Tell Us Your Story

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* What happened in your life which caused you to need an IHSS worker? Was it from an accident, injury, aging, congenital disorder, etc.?

Congenital Disorder

Mental Illness

Accident

Injury

Age Related Pain

Cancer/Stroke

Depression

Alzheimer's/Dementia

Other

* What type of impairment(s) are you experiencing? For example: Visual, Hearing, Mobility, etc. (Check all that apply)

Visual

Hearing

Mobility

Neurodevelopmental/Neurological

Speech

Cognitive

Chronic Illness-related

Pain-related

Multiple Impairments (e.g., deaf, blindness)

Other

* What types of tasks do you rely on your IHSS Caregiver for?

Domestic Services

Meal Preperation

Meal Clean-Up

Laundry

Shopping for Food

Respiration

Bowel/Bladder Care

Feeding

Routine Bed Baths

Dressing

Menstrual Care

Ambulation

Transfer

Bathing/Oral Hygiene/Grooming

Care/Assistance with Prosthesis

Accompaniment to Medical Appointments

Protective Supervision

Paramedical Services

Heavy Cleaning

* What would you do if the IHSS program ended or if your Caregiver's hours were drastically cut?

Pay a provider out of your own pocket

Have a provider with NO pay

Have NO provider and be on your own

Asks a friend or family to help you with no pay to them

Move or try to move to a senior home, full-time nursing home or facility

Spend more time at a local senior center or ILC (Independent Living Center)

End up in the emergency room due to lack of provider

* Do we have your consent to share your story on our website and also with your legislature or other advocacy efforts in your area? If YES, please type your first and last name along with your email address and/or phone number. If NO, please type no.

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Personal Assistance Services Council | 3452 E. Foothill Blvd. Suite 900 | Pasadena, CA 91107 US

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