WNPC Puerto Rico Caregiver Support
The Caregiver Support Floor at La Clinica follows the Baltimore model -- peer lounge, nap pods, rest rooms with intercoms, social work, therapy, respite care -- shaped by Puerto Rican family structure and the island's particular caregiver burden.
Caregiving in Puerto Rico is multigenerational and communal in ways that resemble the Hawaiian 'ohana model more than mainland nuclear family assumptions. An abuela, a mother, a tia, and an older cousin may all share the caregiving for a child with complex medical needs, and the caregiver floor serves the entire network rather than designating one "primary caregiver." The peer lounge accommodates groups, and the social workers understand that the caregiving unit in a Puerto Rican family is the family, not the individual.
The post-Maria dimension of caregiving at the PR site is unique in the WNPC network. Caregivers at La Clinica include people who held their families together during months without power, without running water, without medications, without medical care, without functioning roads, without communication systems. They rationed insulin by candlelight. They ran generators for ventilators until the fuel ran out and then carried their loved ones to the car and drove through debris to the nearest hospital that was still operating. They did what the infrastructure should have done and what the federal government failed to ensure. The trauma of that experience sits alongside the ongoing daily trauma of caregiving in a healthcare system that is still collapsing, and the therapy rooms on the caregiver floor hold both.
The social workers navigate the particular bureaucratic landscape of Puerto Rico -- the territorial Medicaid system (which receives less federal funding than state Medicaid), the FEMA claims that are still being processed years after the storms, the disability services that exist on paper but are underfunded in practice. The Harlow-Keller Fund operates at the PR site with awareness that the gap between what families need and what the system provides is wider here than anywhere else in the WNPC network, because the system itself is funded at a fraction of the mainland standard.