — Long Term Care Workers
(SEIU-ULTCW) at 1-888-373-3018 or www.seiu-ultcw.org

For an electronic copy of the handbook, please visit:

[url of electronic pdf]

PRINTER’S UNION

LOGO

Practical Tips for

Homecare Workers

STAY SAFE
AT WORK

Hello!

My name is Natalia.
I love being a homecare worker!
But it can be dangerous. Two
years ago I slipped while helping
Clara take a shower.
I twisted my ankle and was on crutches for two
weeks. I couldn’t work so I didn’t get paid, and
couldn’t take care of my family and the people
who needed me.
That changed the way I look at my
job. I found there’s a lot to learn,
and what we don’t know CAN hurt
us — and the people we care for.
We can protect ourselves
Before I got hurt, I didn’t think
much about my own safety.
Now, I think things through
before doing them. I watch
out for hazards and try
to use the right tools and
techniques. This handbook
helps me do my work well
and safely.

I’m Clara.
Natalia has worked
for me for three years.
When she got hurt, it
really shook me up.
As her employer, I’m
responsible for making my home a
safe workplace. I don’t ever
want anyone to get hurt
again while helping me.
I care about her. And,
if she gets hurt, my life
gets much harder —
I have to show another
worker how to take care of me.
Why should consumers read this handbook?
I’ve heard lots of things about safety, but it’s hard to
find one source of reliable information. That’s what this
handbook is: a collection of
practical tips to keep my
home safe for Natalia —
and for me.

Turn the page to learn
How to use this handbook
introduction

1

How to use
this handbook

3. Keep track of good ideas to make your work safer.
Fill out the to do list at the end of each Safety Tip:

to do list
Supplies needed:
Long-handled duster, mop, scrub brush

1. Look over the checklist on the next page and see
which Safety Tips apply to you. Go to those pages to
find out:

Stepstool

Kneepads

Other:

Cleaning gloves

New ways to do the tasks:

Tie a rag to end of a broom to dust upper shelves

What to watch out for and the

tools & tips that can help you both stay safe
People or places we will contact for help, tools, or information:

Consumer will ask her family if they have kneepads
Worker will mix dish soap and water (p.19) for
trying out the general cleaner.

2. Read How to talk to each other about safety on
p. 6 for suggestions on how to communicate your concerns to each other. Each Safety Tip also has a:

talk it over section with examples of what
you could say.

Working with the consumer
is the best, but not the only,
way to use the handbook.
You can use it on your own
or with others such as family
members or guardians.

4.

Create your own action plan for safety on
page 82. Keep it on hand to remind you both
about staying safe.

5.

Review the find help section at the end of each
Safety Tip and the resources starting on p. 75
for local groups that can help you.

Remember, staying safe on the job is important
not only for you, but also the people you care for.
Congratulations on taking time to Care for

Yourself while Caring for Others.
2

introduction

introduction 3

Checklist

7.  Do you cook and shop for the consumer?
go to p. 44

What hazards

are you exposed to?
1.  Do you mop, scrub, or do other
housecleaning tasks for the consumer?
go to p. 10

2.  Do you use cleaning products
such as bleach or toilet cleaner?
go to p. 16

3. Do you do the consumer’s laundry?
go to p. 22

4.  Do you help the consumer move (transfer)
from place to place in the home?
go to p. 26

5. Do you help the consumer take a
bath or shower?
go to p. 34

6.  Do you use needles or other sharp objects
such as razors and diabetes sticks?
go to p. 38

4

checklist

8.  Are there conditions in the home
that could lead to trips and falls?
go to p. 50

9. Are there fire and electrical hazards
in the home?
go to p. 56

10. Do you feel overloaded with stress
and worry about your work?
go to p. 64

11. Do you have injuries, aches and pains
or other physical symptoms that might
be caused by your work?
go to p. 70

12. Do you want to know where to find help
about these hazards?
go to Resources on p. 75

Create your own action plan for safety

on p. 82

Let’s get started!
Turn the page for tips on
How to talk to each other
about safety.
checklist

5

How to talk to each
other about safety
What’s wrong with this conversation?
“You can’t keep your
stuff all over the place.
It’s too cluttered – and
dangerous!”

tips for effective communication
Learn ways to state a concern about your
safety in a manner that encourages both of
you to find a positive solution – together.
 ring up a safety issue as soon as possible.
B
If you don’t, the problem can get worse and one or
both of you can get angry.

“It’s MY house! You can’t
tell me what to do!”

 lan the discussion in advance. Practice with a
P
friend or write down what you want to say.
Be respectful.

Homecare worker: “May I move the phone

cord out of the way so we don’t trip? I’ll make
sure you can still reach the phone easily.”
 se “I” statements. Talk about what you observe
U
and how it affects you rather than blame the other.

Homecare worker: “If I tried that, I’m afraid

that I could hurt my back.”
Consumer: “I worry that if we change the

way things are organized I won’t be able to
find the things I need.”
 ook at the issue from the other person’s
L
perspective.

here’s what’s wrong
 alking like this doesn’t give either of you room to
T
think of solutions.
 ach person may feel the other is not respectful and
E
doesn’t care about her/his needs. Both of you can
get angry and defensive.

Homecare worker: “It must be hard having

someone rearrange your things. But I wonder if we can move some things from the
floor so we’d have more room to walk.”
Consumer: “I’ve always done the laundry that

way, but if it puts too much strain on your
back, it’s OK with me to try it another way.”
continues

6

talk about safety

talk about safety

7

tips for effective communication continued

Consider
several solutions so there’s not just
one option.

 tips for working with consumers
who have speech difficulties
Find a quiet area and give them your full attention.

Homecare worker: “That cleaning product

Don’t interrupt or finish their sentences.

is too strong for me. I’m concerned about
my health. I could continue using it if I can
open the window or use a fan. Or I could
make a cleaner that works as well but is
safer and less expensive. Which would
you prefer?

If you have trouble understanding, don’t nod. Simply
ask them to repeat.
If after trying, you still cannot understand them, ask
them to write it down or suggest another way such as:

 now your bottom line – the minimum you
K
can accept.
Homecare worker: “I’m sorry. I’m not

comfortable changing the bandage 
without wearing gloves. Using gloves 
is safer for both of us.”

• Communication boards and books
• Computers (text or graphics/pictures)
• Assistance from a family member or friend who is

experienced in communicating with the consumer


when communication breaks down
Sometimes you may feel threatened by what
consumers or other people in the house say or do.
If you believe you are in immediate danger, call 911.
Otherwise, consider these options:

Talk to the consumer when he/she is calm.

 sk a friend or family member to accompany you
A
when you speak with the consumer.

 equest help from an agency that also works with
R
the consumer.

If you can’t resolve the situation, consider other
employment for yourself or other care options for
the consumer.

8

talk about safety

talk about safety

9

Mopping, scrubbing, and
other housecleaning tasks

Long-handled brush
Limit
bending.

Gloves

Cushion your knees.

Keep supplies near.

tools
Use these things to make the tasks safer:

watch out for
Back and shoulder injuries • General aches and pains

 long-handled duster, mop, and scrub brush to limit
A
bending while you clean the floor, walls, tubs, and toilets
 stepstool to help you clean high places without
A
over-reaching and possibly losing your balance
Knee pads or a folded towel to cushion your knees

10

safety tip 1

housecleaning 11

tips
 void reaching and bending. Move as close as
A
possible to the task. For example, when making
a bed, walk around it so you don’t have to reach.
Raise the bed if it is adjustable.
 very few minutes, stretch and change positions.
E
Switch hands if you can.

 ry not to twist your body – move your feet instead.
T
Bend your knees, not your back.
 hen lifting a heavy object, hold it close to your body.
W
Lift with your legs. This puts less stress on your back. If it’s
too heavy to lift without strain, get help.
If you move furniture to clean the floor, push, don’t pull.
If it’s too hard to move, get help. Put casters on the feet of
heavy furniture so it is easier to move.

“Sometimes I’ve attached
a rag to the end of a
broom to clean hard-toreach places.”

Chun, Oakland homecare worker

“If there is anything heavy that needs to
be lifted, I won’t let the homecare worker
lift it alone. We either ask for help from
a neighbor or my nephew, or we slide
things, or put them in a cart and push it.”
Dennis, Fremont consumer

12

safety tip 1

housecleaning 13

talk it over
You could say: “Tools with long handles make
it easier on my back and help me stay strong and
healthy enough to keep working.”

to do list
Supplies needed:
Long-handled duster, mop, scrub brush
Stepstool

Kneepads

Other:

New ways to do the tasks:

find help
Hardware and discount stores
sell stepstools, long-handled
tools, kneepads, and casters
and sliders for furniture.

People or places we will contact for help, tools, or information:

14

safety tip 1

housecleaning 15

Working with
cleaning products

Open windows.

Wear Gloves.
Spray onto sponge.

watch out for

tools
Use these things to make this work safer:

Skin rashes or burns • Red, itchy eyes • Breathing trouble
(wheezing, coughing, shortness of breath) • Headaches
or dizziness

 ess harmful chemicals when possible
L
(You can make your own cleaners – see
“Simple recipes for safer cleaners” on p. 19.)

If you notice any of these problems, STOP using
the product at once, wash up, and get fresh air!

Cleaning gloves to protect your skin

16 safety tip 2

cleaning products 17

tips
 eep products in their original
K
labeled containers. If you make your
own solution, write the contents on
the bottle.
Read labels and follow directions.
Keep containers closed when not in use.
 pen windows and/or use a fan to
O
get fresh air.
 pray product on sponge rather than
S
around the area to be cleaned.
 on’t mix different cleaning products.
D
NEVER mix bleach and ammonia!
The fumes can be deadly!

Simple recipes for safer cleaners
These cleaners work well and are simple to make
from items found at the grocery store. Important:
If you store them, label them!
General cleaners
Mix 7 drops of dish soap in a standard size
(24 oz.) spray bottle and fill with water. Cleans
counters, floors, and walls.
Mix baking soda with warm water. Cleans tubs,
tiles, showers, and toilet bowls.
Floor cleaners
Add ½ cup white vinegar to ½ gallon water.
No need to rinse. Cleans linoleum and tile.

18 safety tip 2

Glass cleaner
Mix 1/2 white vinegar with 1/2 water.
Rub windows with newspaper.
continues

cleaning products 19

Simple Recipes continued
Drain cleaner
Pour ½ cup of baking soda down the drain,
then ½ cup white vinegar. Let sit for 15 minutes,
and then pour a pot of boiling water down the drain.
Furniture cleaner and polish
Mix 1 part lemon juice with 2 parts olive or
mineral oil. Use with a spray bottle and sponge
or cloth.
Oven cleaner
(Do not use on self-cleaning ovens)
Mix 1 cup baking soda with water to make
a paste. Apply to oven surfaces and let stand.
Scrub with a scouring pad.

talk it over
You could say: “This cleaning product can affect
our breathing and irritate our eyes, but I can make
another cleaner that is safer and works just as well.”

find help
 rocery, drug, and hardware stores may carry
G
cleaning gloves and safer cleaning products.
 or a poison emergency, call the Poison Control
F
Center 1-800-222-1222

to do list
Supplies needed:
Cleaning gloves

“We make a list at the beginning of the month
to buy any necessary supplies to keep the
house clean. We create the list together,
and sometimes she suggests a substitute
for something that bothers her. Then I buy
what’s on the list without hesitation.”

Less harmful cleaning products

Other:
New ways to do the tasks:

People or places we will contact for help, tools, or information:
Elsa, Oakland consumer

20 safety tip 2

cleaning products 21

3

Doing laundry
for the consumer

Keep line of sight clear.

Reduce large loads
into smaller loads.

tools
Use these things to make this work safer:
Pillowcases or laundry bags to carry small loads

watch out for
Exposure to infectious diseases from laundry soiled
with body fluids • Aches and pains from lifting, carrying,
and loading or unloading laundry

22 safety tip 3

Carts to transport heavy loads
 isposable gloves to protect your skin if blood or
D
body fluids may be present
 eavy-duty plastic bags for carrying soiled
H
laundry to protect your skin from contact with blood
or body fluids
laundry 23

“When I got a cart the worker could use it
for both laundry and groceries.”
Natalia, Oakland consumer

Disposable gloves

find help
Heavy-duty plastic bag

tips
 andle laundry soiled with blood or body fluids
H
carefully. Follow “Universal Precautions” on p. 41.
Tie laundry bags shut and make sure they don’t leak.
 eep your back as straight as possible when
K
unloading items from a washer or dryer.

 ardware and discount stores sell plastic
H
bags, gloves, aprons, and carts.

to do list
Supplies needed:
Smaller laundry bags
Heavy duty plastic bags

Carts

Disposable gloves

Other:

New ways to do the tasks:

 on’t let the load you’re carrying block your line
D
of sight. You could trip or fall.
 ivide big loads into smaller ones to make them
D
lighter and easier to carry.
People or places we will contact for help, tools, or information:

talk it over
You could say: “It’s hard on my back to carry such
a big laundry basket. Could we try to find a cart for
me to use?”
24

safety tip 3

laundry 25

Helping the consumer
move from place to place

Gait belt

Do not twist.

Slide
or transfer
board

Bend your knees,
not your back.

One foot forward,
one back.

tools 
Use these things to make this work safer:
 gait belt buckled around the consumer’s waist
A
is a simple, low-cost way to help with transfers and
keep workers from straining their backs.

watch out for
Back and shoulder injuries • General aches and pains
26 safety tip 4

 slide or transfer board to help the consumer
A
move between two locations such as a wheelchair
and bed, wheelchair and toilet, etc.

continues

transferring 27

Handrail

Keep your
back as straight
as possible.

Toilet seat with
support arms

Consumer’s
arms around
your body,
NOT your neck

Shower chair

tools continued
Use these things to make this work safer:

Use safe lifting practices.

 Hoyer lift, a portable electric device that
A
helps you lift and transfer the consumer

 on’t try anything you think might be unsafe.
D
If needed, get help from another person.

 andrails, grab bars, or vertical poles installed to
H
help the consumer sit, rise, and stay upright

 eep the consumer close to your body while you
K
are assisting.

 hower chairs that let the consumer bathe
S
more safely

Bend your knees, not your back while moving
him/her. Do not twist at the waist. Try to turn your
whole body.

 aised, lockable toilet seats with support arms
R
to make bathroom visits easier and safer

“I ask family members or former caregivers to come
talk to a new caregiver. They can show what is safe
and what is not.”
Mark, Oakland consumer

28 safety tip 4

tips

 ave the consumer put his/her arms around your
H
body, NOT your neck.
 o not pull with your arms or your back.
D

Give yourself a strong base of support:
 eep your feet at least as wide apart as
K
your shoulders.

Put one foot forward, the other back.
transferring 29

talk it over
You could say: “How are you usually transferred?
Tell me if there are special precautions I should
know. Can we work together to make it safe for
my back?”

When the consumer uses a wheelchair
 ush, don’t pull the wheelchair – it’s easier on your back.
P
 efore helping with a transfer, remove or fold back the
B
leg rests and make sure the brakes on both sides
are locked.

If you’re concerned that the consumer might fall
 ave a plan in mind, including a number to call for help.
H
If

the consumer starts to fall, minimize the possibility of
injury to both of you by controlling the fall – guiding him/
her slowly to the floor.
 fter making sure that the consumer is
A
not injured, assist him/her to rise or get help
to lift him.

� If there’s ANY POSSIBILITY
the consumer has been injured,
DO NOT MOVE HIM/HER –
CALL 911.

If the wheelchair is motorized, make sure the chair’s
power is turned off before the transfer so it doesn’t
accidently move and lead to an injury.

“At first, I didn’t know how to help my client
in and out of bed, but my sister, who’s also
a homecare worker, suggested ways to do
it safely. This made things much better. I
had been going to a chiropractor a lot but
I didn’t need to after I made a few changes.”
Christine, Hayward homecare worker

Use a chair to help someone get up.
30 safety tip 4

transferring 31

find help
equipment

to do list
Supplies needed:

Call Eden I & R’s referral line at 211.

Gait belt

 onsumers can ask their doctors about
C
getting a wheelchair, walker, cane, or other
device to help them move around. Doctors
can write prescriptions for these devices,
sometimes called “durable medical equipment.”

Handrails, grab bars, or vertical posts

 he Center for Independent Living in
T
Berkeley, 510-841-4776

 ommunity Resources for Independent
C
Living in Hayward, 510-881-5743

 roducts and equipment may be available
P
from Home CARES Equipment Recyclers,
510-251-2273.

Slide or transfer board

Hoyer lift
Shower chair

Raised, lockable toilet seats with support arms
Other:
New ways to do the tasks:

training

 ocal adult schools or community colleges
L
provide Certified Nursing Assistant or Homecare
Worker classes that cover lifting, transfers, and
other procedures.

 he Public Authority for In-Home Supportive
T
Services (PA for IHSS) in Alameda County,
510-577-3554

 ervice Employees International Union –
S
United Long Term Care Workers
(SEIU-ULTCWU), 1-888-373-3018

If the consumer bought equipment from a medical
equipment supply company, the company can
show you how to use it.

People or places we will contact for help, tools, or information:

For more, see the Resources Section.�
32 safety tip 4

transferring 33

5

Helping the consumer
take a bath or shower
Handrail
Hand-held
shower

Gloves

Stool helps you
limit bending.

Shower
chair

tools 
Use these things to make this work safer:
Handrails installed for the consumer to use
A stool to sit on to keep you from reaching or bending

too much
A shower chair to help the consumer bathe with

less assistance
gloves should be worn any time there
is a chance of contact with blood or body fluids.
(See p. 41 for “Universal Precautions.”)
Disposable

watch out for
Muscle strains and sprains from lifting, transferring, and
reaching • Exposure to infectious diseases
34 safety tip 5

 hand-held shower or shower hose to make
A
bathing easier
continues

bathing 35

find help

tools continued
Use these things to make this work safer:
A long-handled bath brush to limit reaching
Folded towels or bath mats to protect your knees

if you’re kneeling
A non-slip mat or tub strips to prevent falls or slips

“I tell clients who live in apartments or senior housing
to ask the building manager to install grab rails and
removable shower heads.”
Helen, Oakland homecare worker

tips

For

information on where to find medical equipment,
call Eden I & R’s information referral line, 211.
Products

and equipment may be available
from Home CARES Equipment Recyclers,
510-251-2273.
equipment supply companies may
accept a prescription from a doctor for shower chairs.
Medical

Local

drug stores and discount stores sell
products that help in bathing and showering.

For more, see the Resources Section.

to do list
Supplies needed:

all your supplies (shampoos, soaps, etc.)
nearby so you don’t have to reach as much.
Keep

Non-slip mat or tub strips

Handrails

Long-handled bath brush

Shower chair

Disposable gloves

“I thought I might not like the feel of gloves
against my skin, but I don’t mind it and
it helps protect my worker’s hands.”

talk it over

Stool

Hand-held shower or shower hose

Other:
New ways to do the tasks:

Gabriel, Berkeley consumer

People or places we will contact for help, tools, or information:

You could say: “I’ve heard from other people
that they ask their doctor for a prescription to get
a shower chair. They say the chair makes taking
baths much easier.”
36 safety tip 5

bathing 37

6

Handling needles
and sharps

Sharps container

Disposable gloves

You are at risk for HIV/AIDS, hepatitis,
and other diseases if you:
Are

stuck by a needle or “sharp” (an object that can
pierce your skin) that has infected blood on it. It could be a
needle that you are using for an injection or a diabetes stick,
a discarded needle that accidentally sticks you when you
are cleaning up trash, a razor, or a piece of broken glass.

watch out for
Contact with blood and body fluid. They can be infected
with disease. Diseases carried in blood include HIV,
the virus that causes AIDS, and Hepatitis B & C,
incurable liver diseases.
38 safety tip 6

 re splashed in the eyes with infected blood
A
 ouch infected blood when you have a cut, open sore,
T
or broken skin

Consumers may also be at risk of getting an infectious
disease from homecare workers.
needles & sharps 39

Universal Precautions

tools 
Use these things to make this work safer:
 isposable gloves
D
 sharps container for throwing away used
A
needles or other sharps

“I tell consumers that 
I’m keeping us both safe
by wearing gloves and 
following the guidelines.”
Dolores, Dublin homecare worker

tips
If you get a needle stick or a cut from a sharp,
wash the area with soap and water. If the contact
is with your nose, mouth, or skin, flush with water.
If it is with your eyes, rinse them with clean water
or salt water. Contact your doctor and call
In-Home Supportive Services Payroll,
510-577-1877, to make a workers’ compensation
claim (in Alameda County). For more information
about workers’ compensation, see Tip 11.

“I provide gloves, even masks, and clean towels, and I want
the homecare worker to use them. If they’re coughing or
something else, I would like them to put on a filter mask.”

You can’t tell if people are infected with HIV or Hepatitis B
just by looking at them. Using “Universal Precautions”
means protecting yourself as if all blood and body fluids
could be infected. Use Universal Precautions whenever
there is a chance of contact with blood or body fluids,
including during tasks such as bathing, wound care,
laundry, and toileting.
1. Wear disposable gloves every time you may be in
contact with blood or body fluids. Ask the consumer
about skin allergies to specific products. Use special
gloves if either of you is allergic to latex or vinyl.
 ake sure the gloves fit. Replace them if they get torn
M
or damaged.
 se new gloves for each new consumer and each new
U
task. NEVER re-use disposable gloves. Throw away
used gloves.
 ash your hands before you put on gloves and after you
W
take them off. NEVER touch your mouth or eyes while
wearing used gloves.
 urn gloves inside out when removing them. Put them
T
in a plastic bag and tie the bag for disposal.

2. Wash your hands often.
 ash with soap and running water at regular times
W
during your work.

 emove any blood or body waste from your or the
R
consumer’s skin by washing with soap and running water.
continues

Dianne, Oakland consumer

40 safety tip 6

needles & sharps 41

Universal Precautions continued
3. Handle sharps with extreme care.
 oint sharps away from your body and discard them
P
immediately after use into a sharps container. Never put
sharps in a regular recycling bin or trash can.
 ever reach into a trash bag! It could contain needles
N
or other sharps.
 ever recap a needle or touch the point.
N

4. Cover cuts, sores, or breaks in your skin and the consumer’s
skin with bandages, unless the doctor says otherwise.
5. Use bleach to carefully clean household surfaces that may have blood
or body fluids on them. Mix one
part bleach to 10 parts water.
Make this solution fresh each day–
and label it.
6. Get a vaccination to protect you from Hepatitis B
(See find help section, below).

 all Eden I & R’s information referral line at 211 to find
C
out about Hepatitis B and flu vaccinations.

If you are an Alameda Alliance for Health member,
check with your assigned doctor or clinic for vaccines
(Hepatitis B, flu, etc.) and other exams and screenings.
 o get a sharps container, contact your medical
T
provider, drugstore, or medical supply store.
 o find out where to drop off your sharps container, contact
T
Alameda County Household Hazardous Waste,
800-606-6606.

For more, see the Resources Section.

to do list
Supplies needed:
Disposable gloves

talk it over
You could say: “I always use gloves when I help
consumers take their blood sugar test (or another task
that could expose you to infection.) As homecare
workers, we have to be very careful to protect
ourselves from serious problems.”

find help

Bleach

Sharps container

Bandages

Other:

New ways to do the tasks:

People or places we will contact for help, tools, or information:

 isposable gloves are available at grocery stores,
D
drugstores, and medical supply stores.
 heck with your doctor or clinic about getting a
C
Hepatitis B vaccination.

42 safety tip 6

needles & sharps 43

7

Cooking and shopping
for the consumer
Put
knives
away.

Clean up spills.

tools
Use these things to make the tasks safer:
 otholders, gloves, or mitts when handling food on
P
the stove or in the oven

watch out for

Stepstools to reach items overhead

Burns • Fires • Cuts from knives • Muscle strains
and sprains from reaching and lifting • Slips and falls
from spills

Carts to carry groceries or other heavy items

44 safety tip 7

Tongs to lower food into boiling water
 ire extinguishers labeled as B, B-C, or A-B-C for
F
flammable liquids
cooking 45

tips
Knives:

Shopping:

Store knives safely.

If you are interrupted while cutting something,
lay the knife down in a flat, safe space.

 imit the amount you carry by hand. Use a cart
L
if possible.

Follow safe lifting and carrying guidelines.

• Keep your back as straight as possible

Stoves:

• Make sure bags are light and easy to carry.

Set pot handles away from burners.

Storing and moving items:

 ift pot covers slowly, away from your face,
L
to protect yourself from steam.

Never leave hot oil or grease unattended.

 tore heavy and frequently used items at
S
waist height, if possible, to reduce reaching
and bending.

 on’t leave the room while a burner is on.
D
Fires can start when the liquid evaporates or
food gets too hot.

Move heavy items one at a time.

 EVER pour water on a cooking fire!
N
Use a fire extinguisher that is rated for flammable
liquids or put a lid on the pan and turn off the
heat. Don’t take the lid off until the pan is
completely cooled.

If there’s a fire in the oven, turn off the
oven, keep the oven door closed and phone
911 for help.

46 safety tip 7

 et a falling knife fall. Never try to catch a
L
falling knife.

and use your legs while lifting.

cooking 47

to do list
“When my homecare worker used to
buy groceries for me, she would carry the
groceries to my house from the market.
Now when we shop, I borrow a cart from
my neighbor. This makes it easier for her –
she no longer has to carry heavy grocery
bags to my house.”

Supplies needed:
Potholders, gloves or mitts
Tongs

Stepstools

Carts

Fire extinguishers labeled B, B-C, or A-B-C

Other:
New ways to do the tasks:

Ling, Oakland consumer

talk it over
You could say: “If we move these items to
a lower shelf, I won’t have to reach so high.
Do you mind if I do that to protect my back?”

People or places we will contact for help, tools, or information:

find help
 ou can buy potholders, cooking gloves or
Y
mitts, stepstools, grocery carts and tongs at
most hardware and discount stores.

48 safety tip 7

cooking 49

8

Preventing trips and falls
Cord out
of the way

Clear pathway
to walk.

Non-slippery shoes

tools
Use these things to make the tasks safer:
Shoes with non-slip soles

watch out for
Bruises and sprains • Broken bones

 arpet fasteners or double-sided carpet tape to help
C
keep rugs in place
 dequate lighting throughout the home, including
A
walkways, stairs, and outdoor areas. Make sure all light
bulbs are working.
Keep flashlights on hand in case of power outages.

50 safety tip 8

trips & falls 51

tips
Use non-skid wax on floors or no wax at all.
 lear walkways and stairs of obstacles and
C
tripping hazards like boxes, papers, and other items.

tips continued
 n stairs, use railings and take your time.
O
Make sure your vision is not blocked by anything
you carry.

 ove or remove items that might cause falls,
M
such as

• Phone cords and electric extension cords

• Curled or wrinkled rugs, mats, or carpets

• Oxygen tubing
 eep a mop and towels on hand to clean up
K
spills quickly. (Remember that dry spills, such
as flour, sugar, and coffee grounds can also lead
to falls.)
Sweep or vacuum the floor regularly.
 ever leave drawers open on dressers, file
N
cabinets, etc.
 o not place throw rugs at the top or bottom
D
of stairs.

Of special concern:
When working with consumers who have
vision or memory disabilities, make sure
to request permission to move belongings,
even if they are in an unsafe location.

52 safety tip 8

talk it over
Be sensitive to the fact that the consumer may not
want the house and its contents rearranged.
You could say: “I know you might not like having
your things moved, but we need clear pathways so
neither of us will get hurt. What could we do to make
this area safer?”
trips & falls 53

“Rugs on the floor are a big problem. If the worker
doesn’t trip, then I might. Homecare workers don’t
want to get hurt and they don’t want the consumers
to get hurt, especially seniors like me, who may
take a long time to heal.”

to do list
Supplies needed:
Shoes with non-slip soles
Carpet fasteners or double-sided carpet tape
Flashlights

Paul, Oakland consumer

Other:

New ways to do the tasks:

find help
 lameda County’s Senior Injury Prevention
A
Program (SIPP), 510-577-3535, offers training
programs, a video, and a booklet.
Some cities offer fall prevention programs.

• Bancroft Senior Center, 510-351-3299,
offers a free fall risk prevention exercise.

• LIFE ElderCare, Inc., 510-574-2090,

People or places we will contact for help, tools, or information:

provides an in-home exercise program and
fall prevention evaluation for seniors of the
Tri-City area.

• Spectrum Community Services, Inc.,

510-881-0300 ext. 270, offers a free fall risk
reduction program.

 ocal stores sell flashlights, batteries, mops, and
L
carpet fasteners.

For more, see the Resources Section.

54 safety tip 8

trips & falls 55

9

Fire and electrical safety
Smoke alarm
with new batteries

Fire
extinguisher

Cord in good shape

tools
Have these things available or installed
to make the job safer:
 moke alarms on each floor (Check batteries
S
at least once a year.)

watch out for
Electric Shocks • Burns
56 safety tip 9

 ire extinguisher – Know where it is and make
F
sure it has been serviced regularly. Get training on
how to use it. If there is no extinguisher, ask the
apartment manager about it, if appropriate.
fire & electrical safety 57

“We live in the Bay Area! It’s really important we
plan together in case we have to evacuate. I’ve
made sure we both have emergency contact
numbers to call in case anything should happen.”
Patricia, Hayward consumer

tips
General fire safety:

 lan and practice evacuation in case of a fire.
P
Know where the exits (including windows) are.

 rite down emergency numbers –
W
In case of emergency dial 911 to reach
the fire department, police or emergency
medical services.

Cigarette smoking is the most frequent
cause of fires in the home.

 on’t use water to put out a cooking fire.
D
Use an extinguisher or smother the fire instead.

 ake sure lit cigarettes are never near flammable
M
items such as oxygen tanks, paper, drapes, etc.

 ake sure that the stove is turned off when
M
not in use.

 lace space heaters away from pathways
P
so they are not likely to be knocked down. Also
keep them away from fabric, clothing, etc.

If the consumer smokes and takes medication that
causes drowsiness or forgetfulness, pay extra
attention to prevent a fire.

 ut water on cigarettes before throwing them in
P
the trash.

 dvise the consumer not to smoke in bed. Make
A
sure that ashtrays are located away from mattresses
and bedding.

58 safety tip 9

 emove lint from the dryer before doing
R
another load. It could catch fire.

fire & electrical safety 59

Oxygen

Electrical safety continued


Keep
all flames away from oxygen equipment –
including lit cigarettes, candles, matches, and stoves.

If you get even a small shock from an appliance,
stop using it immediately until it’s fixed.

 tore oxygen tanks in well-ventilated areas,
S
not closets or other small spaces.

 ever use a hair dryer, radio, TV, or other
N
electric appliance near water.

 light switch or electric outlet hot to the touch
A
can indicate unsafe wiring – get help!

 o not place electrical cords under rugs
D
or carpets.

talk it over
Avoid overloading
plugs and outlets

Electrical safety

 void putting too much of a load on extension cords.
A
(Check the rating tag on the cord.)

 ave missing outlet covers and frayed cords
H
replaced.

 heck that appliances like lamps, hair dryers, coffee
C
makers, mixers, microwaves, and toaster ovens are
in good condition with intact cords and plugs.

60 safety tip 9

You could say: “Smoke alarms and fire
extinguishers will make your home safer and
help protect us both. What can I do to help
you get them?”

fire & electrical safety 61

find help
 any hardware, home supply, or general
M
merchandise stores carry smoke alarms. Call
your local fire department (on a nonemergency
telephone number) for suggestions. Some fire
departments may also provide seniors and low
income individuals with smoke detectors and
help install them.

to do list
Supplies needed:
Smoke alarms

Fire extinguisher

Other:
New ways to do the tasks:

If the consumer lives in an apartment building or
senior residence, ask the building manager for
a smoke alarm.
Most local hardware stores sell fire extinguishers.
Get an all-purpose type (called ABC dry chemical
10 lb. extinguisher).

People or places we will contact for help, tools, or information:

“I sit down with the consumer at the
first visit and we go through numbers
to call, including doctors and family,
how to get out in case of fire or other
emergency.”
Jackie, Oakland homecare worker

62 safety tip 9

fire & electrical safety 63

10

Dealing with stress
from the job

Some causes of job stress for homecare
workers are:
Concern about the well-being of the consumer
Long hours
Pressure to do tasks quickly or too many tasks at once
Fears about losing your job
Poor communication between you and the consumer
J ob tasks that you believe are hazardous or conditions
in the consumer’s home that you believe are unsafe

Too much stress on the job can make you:
Feel sad and depressed
Cry more often than usual
Have low energy
 ot want to do things you
N
used to enjoy
Have sleeping problems
Have changes in your appetite
Become sick more often

watch out for
Stress occurs when your mind and body are overloaded
with pressure and worry. This overload is not good for
your health, especially if it continues over a long period
of time.
64 safety tip 10

Increase use of alcohol, tobacco, or drugs
Feel angry at the consumer or other people
Think about hurting yourself or others

stress from the job 65

tips
It’s hard work caring for another person. Take care
of yourself! If you don’t, you won’t be much help
to anyone else. Here are some ways to deal with
stress on the job:

 ake a list of what is causing your stress at
M
work. Are there ways to reduce these problems?

 hile you’re trying to work out problems on the job,
W
follow healthy living suggestions, such as:

• Exercising

• Eating well

• Talking to a friend or counselor

 tart by selecting one or two issues to work
S
on so you don’t feel overwhelmed.

• Getting enough sleep

 alk to friends, family members, or other
T
homecare workers.

• Keeping up-to-date on vaccinations such as flu shots

• Trying to avoid alcohol and drugs

 all an agency or program for help. (See find
C
help section, on pg. 68)

If appropriate, talk to the consumer about the
problem(s). You might invite a person who is
supportive of you and the consumer to be present.
Come prepared with ideas for possible solutions.

66 safety tip 10

stress from the job 67

find help
 or questions about or problems with your
F
paycheck, call In-Home Supportive Services
(IHSS) Payroll, 510-577-1877.
If you are unsure about your health benefits,
need more work or want training, call the Public
Authority, 510-577-3552.
 or questions that the union can help with, such
F
as finding meetings in your area, getting training,
and joining the fight to protect homecare services,
call SEIU-ULTCW,1-888-373-3018.

•C
 risis Support Services of Alameda County,

800-309-2131, which offers support to people
of all ages and backgrounds during times
of crisis

• Information and Assistance, 211 ( Eden

Information and Referral), or 1-800-510-2020
(Alameda County Adult and Aging Services) to
find agencies and programs that might help.

to do list
New ways to handle stress:

If you found your homecare job through the Public
Authority Registry, call your Registry Coordinator
for ideas and assistance, 510-577-5694.
If there is abuse in the home, or if someone is
abusing the consumer, call Adult Protective
Services, 510-577-3500.
 o find out about stress management counselT
ing, call your health plan, HMO, or MediCal
provider.

People or places we will contact for help, tools, or information:

 or information on other sources of counseling
F
for homecare workers, call:

• Family Caregiver Alliance, 415-434-3388,
which offers free or low cost services and
resources for all Bay Area residents

68 safety tip 10

stress from the job 69

11

Getting help for
a work injury through
Workers’ Compensation

How do work-related injuries occur?
 hrough a single event, such as falling and hurting your
T
back or getting burned while cooking for the consumer
 hrough repeated activity or contact, such as back
T
strain from daily assisting with transfers, asthma from
repeated exposure to animals or dust, or a skin rash from
working with chemicals

What benefits can you receive
if you are injured on the job?
 edical care to help you recover from an injury or illness
M
caused by work
 emporary disability benefits – payments if you lose
T
wages because your injury prevents you from doing your
usual job while you are recovering. To be eligible, you must
be unable to do your usual job for more than three days or
be hospitalized overnight. Temporary disability benefits are
generally 2/3 of your salary.
 ermanent disability benefits – if you don’t recover
P
completely
 ocational Rehabilitation vouchers (available to some
V
injured workers) – limited resources for retraining or skill
enhancement

Did you know:

 eath benefits – payments to your spouse, children, or
D
other dependents if you die from a job injury or illness

If you’re injured on the job, you can get
Workers’ Compensation that can cover
your medical care and some paid time off
to recover, if needed.

70 safety tip 11

work injuries 71

tips
What to do if you have a job injury
1) Get emergency treatment if needed. If it’s
a medical emergency, call 911 or go to an
emergency room right away!
2) Report the injury promptly to In-Home Supportive
Service (IHSS) Payroll, 510-577-1877. Report
within 30 days of the injury or you could lose
your right to benefits.
3) File a claim form. IHSS Payroll must give you
or mail you the claim form within one working day
after you report your injury or illness. Read, fill out
the “employee” portion, and sign the claim form.
Return the form to Payroll right away.
4) I HSS Payroll must fill out and mail the completed
form to a Workers’ Compensation claims
administrator, the State Compensation Insurance
Fund (SCIF). Call SCIF (951-697-7300) within
one week of filing your claim with IHSS Payroll
to make sure that it was
received. IHSS Payroll must
give or mail you a copy
of the completed form
within one working
day after you filed
it. Keep this copy.

5) SCIF must decide within
a reasonable time whether
to accept or deny your
claim. If you receive a
letter saying the claim is
denied, you have the right
to challenge the decision.
If you don’t receive a letter
denying your claim within
90 days of reporting
the injury, your claim is
considered accepted in
most cases.
6) Get good medical care. Within one working
day after you file a claim form, SCIF is required
to authorize medical treatment for up to $10,000
while your claim is being investigated.

Who can treat you?
If you have Alliance Group Care or the
SEIU Trust, those healthcare professionals
will treat you for an on-the-job injury.
If you have other insurance, your medical
provider should treat you, even while the
claim is pending. Your health insurer will seek
reimbursement from SCIF later if your injury is
covered by workers’ compensation.
Call SCIF, 951-697-7300, for a medical referral.

72

safety tip 11

work injuries 73

find help
Learn your rights in workers’ compensation
cases. Don’t be afraid to ask questions and
speak up. See whether In-Home Supportive Service
(IHSS) or the claims administrator can agree to
resolve the problem. If this doesn’t work, don’t
delay getting help.
I HSS Payroll in Alameda County –
to first report your injury: 510-577-1877
 tate Compensation Insurance Fund (SCIF)
S
— for information on your claim: 951-697-7300
 EIU-ULTCW — for union representation:
S
1-888-373-3018
 ontact a State Information & Assistance
C
(I&A) officer who can answer questions and
help injured workers. This person may provide
information and forms and help resolve
problems. Some I&A officers hold workshops
for injured workers.
For more information, go to www.dir.ca.gov/dw.
To contact a local office, check the Government
Pages at the front of the phone book under
“State Government Offices/Industrial Relations/
Workers’ Compensation.” The Oakland I & A
office can be reached at 510-622-2861.

74

safety tip 11: work injuries

Resources

Information and Referral
Alameda County Adult and Aging Services
Information and Referral
1-800-510-2020
6955 Foothill Blvd., 3rd floor, Oakland, CA 94605
www.alamedasocialservices.org. In search box type:
“adult aging services”
Provides current information on resources available to 
seniors and their families, including listing for assistive 
devices, caregiver support groups, and other non-profit 
and public agency services.

Eden Information & Referral, Inc.
510-537-2710
570 B Street, Hayward, CA 94541
www.edenir.org/
[email protected]
Provides 211, a free, accessible, 3-digit telephone number
that enables all Alameda County residents easy access 
to customized multilingual health, housing, and human 
services information 24 hours a day, 7 days a week, and
365 days a year.

resources 75

Information and Referral continued

Homecare Workers Training Center

Family Bridges, Inc.

Class Hotline 866-888-1213
LVN Infoline 213-985-1687
www.homecareworkers.org

510-839-2022
168 11th Street, Oakland, CA 94607
www.fambridges.org/index.html
[email protected]
Provides information and referral, language assistance, and
naturalization services; offers assistance in Cantonese and
Mandarin as well as other languages upon request.

Labor Occupational Health Program (LOHP)
University of California, Berkeley
510-642-5507
2223 Fulton Street, Berkeley, CA 94720
[email protected]
www.lohp.org/

Mailing address:
3010 Wilshire Blvd. #105
Los Angeles, CA 90010
Provides classes throughout California in a broad range
of topics, from dealing with dementia to CPR to beginning
computers.

In-Home Supportive Services (IHSS) Payroll of
Alameda County
510-577-1877
6955 Foothill Blvd., 3rd floor, Oakland, CA 94605

Provides information on improving health and safety in 
the workplace.

Manages IHSS homecare worker enrollment, processes
IHSS payroll timesheets, deals with IHSS payment 
problems and submits worker’s compensation claims.

Organizations Serving Homecare Workers

Public Authority for In-Home Supportive Services
(PA for IHSS) in Alameda County

Service Employees International Union –
Long Term Care Workers (SEIU-ULTCW)
1-888-373-3018
440 Grand Ave., Suite 250, Oakland, CA 94610
www.seiu-ultcw.org/
Provides training and opportunities to gather with other
homecare workers, and can refer you to the Homecare 
Workers Training Center (see following page).

76 resources

510-577-3552
6955 Foothill Blvd., 3rd floor, Oakland, CA 94605
www.ac-pa4ihss.org
Provides training programs for homecare workers and
consumers, registry services for assistance in connecting
homecare workers to consumers, emergency replacement
services, enrollment in homecare worker health benefits
plan, and advocacy.

resources 77

Mujeres Unidas y Activas – Oakland

Center for Independent Living (CIL)

510-261-3398
2647 International Blvd., Suite 701
Oakland, CA 94601
www.mujeresunidas.net

510-841-4776
TTY: 510-848-3101
2539 Telegraph Avenue, Berkeley, CA 94704
www.cilberkeley.org/index.htm
[email protected]

Provides job training and placement as home health care and
childcare providers and housecleaners; training to negotiate
contracts and build skills; and workers’ rights campaigns that
teach immigrant women to advocate for themselves.

Provides advocacy, counseling, education, referrals, and 
assistive technology services on how to use assistive 
devices such as ramps, wheelchairs, TTYs, and computers.

Community Resources for Independent Living (CRIL)

Organizations Serving Consumers
In-Home Supportive Services (IHSS) of Alameda County
510-577-1900
6955 Foothill Blvd., 3rd floor, Oakland, CA 94605
www.alamedasocialservices.org
Pays for homecare workers to assist low-income seniors 
and people with disabilities in their homes. Consumers must
apply and qualify in order to receive this public benefit.

Public Authority for In-Home Supportive Services
(PA for IHSS) in Alameda County
510-577-3552
TTY: 510-577-3549
6955 Foothill Blvd., 3rd floor, Oakland, CA 94605
www.ac-pa4ihss.org/
Provides training programs for homecare workers and 
consumers, registry services for assistance in connecting
homecare workers to consumers, emergency replacement
services, enrollment in homecare worker health benefits plan,
and advocacy.

78 resources

510-881-5743
TTY: 510- 881-0218
439 A Street, Hayward, CA 94541
www.cril-online.org/
[email protected]
CRIL provides advocacy, counseling, education, referrals,
and assistive technology services. Recommends the most
current technological devices, equipment, and resources to
accommodate a wide spectrum of disabilities. CRIL also
provides a base home accessibility and safety assessment.

Alameda County Health Care Services Agency
Public Health Department Senior Injury Prevention
Program (SIPP)
510-577-3535
SIPP Coordinator Hours: Monday-Friday, 7-5
6955 Foothill Blvd, Suite 300, Oakland, CA 94605
www.acgov.org/ems/ems_SIPP.htm (or Google “Senior
Injury Prevention”)
Hosts free fall-prevention and driving safety discussion groups,
conducts older adult traffic safety and mobility trainings for 
service providers, and provides a fall prevention video that is
available to senior centers, residential facilities, faith-based 
facilities, and other locations where older adults congregate.
resources 79

Medical Supplies and Equipment
Alameda County Network of Care for Seniors &
People with Disabilities
www.alameda.networkofcare.org/aging/home/index.cfm
Internet-based community resource offers information about
caregiving, diseases, day-to-day challenges, and advocacy.
The Assistive Devices section provides information on 
devices to assist with activities of daily living; accessibility,
cooking, cleaning, and other household activities; protecting
health and home; allowing people to sit comfortably 
and safely; and aiding people with disabilities. Note: Many
assistive devices are now covered by Medicaid or Medi-Cal.

Home CARES Equipment Recyclers
510-251-2273
2619 Broadway, Oakland, CA 94612
www.homecares.org
Provides free home health care equipment and supplies for people
without medical insurance or whose medical insurance does not
cover the cost of home medical supplies. Available equipment
and supplies may include but is not limited to canes, walkers,
ostomy supplies, gauze bandages, crutches, portable commodes,
blood pressure kits, oxygen equipment, feeding kits and tubing,
tub transfer benches, tub seats, tub stools, and wheelchairs.

Health Care and Mental Health
(See also Information and Referral)
Alameda Alliance for Health
510-747-4500 or TTY: 510-747-4501
1240 South Loop Road, Alameda, CA 94502
www.alamedaalliance.org/

Family Caregiver Alliance (FCA), National Center
on Caregiving SF Bay Area Caregiver Services
415-434-3388
180 Montgomery St., Suite 1100, San Francisco, CA 94104
www.caregiver.org. In search box type: “SF Bay Area”
and click on SF Bay Area Caregiver Services.
[email protected]
For residents of the six-county San Francisco Bay Area, FCA
provides information, emotional support, consultation on
care planning, links to community programs, legal/financial
consultation, respite services, counseling, publications, and
educational programs. All services are free or low cost.

Crisis Support Services of Alameda County
24 Hour Crisis Line: 1-800-309-2131
www.crisissupport.org/index1.html
[email protected]
Offers support to people of all ages and backgrounds 
during times of crisis, working to prevent suicide and offer
hope and caring during times of hopelessness; helps 
community members in times of grief and stress.

Other
Alameda County Household Hazardous Waste
1-800-606-6606
1537 Webster Street, Oakland, CA 94612
www.stopwaste.org/
[email protected]
Provides information on where to drop off sharps containers.

Provides health care insurance. All health care is arranged
through a contracted doctor.
80 resources

resources 81

Our action plan for safety
Make a plan to help you and the consumer
stay safe together. Look back at each Safety
Tip and create a list of:

Our action plan for safety
Make a plan to help you and the consumer
stay safe together. Look back at each Safety
Tip and create a list of:

Supplies you need:

Supplies you need:

Safety Tips you will follow:

Safety Tips you will follow:

Issues you need to discuss:

Issues you need to discuss:

Phone numbers to call, organizations to contact for assistance:

Phone numbers to call, organizations to contact for assistance:

82 action plan

action plan 83

Our action plan for safety
Make a plan to help you and the consumer
stay safe together. Look back at each Safety
Tip and create a list of:
Supplies you need:

Acknowledgements
This handbook was developed by staff from
the following organizations:
Labor Occupational Health Program (LOHP) at UC Berkeley
www.lohp.org
The National Institute for Occupational Safety and Health (NIOSH)
which also provided funding and technical support to this project.
www.cdc.gov/niosh/
The Public Authority for In-Home Supportive Services
(PA for IHSS) in Alameda County www.ac-pa4ihss.org
The Service Employees International Union Long Term Care
Workers (SEIU-ULTCW) www.seiu-ultcw.org

Safety Tips you will follow:
Design: Underground Advertising Illustrations: Mary Ann Zapalac
Spanish Translation: Lisa de Avila, Muse,
Excellence in Writing and Translation

Issues you need to discuss:

Phone numbers to call, organizations to contact for assistance:

Chinese Translation: Kai Lui, edited by Ken Fong
Homecare Worker and Consumer Leadership Group:
Special thanks to the following homecare workers and consumers
who helped develop the initial concept, reviewed drafts,
and participated in the field testing of the handbook. Their help and
inspiration have been invaluable.
Workers: Thanh Ahlfenger, Teresa Armas, Brenda Blannon,
LiYa Chen, Maria Luisa Figueroa, Faye Herald, Xin Fang Huang,
Phyllis Malandra, KeTian Ouyang, Ada Wong
Consumers: Mark Beckwith, Rosa Ortiz, Carmen Rivera-Hendrickson,
Michelle Rousey
We also thank the many people, agencies, and organizations in the
community who participated in developing this handbook.

84 action plan

Printer’s Name, 2010