We want to continue to highlight the work of our amazing adult foster care home providers in Oregon.
Matt Gannon spent some time talking with Margaret Gikaru, RN-BSN, operator of Troutdale Adult Home Care, which is a classification 3 care home in Multnomah County. Please read below to learn more about Margaret.
Tell us a bit about your background and what lead you to work in care and service.
My husband and I arrived together in the United States from Kenya in 1995. We flew into Los Angeles with only $70 between us, and I was 9 months pregnant. We started our lives in the United States in California but moved to Seattle, Washington two years later.
Being African immigrants, we are used to taking care of our elderly and I helped to take care of my grandma when I was a little girl. We didn’t have nursing homes in Kenya then. When our parents grew old, we’d take care of them. It was a new experience for us when we came to America and realized we could work in care settings to take care of elders. We decided to move from California to Washington because most of our family was in Seattle.
I started working as a certified nursing assistant (CNA) and started working in a nursing home in 1997. We recognized that it is easy to get a job as a CNA and raise a family. Within a few weeks, you can be working with a certificate from the state. While raising a family, we found this to be easier than having an office job, especially arriving from Kenya. I then began working in in-home care and was also working at an adult family home. I worked as a CNA for a total of six years.
My husband was in a different field before we started this business, mostly in computer software engineering and health information management systems focused on global health. Switching his career to be part of this business was a challenge, but he fit in quite fast, and I value his support.
At what point did you decide to become a nurse?
I was encouraged by my manager at the time who was a registered nurse (RN) and was the owner of the adult family home I was working in. She encouraged me to go to school to become a licensed practical nurse (LPN). She saw something in me. In fact, she once told me if she ever got ill or needed care, she would want me to be her nurse. After graduating as an LPN, I worked at a home care agency for six years while pursuing my RN degree.
After graduation, I continued working for the home care agency. Soon thereafter, I went back to the same school to get my bachelor's degree in nursing, BSN. Soon after graduation, I started working at Valley Medical Hospital, a University of Washington affiliate. I worked there for six years - three of those years were in the intensive care unit (ICU). I worked there up until January of 2021, which was right before starting our Troutdale Adult Home Care business in Oregon.
Why are adult foster care homes so special?
As compared to institutional care, you can care for people in a more person-centered way. For example, regarding a resident's diet, the idea is to create an environment that is as like a family home as possible. Serving only five people we can really tailor the menu to the residents' desires, so this is never a problem.
Because it is a home-like setting, we can be more flexible in involving the special and important family and friend connections. We feel it provides better outcomes for the residents in this type of care setting. We have live-in caregivers, and they get to know the residents in a uniquely special way, as compared to many other places where turnover is high and the few caregivers working must care for so many. There is more consistency here, and this is good for everyone.
"We feel it provides better outcomes for the residents in this type of care setting."
What does nursing add to the overall success of care homes?
Because of my experience and training I can move into any high-acuity care situation with a resident and provide the right care to them with confidence, ease, and experience. When giving reports or communicating with the healthcare teams, I understand the language and can interpret important information. This is information such as what to ask and how to use my voice as an advocate, and this can make things so much clearer for everyone. This matters for quality of care. This experience and skill set makes a difference.
What do you love most about the work you do?
We live where we work. Having the flexibility makes a real difference and I enjoy being my own boss. Countless times in my career my patients or residents have told me they cannot do what I do for people, and they don’t know how I do it. It is in those times I know I am making a difference, and we get to make this difference in our own care home and do this together.
"It is in those times I know I am making a difference, and we get to make this difference in our own care home and do this together."
Anything else you'd like us to know about you?
We have four kids: three boys, and one girl. In this country, there is the old motto from the Army “be all that you can be,” and as immigrants, we feel we are here to achieve our dreams. Now, we are doing just that, and we know we cannot do this where we come from. Also, as immigrants, we are so very grateful to have the opportunities we've had and to create the life for our family that we want.
Together, we notice some challenges in this business. Finding caregivers is one of the biggest and we know this is a problem in many different healthcare settings. As a community of care home providers, we do not have a voice yet. We, and some other interested providers, are looking to gather and create a Council of Providers and have a seat at the table at both the state and county level to create necessary changes in the industry.
You can reach out to Margaret at firstname.lastname@example.org.