Stanley Rachal was a pretty typical guy in his mid-30s a decade or so ago. He was living in a small town in Louisiana, working full-time and going to school to earn a criminal justice degree. Then a heart attack set him on a downward spiral that saw him lose his home, suffer two more heart attacks and a series of strokes, and eventually wind up sleeping on the porch of the nursing home where he was working as a housekeeper.
But this story has a happy ending. Thanks to people who cared about him, and with the help of the DADS Community Based Alternatives program, Rachal -- who is a Medicaid recipient -- now has a decent place to live, help with the daily necessities of life and many of the things that most of us take for granted.
In other words, he got his life back.
Rachal's world started to unravel in 1996 when he had the first of three heart attacks. He was in the hospital for three months and, when some vital paperwork didn't get signed, he lost his apartment and everything in it.
He moved to Fort Worth, Texas, and lived with a friend while he supported himself by working in a coffee shop and a liquor store. While living in Fort Worth, Rachal had a second heart attack and then, almost unbelievably, a third.
Rachal moved to Cleburne, Texas, and things started to look up. He took a job on the housekeeping staff at Colonial Nursing Home, but the pay wasn't enough to allow him to afford an apartment.
A nurse at Colonial, Scarlotte Pancerzewski, noticed one day that Rachal didn't seem to be walking steadily, and that his shoes were extremely run down. When she asked him about his condition, he told her he had to walk 45 minutes to get to work. Once, when he seemed particularly worn out, she mentioned his condition to one of the nurse aides. The aide told Pancerzewski that Rachal sometimes slept on the nursing home porch.
"I asked him about it and he said he only made $5.50 an hour and it was hard for him to save enough to move into an apartment," she said, "so he was sleeping at a motel three nights a week and the other four he'd sleep on the porch when his money ran out."
Pancerzewski and her husband invited Rachal to move into their home. During his stay there, he took classes to become a nurse's aide. Once certified, he got a new job that paid enough that he could afford an apartment. He moved out of the Pancerzewskis' house and into a place he shared with a couple of other men. Things were looking up for Rachal
After about a year, he returned to Colonial. He'd been there about a month when bad luck struck again. One day, as he was dressing to go to work, he noticed he felt "off." He said, "When I got to work I was walking funny, running into things. One of the nurses said she thought I'd had a stroke."
A trip to the emergency room initially revealed nothing. When he returned three days later, doctors had a different story. "I went back and they said they'd looked at my CAT scans and that I'd had three mini-strokes," he said. "I had sustained damage to three parts of my brain."
The strokes left Rachal unable to work. He lived for more than a year in a nursing home, recuperating from his stroke, and feared he might spend the rest of his life there. He didn't know he had options until his physician asked him why he was still in a nursing home.
"I wanted to get out," he said, "but I needed help."
Help came from a social worker at the nursing home who knew of DADS' Promoting Independence initiative, which supports allowing people with disabilities to live in the most appropriate care setting available. Texas gets Medicaid funds that enhance DADS' Money Follows the Person initiative, which helps people who live in nursing facilities return to the community.
Phyllis Levy, MSW, who does contract work for North Central Texas Area Agency on Aging, served as a coordinator between Rachal and the DADS office in Cleburne. Levy said that because Rachal was unable to work or care for himself, he was in a situation from which he might not have been able to extricate himself.
"He was a young guy stuck in a nursing home with no resources, no family and no siblings," she said. She explained that when Rachal was released from the hospital, his lack of a support network severely narrowed his options. "If you don't have family, they put you in a nursing home and if you don't have a support system, you get left there."
With transitional help from the AAA and DADS, Rachal got out of the nursing home and into an apartment, and was even able to purchase some furniture.
Rachal's life is a lot better now. "I live alone in an apartment. If I have to go to the doctor, I call Medicaid Transport system and they send someone over to take me. And the pharmacy delivers my medications," he said. "CBA took care of all the stuff in my apartment – my furniture, my cleaning stuff, all my cooking utensils. And every two weeks a nurse comes by and sorts out my meds so I don't get confused.
"Everything I have now is because of CBA, and I'm very grateful," Rachal said. "If I have any problems I just call my caseworker and she does her best to try to help me. I have no complaints about anything."
— Story by Jeff Carmack
— Photos by Brian Hollingsworth
Published: August 2008