Meals on Wheels Involves Much More than Food Delivery

Steve Stoyke, Nurse Case Manager and Merry Prankster
Steve Stoyke, Nurse Case Manager and Merry Prankster

The room was in stitches as Steve Stoyke fired off one quirky, off-beat joke after another.

It was late on a recent Friday afternoon and the case workers were slowly unwinding after another hectic week at the Frederick County Department of Aging.  The scene was not uncommon — Stoyke, a Meals on Wheels case worker and licensed practical nurse (LPN) — has regaled his co-workers many times before with his keen, if perhaps somewhat bohemian, sense of humor.

A food and beverage caterer in another life years ago, he is clearly the merry office prankster.  But one would be quite mistaken if they thought that was his main talent.  Behind the smile and bantering is a fiercely dedicated case worker who has, since 2003, been largely responsible for turning the DOA’s Meals on Wheels (MoW) program into something much more than just a food delivery service for those in need of more nutritious food.

One of the first things he realized when he began working for MoW 12 years ago is that many of the clients are vulnerable, frail people in urgent need of many more services, including health care.  The realization in 2003 that the program did not have a system for arranging or providing other services was more than a little disturbing — as a health care professional, he can be held accountable for clients who get hurt or are not properly cared for.  And besides, taking care of people is what he does.

“I took my nursing attitude and put it in place here,” Stoyke said.  “I was looking at these people as my patients.  They weren’t taking their pills.  . . . And in other cases, they weren’t washing themselves [and we had to do something about it].”

Under his direction, new client assessment policies and procedures were instituted and today, MoW applicants undergo a thorough evaluation of their living conditions and needs.  A comprehensive form requires Stoyke and other case workers to find out the health and functional abilities of each person.  “I go in and look for odors and skin color,” he said.  “Are their glasses clean?  Is the bathroom clean?  Sometimes, [with their permission] I go through their medicine cabinets to see what’s there.”

Periodically, he steps in to offer temporary health care assistance and to function as a provider of basic necessities.  On one occasion, he helped a 94-year-old blind client organize the 27 daily prescription pills  she takes to make sure they are taken properly.  And in another instance, he secured a doctor’s orders to temporarily conduct Foley flushes, which are a way to avoid bladder infection if someone must use a catheter.  And sometimes, clients can’t do AccuChecks for diabetes.  So he does them.

“We go way beyond our job simply because it is the right thing to do,” he said.

Something Stoyke and his colleagues have learned over the years to look for are signs of neglect and abuse.  Once, they learned about a man and woman who had won the confidence of an elderly MoW client and were living in her house and spending her money.  There have also been tense moments when case workers have reported clients living in substandard potentially dangerous housing.

It is almost comic relief when DOA staffers encounter MoW applicants who don’t need the help.  For instance, there was the time a few giggles had to be suppressed when a wealthy woman in a fine home applied because she did not like to wash dishes or get her sink dirty.

But mainly, case workers encounter people in desperate need.  “I’ve gone home in tears before,” said Stoyke.  “It just kills you sometimes.”

But not enough to give up.  That he has no intention of doing.  He will continue to drive 20 to 80 miles a day to visit and meet the needs of MoW clients.  “We do the best we can with what we’ve got,” he said.  “I still see this program as being the best bang for the buck.”

Jeff Trewhitt is a contributing writer and MOW volunteer.

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