Home Alone: Family Caregivers Providing Complex Chronic Care
|
|
- Berniece Beasley
- 5 years ago
- Views:
Transcription
1 Home Alone: Family Caregivers Providing Complex Chronic Care Title text here Susan Reinhard, RN, PhD AARP Public Policy Institute Katz Policy Lecture Benjamin Rose Institute on Aging September 28, 2012
2 Objectives Describe the "new normal" for family caregivers. Debate what ADLs and IADLs tell us about the work of family caregiving, and the new focus on medical/nursing tasks Discuss a "call to action" to meet the challenges of family caregiving. 2
3 Family Caregiver Broad Definition Any relative, partner, friend or neighbor who has a significant relationship with, and who provides a broad range of assistance for, an older person or an adult with a chronic or disabling condition. In Person-Centered Planning, if the consumer includes a family member in the plan for HCBS, the family caregiver needs to be seriously considered 3
4 Valuing the Invaluable In 2009, about 42.1 million family caregivers in the U.S. provided care to an adult with limitations in daily activities at any given point in time The estimated economic value of their unpaid contributions was about $450 billion in 2009 from an estimated $375 billion in
5 How Much is $450 Billion? $600 $500 $400 $509 $450 In Billions, 2009 Data $300 $361 $200 $203 $100 $0 Total Medicare Family Caregiving Total Medicaid Total Formal LTSS 5
6 Family Caregiving in the Old Days 6
7 Family Caregiving The New Normal 7
8 What s Different About Caregiving Now Than in the Past? Serve as both care coordinators and service providers o Navigating an increasingly fragmented and confusing health care and LTSS delivery system Monitor chronic and sometimes acute medical conditions as well as provide LTSS at home o Impact of shorter hospital stays; discharging sicker and quicker 8
9 Family Caregivers Fill Big Gaps in Health Care and LTSS Family members are part of the delivery of health care o Influencing health care decisions, treatment, and outcome o Serving as continuity connectors and the eyes and ears -Especially for persons with dementia o Assuming a health management role in the home 20-year trends in family caregiving and LTSS show that: o Until the mid-1990s, family care was augmented by some paid help o That trend has reversed and more families are carrying the load alone o Family caregivers are assisting older relatives/friends with higher rates of disability than in the past Source: Trends in Disability, Community Living, and Caregiving: Analysis of Data from the National Long-Term Care Survey by: Donald L. Redfoot, Ari Houser, Mary Jo Gibson, AARP Public Policy Institute, September
10 Families Are Deeply Worried For many families in the midst of caregiving, there is deep worry and quality of care and quality of life o Families don t know who to call or where to go, to get the right kind of affordable help when they need it Deep frustration and a sense of hopelessness about our health care and LTSS system when you are going through it 10
11 In Their Own Words Overall, I am fearful of being able to handle all of her needs. I am fearful that she could fall again. I am fearful that she could get hurt again and that I won t be able to help her. More than anything it s the constant fear. -Spanish-speaking Latina Caregiver, Los Angeles Source: AARP Public Policy Institute Focus Groups with Diverse Family Caregivers, Los Angeles,
12 What do ADLs and IADLs Tell Us about the Work of Family Caregiving? Katz started it all in the 1950s at Benjamin Rose with Activities of Daily Living (ADLs) o Designed to measure course of recovery in older adults who had hip fractures o Published in 1963 Earliest measure of Instrumental Activities of Daily Living (IADL) published in 1969 o o Designed to measure aspects of independent living Included money management and medications from the perspectives of the 1960s Over 40 different clinical and survey indexes of functional status now 12
13 What do ADLs and IADLs Tell Us about the Work of Family Caregiving? Researchers in the new field of family caregiving in the 1980s o Applied ADLs and IADL scales to family caregivers o Assumption that what caregivers provide is the mirror image of the functional limitations of the care recipient o Although there is intuitive appeal as an indicator of care demands, ADLs and IADLs fail to consider many aspects of the work of family caregiving 13
14 What do ADLs and IADLs Tell Us about the Work of Family Caregiving? ADL and IADL scales moved into public policy in the 1980s o 1982 National Long Term Care Survey of Medicare Beneficiaries, caregiver supplement o Now, application of the care recipient s ADL/IADL scores to eligibility for both private and publicly financed support for family caregivers -Respite care -LTC Insurance payment for personal care 14
15 Some Problems in Applying ADLs and IADLs to the Work of Family Caregiving? Contextual issues some examples o Does the care recipient weigh 300 pounds? Makes a difference in all ADLs o Does the care recipient have dementia? o Does the care recipient resist, like bathing and dressing? o Does the need for standby assistance count as a scorable limitation? 15
16 Some Problems in Applying ADLs and IADLs to the Work of Family Caregiving? Contextual issues some examples o Does the care have to be provided at a specific time every day? o Is the care considered intimate, even taboo o Is the care tiring, difficult or upsetting (Poulshock & Deimling, Benjamin Rose, 1984) o Does the family caregiver need to shop because the person lives on the third floor without an elevator but could have been able to shop if she lived in accessible housing? Is this an IADL limitation for the care recipient? 16
17 What is Missing or Needs to Move into Another Measure? The realities of 2012 for family caregivers call for a new job description not imagined 50 years ago when Katz and Lawton developed ADLs and IADLs Few pills in 1960, never mind injections and IVs o Now Polypharmacy o Crushing pills, some with food, some without food o Many side effects, adverse reactions leading to hospitalizations o Knowledge and monitoring very important and worrisome Is helping with medications really an IADL? 17
18 New Research Home Alone: Family Caregivers Providing Complex Chronic Care Partnership between the AARP Public Policy Institute and the United Hospital Fund Funded by The John A. Hartford Foundation We ask family caregivers to do things that would make first-year nursing students shudder ----Susan C. Reinhard 18
19 New Research on Medical/Nursing Tasks Part of a larger initiative, Professional Partners Supporting Family Caregivers, which seeks a better understanding of what family caregivers are expected to do and how health care professionals can better support them in their work. Conducted in partnership with Carol Levine and colleagues at the United Hospital Fund Released next week and presented for the first time at the Benjamin Rose Institute for Aging 19
20 Methodology and Sample Survey questions were based on a review of other national family caregiver surveys, literature on caregiver tasks, review of tasks delegated by registered nurses to unlicensed direct care workers and the authors experiences interviewing family caregivers and health care professionals. Knowledge Networks (KN), a survey research firm, was engaged to field the survey. Initial screening question: In the past 12 months, have you provided unpaid care to a relative, partner, or friend age 18 years or older to help them take care of themselves because of a chronic illness or disability? 20
21 Methodology and Sample The respondents were then asked Beyond emotional support and companionship, caregiving may include many different types of specific help. Did you help with: o Personal care tasks (such as bathing, dressing, grooming, eating, moving from bed to chair, or going to the toilet); o Household tasks (such as shopping, managing personal finances, arranging for outside services, or providing transportation); or o Medical or nursing tasks (such as managing medications, changing dressing on wounds, monitoring equipment like oxygen tanks)? 21
22 Almost Half of Family Caregivers Perform Medical/Nursing Tasks Distribution of 1,677 Caregivers by Task: Medical/Nursing, ADL, IADL Tasks M/N only 30 M/N and ADL/IADL 747 ADL/IADL only, 900 ADL/IADL only 900 M/N and ADL/IADL 747 M/N only 30 Columns do not sum to 100 percent because respondents could select multiple options 22
23 Almost Half of Family Caregivers Perform Medical/Nursing Tasks Distribution of 747 Caregivers Performing Medical/Nursing, ADL, IADL Tasks M/N Tasks + ADL, 35 M/N Tasks + IADL, 211 M/N Tasks+ ADL + IADL, 501 M/N + ADL 35 M/N + ADL + IADL 501 M/N + IADL
24 Almost Half of Family Caregivers Perform Medical/Nursing Tasks Distribution of 900 Caregivers Performing ADL, IADL Tasks ADL, 46 IADL + ADL, 249 IADL, 605 ADL 46 IADL + ADL 249 IADL
25 Family Caregivers Find Some Tasks More Difficult than Others Some tasks not generally considered difficult by professionals like meal preparation were hard to do because of special diets and feeding problems. Less surprisingly, half of family caregivers who operate mechanical equipment, such as mechanical ventilators, feeding tubes, or home dialysis equipment, found this work hard to do. And two out of three (67 percent) of those who managed incontinence (as distinct from helping a person to the toilet) found this very hard to do. 25
26 So Many Meds, So Little Training Three out of four family caregivers who provided medical/nursing tasks were managing medications, including administering intravenous fluids and injections. Almost half were administering 5 to 9 prescription medications a day; one in five was helping with ten or more prescription medications a day. Most of these family caregivers learned how to manage at least some of the medications on their own. I constantly monitor drugs -Family Caregiver Many found this work difficult because it was timeconsuming and inconvenient, they were afraid of making a mistake, and/or the care recipient would not cooperate. 26
27 Wound Care is Very Challenging and Training is Needed More than a third (35%) of family caregivers who provided medical/nursing tasks reported doing wound care. While fewer caregivers performed wound care tasks than medication management, a greater percentage of them (66%) identified it as difficult and many (38%) would like more training. Of these caregivers, close to half (47%) were afraid of making a mistake and/or harming their family member. 27
28 Family Caregivers Feel Pressured 28
29 Family Caregivers are the Coordinators Family caregivers of chronically ill persons frequently serve as care coordinators. Family caregivers who performed medical/nursing tasks were more than twice as likely to act as care coordinators as those who mainly provided personal care. 29
30 Few Home Visits by Health Care Professionals Type of Health Care Providers Making Home Visits ALL M/N Tasks ADL/IADL Nurse Physical Therapist Licensed Social Worker Occupation Therapy Doctor Respiratory Therapist Other Sixty-nine percent of the care recipients did not have any home visits by health care professionals. Of those who did have home visits, roughly seven in ten were visited by a nurse 30
31 The More tasks, the Greater the Consequences for Family Caregiver Well Being Family caregivers who performed five or more medical/nursing tasks were most likely to believe they are making an important contribution. Compared to those who performed one or two tasks, they were also most likely to report feeling stressed and worried about making a mistake. More than half reported feeling down, depressed or hopeless in the last two weeks More than a third reported fair or poor health. In the last year and a half I have developed high blood pressure, diabetes, and weight gain so now I have sleep apnea -Family Caregiver 31
32 These Caregivers Help Avoid Institutionalization The more medical/nursing tasks family caregivers perform, the more likely they reported helping the care recipient avoid nursing home placement. Three out of four family caregivers who provided assistance with five or more medical/nursing tasks reported they were helping their family member avoid institutionalization. The same was true for those caring for people with five or more chronic conditions. Those who had some training were more likely to say they were able to help avoid nursing home placement. 32
33 Recommendations The report findings highlight an urgent need for both individual and collective action. This effort requires the coordinated efforts of all sectors hospitals, home care agencies, community agencies, nursing homes, hospices, and physician and other clinician practices. Based on the findings in this report, ten recommendations for action were made. 1. A consensus-building body should revisit measures of activities of daily living (ADLs) and instrumental activities of daily living (IADLs). 33
34 Recommendations 2. Individual health care professionals must fundamentally reassess and restructure the way they interact with family caregivers in daily practice. 3. Health care provider organizations (hospitals, rehabilitation centers, home care agencies, nursing homes, and hospices) must support health care professionals in their efforts through adequate resources and strong leadership. 34
35 Recommendations 4. Professional organizations should lead and support professionals in their efforts to improve communication and training for family caregivers. 5. Leaders in medical, nursing, social work, allied health professional training, and continuing education should examine their curricula to determine where and how the importance of acknowledging, supporting, and training family caregivers can be added or strengthened. 6. Accrediting and standard-setting organizations must take seriously their evaluation of how well institutions incorporate family caregiver needs and require corrective steps to address deficiencies. 35
36 Recommendations 7. Federal policymakers should proactively consider family caregivers in developing new models of care that focus on coordination and quality improvement. 8. State policymakers should proactively consider family caregivers in funding and policy development. 9. Caregiver advocacy and support organizations should include in their service and policy agendas resources that address the needs of family caregivers who have taken on the triple burden of personal care, household chores, and medical/nursing tasks 36
37 Recommendations 10. Academic and government researchers should conduct further studies to understand medical/nursing tasks performed by different types of family caregivers and their needs for training and support. We encourage further research in these areas: Diverse populations, particularly ethnic minorities, family caregivers whose primary language is not English, and other groups whose experiences may differ from a national sample Spousal caregivers, who are likely to be of the same age as the care recipient and at risk for chronic health conditions Family caregivers of people with cognitive or behavioral conditions that may make performing medical/nursing tasks more difficult 37
38 Caregiving Gains Recognition Among Policymakers, Health Professionals AARP Public Policy Institute Initiatives LTSS Scorecard: Framework for High-performing LTSS System o Among four other key dimensions, includes recognition of and support for family caregivers as a key component of state systems of LTSS o Funding from The Commonwealth Fund and The SCAN Foundation 38
39 AARP Public Policy Institute Initiatives Long Term Services and Supports Scorecard: Framework for Highperforming LTSS System o Support for Family Caregivers includes recognition of and support for family caregivers as a key component of state systems of LTSS Support for Family Caregivers: o Paid and unpaid family medical leave, paid sick days, protection against caregiver discrimination in the workplace, caregiver assessment o Registered nurses provide delegation of health maintenance tasks to non-family members. 39
40 Take Aways Investing in better recognition of and support for caregiving families can reduce higher expenditures later Families are increasingly charged with the responsibility of performing all levels of health-related tasks for those they care for often without the training and support from professionals that they need Family caregivers need more recognition and support from professionals across settings 40
41 Questions? Susan Reinhard
Caregiver Stress. F r e q u e n t l y A s k e d Q u e s t i o n s. Q: Who are our nation's caregivers?
Caregiver Stress Q: What is a caregiver? A: A caregiver is anyone who provides help to another person in need. Usually, the person receiving care has a condition such as dementia, cancer, or brain injury
More informationALLOWED VS. AUTHORIZED HOURS CASE MANAGEMENT IN-SERVICE POWER HOUR JULY 14, 2016 MEDICAID APD LTC SYSTEMS
ALLOWED VS. AUTHORIZED HOURS CASE MANAGEMENT IN-SERVICE POWER HOUR JULY 14, 2016 MEDICAID APD LTC SYSTEMS 1 AGENDA PURPOSE PLANS BELOW PLANS ABOVE - EXCEPTIONS EXCEPTIONS FOR STATE PLAN PERSONAL CARE 2
More informationIs It Time for In-Home Care?
STEP-BY-STEP GUIDE Is It Time for In-Home Care? Helping Your Loved Ones Maintain Their Independence and Quality of Life 2015 CK Franchising, Inc. Welcome to the Comfort Keepers Guide to In-Home Care Introduction
More informationLong Term Care. Lecture for HS200 Nov 14, 2006
Long Term Care Lecture for HS200 Nov 14, 2006 Steven P. Wallace, Ph.D. Professor, Dept. Community Health Sciences, SPH and Associate Director, UCLA Center for Health Policy Research What is long-term care
More informationFor the Lifespan: The Caregiver Guide Module 3A Caring for Older Adults with Chronic Health Issues
For the Lifespan: The Caregiver Guide Module 3A Caring for Older Adults with Chronic Health Issues Objectives After completing this module, participants will be able to: Understand the common chronic health
More informationDEMENTIA CAREGIVING IN THE U.S.
Research Report February 2017 DEMENTIA CAREGIVING IN THE U.S. IN PARTNERSHIP WITH ACKNOWLEDGEMENTS Gail Gibson Hunt, National Alliance for Caregiving C. Grace Whiting, J.D., National Alliance for Caregiving
More informationGaylord National Resort & Convention Center 8/23/2012
Using Health Policy to Support Nutrition Programs and Link to Health Care August 23, 2012 Mary Jane Koren, M.D., M.P.H. VP LTC Quality Improvement The Commonwealth Fund Two of Five Older Adults Are Not
More informationELDER MEDICAL CARE. Elder Medical. Counseling & Support. Hospice. Care. Care
ELDER MEDICAL CARE Counseling & Support Elder Medical Care Hospice Care Mission To provide counseling, support and care to anyone with a serious illness, so they may live life to the fullest. Vision We
More informationCAREGIVING IN THE U.S. A Focused Look at the Ethnicity of Those Caring for Someone Age 50 or Older. Executive Summary
CAREGIVING IN THE U.S. A Focused Look at the Ethnicity of Those Caring for Someone Age 50 or Older Executive Summary November 2009 National Alliance for Caregiving In Collaboration with AARP Funded by
More informationManaged Long Term Services and Supports (MLTSS)
Cal MediConnect 2017 Managed Long Term Services and Supports (MLTSS) 2017 CMC Annual Training Topics of Discussion What are MLTSS services? Overview of MLTSS programs MLTSS Referrals Services covered Eligibility
More informationOASIS-B1 and OASIS-C Items Unchanged, Items Modified, Items Dropped, and New Items Added.
Items Added. OASIS-B1 Items UNCHANGED on OASIS-C OASIS-C Item # M0014 M0016 M0020 M0030 M0032 M0040 M0050 M0060 M0063 M0064 M0065 M0066 M0069 M0080 M0090 M0100 M0110 M0220 M1005 M1030 M1200 M1230 M1324
More informationInnovations in Medicaid Managed Long-Term Services and Supports: How Health Plans are Providing Support to Family Caregivers
Innovations in Medicaid Managed Long-Term Services and Supports: How Health Plans are Providing Support to Family Caregivers Wednesday, February 28, 2018 1-2 pm EST 1 Scorecard Emerging Innovations
More informationCaring for Minnesota s Aging Population:
Caring for Minnesota s Aging Population: A Look at Policies Supporting Family Caregivers & Older Mn s 1 Family Caregivers Caring for Minnesota s Aging Population: A Look at Public Policy Supporting Family
More informationHow Managed Long-Term Services and Supports Can Help Family Caregivers
April 27, 2017 How Managed Long-Term Services and Supports Can Help Family Caregivers Tips for Using this Webinar Platform Phone dial-in information was provided for the first 500 registrants and is available
More informationIs It Time for In-Home Care?
STEP-BY-STEP GUIDE Is It Time for In-Home Care? Helping Your Loved Ones Maintain Their Independence and Quality of Life 2015 CK Franchising, Inc. Welcome to the Comfort Keepers Guide to In-Home Care Introduction
More informationGERIATRIC SERVICES CAPACITY ASSESSMENT DOMAIN 4 ALTERNATE LIVING ARRANGEMENTS
GERIATRIC SERVICES CAPACITY ASSESSMENT DOMAIN 4 ALTERNATE LIVING ARRANGEMENTS Table of Contents Introduction... 2 Purpose... 2 Serving Senior Medicare-Medicaid Enrollees... 2 How to Use This Tool... 2
More informationAppendix A: Full Questionnaire
Appendix A: Full Questionnaire SCREENER This is an important study about caring for someone with a rare disease or condition, conducted by Greenwald & Associates on behalf of the National Alliance for
More informationDual Eligibles: Medicaid s Role in Filling Medicare s Gaps
I S S U E P A P E R kaiser commission on medicaid and the uninsured March 2004 Dual Eligibles: Medicaid s Role in Filling Medicare s Gaps In 2000, over 7 million people were dual eligibles, low-income
More informationWellness along the Cancer Journey: Caregiving Revised October 2015
Wellness along the Cancer Journey: Caregiving Revised October 2015 Chapter 4: Support for Caregivers Caregivers Rev. 10.8.15 Page 411 Support for Caregivers Circle Of Life: Cancer Education and Wellness
More informationEW Customized Living Contract Planning Worksheet, Part I
Purpose of This Worksheet This planning worksheet is designed to: 1. Delineate component services that can be included in EW customized living and 24 hour customized living packages. 2. Serve as a tool
More informationPalliative and Hospice Care In the United States Jean Root, DO
Palliative and Hospice Care In the United States Jean Root, DO Hello. My name is Jean Root. I am an Osteopathic Physician who specializes in Geriatrics, or care of the elderly. I teach and practice Geriatric
More informationHOW TO GET HELP ON COMMUNITY SUPPORT SERVICES
HOW TO GET HELP ON COMMUNITY SUPPORT SERVICES When an older relative needs care that the family cannot easily provide, community-based services are available to provide help. For older people with complex
More informationAn Overview of Ohio s In-Home Service Program For Older People (PASSPORT)
An Overview of Ohio s In-Home Service Program For Older People (PASSPORT) Shahla Mehdizadeh Robert Applebaum Scripps Gerontology Center Miami University May 2005 This report was produced by Lisa Grant
More informationADULT LONG-TERM CARE SERVICES
ADULT LONG-TERM CARE SERVICES Long-term care is a broad range of supportive medical, personal, and social services needed by people who are unable to meet their basic living needs for an extended period
More informationINTRODUCTION. In our aging society, the challenges of family care are an increasing
INTRODUCTION In our aging society, the challenges of family care are an increasing reality of daily life for America s families. An estimated 44.4 million Americans provide care for adult family members
More informationVA Caregiver Support Program
VA Caregiver Support Program Department of Veterans Affairs Meg Kabat, LCSW-C, CCM National Director, VA Caregiver Support Program Care Management & Social Work 9% of U.S. adults are caregivers 16.9 million
More informationNATIONAL ALLIANCE FOR CAREGIVING
NATIONAL ALLIANCE FOR CAREGIVING Preface Statement of the Alzheimer s Association and the National Alliance for Caregiving Families are the heart and soul of the health and long term care system for an
More informationCaregiving: Health Effects, Treatments, and Future Directions
Caregiving: Health Effects, Treatments, and Future Directions Richard Schulz, PhD Distinguished Service Professor of Psychiatry and Director, University Center for Social and Urban Research University
More informationFUNCTIONAL DISABILITY AND INFORMAL CARE FOR OLDER ADULTS IN MEXICO
FUNCTIONAL DISABILITY AND INFORMAL CARE FOR OLDER ADULTS IN MEXICO Mariana López-Ortega National Institute of Geriatrics, Mexico Flavia C. D. Andrade Dept. of Kinesiology and Community Health, University
More informationNURSING ASSESSMENT AND MONITORING TOOL Member last name First name Middle name Medicaid number
Contact Us 888-287-2443 MEDICALLY FRAGILE NURSING ASSESSMENT AND MONITORING TOOL Member last name First name Middle name Medicaid number Street address Date of birth City County State OK Zip Nurse completing
More informationN4A Annual Conference Philadelphia July 14, The Role of the Family Caregiver and the Aging Network in the Chronic Care Model
N4A Annual Conference Philadelphia July 14, 2015 The Role of the Family Caregiver and the Aging Network in the Chronic Care Model Session Overview Introduction of Panel Importance of Caregiving from the
More informationSpecialized On-Demand Education for Home Care Staff
Home Care Association of New Hampshire and RCTCLearn offer Specialized On-Demand Education for Home Care Staff Providing your agency s staff with high quality continuing professional education doesn t
More informationThe Important Role of Family Caregivers in Washington State s Long-Term Services and Supports System
The Important Role of Family Caregivers in Washington State s Long-Term Services and Supports System Bea Rector, Director The Growing and Changing Nature of Family Caregiving November 29, 2017 Washington
More informationSmooth Moves: Stimulating Mindful Transitions from Hospital to Nursing Home. Your thoughts
Smooth Moves: Stimulating Mindful Transitions from Hospital to Nursing Home Cari Levy, MD, PhD University of Colorado Department of Medicine Division of Health Care Policy and Research Denver- Seattle
More informationCaregiving in the U.S.
RESEARCH REPORT JUNE 2015 Executive Summary Caregiving in the U.S. Conducted by Acknowledgments The National Alliance for Caregiving (NAC) and the AARP Public Policy Institute are proud to present Caregiving
More informationElder Services/Programs
Note: The following applies to Tufts Medicare Preferred HMO and Tufts Health Plan Senior Options members. Program Eligibility/Program Information Possible Services Standard State Home Respite Home Community
More informationPlanning Worksheet Identifying EW Customized Living Components
Planning Worksheet Identifying EW Customized Living Components This tool is designed to facilitate discussion between EW lead agencies (counties, managed care organizations and/or tribes) and current or
More informationNORTH DAKOTA LEVEL OF CARE FORM INSTRUCTIONS TO BE USED WITH LOC FORM ND
For this section, select which type of LOC screen is to be reviewed Requested Screen Type NORTH DAKOTA LEVEL OF CARE FORM INSTRUCTIONS Nursing Facility Swingbed CMFN PACE MFP Provisional MFP Final Tech.
More informationChanging Relationships: You and Your Aging Parent/Relative
Changing Relationships: You and Your Aging Parent/Relative Presenter Camille Koonce Camille Koonce is a certified case manager and aging life care expert. She has a diverse nonprofit background serving
More informationBasic Covered Benefits and Services
Basic Covered Benefits and A prior authorization is when UnitedHealthcare Community Plan gives the doctor permission to perform certain services. Bed Liners Coverage Covered for members age 4 and up; Prior
More informationEmerging Innovations in Managed Long-Term Services and Supports for Family Caregivers
AARP PUBLIC POLICY INSTITUTE NOVEMBER 2017 Long-Term Services and Supports Scorecard Emerging Innovations Emerging Innovations in Managed Long-Term Services and Supports for Family Caregivers Susan C.
More informationCaregiving in the U.S.: How Foundations Can Support Family Caregivers
Caregiving in the U.S.: How Foundations Can Support Family Caregivers Gail Gibson Hunt President & CEO, National Alliance for Caregiving GIA Care for All: Supporting Older Adults, Family Caregivers, and
More informationAugust 25, Dear Acting Administrator Slavitt:
August 25, 2016 Acting Administrator Andy Slavitt Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-1648-P P.O. Box 8016 Baltimore, MD 21244-8016 Re: Medicare
More informationFamily Caregiving and Out-of-Pocket Costs: 2016 Report
Family Caregiving and Out-of-Pocket Costs: 2016 Report Report Prepared by Chuck Rainville Laura Skufca Laura Mehegan November 2016 https://doi.org/10.26419/res.00138.001 AARP is a nonprofit, nonpartisan
More informationIn Solidarity, Paul Pecorale Second Vice President
Caregiving Guide Dear NYSUT Member: On behalf of the NYSUT officers and Board of Directors, we are proud to provide you with this publication, Caregiving Guide. In addition to providing information, referral
More informationKEY FINDINGS from Caregiving in the U.S. National Alliance for Caregiving and AARP. April Funded by MetLife Foundation
KEY FINDINGS from Caregiving in the U.S. National Alliance for Caregiving and AARP April 2004 Funded by MetLife Foundation Profile of Caregivers Estimate that there are 44.4 million American caregivers
More informationNational Resource Center on Native American Aging at the UNDSMHS Center for Rural Health
Assessing Elder Needs How to Measure Benefits and Develop Links to Long-term Care Alan Allery, Ph.D. Richard L. Ludtke, PhD Leander R. McDonald, PhD National Resource Center on Native American Aging at
More informationAn Initial Review of the CY Medicare Home Health Rule. CY2018 Proposed Medicare Home Health Rate Rule and Much More
An Initial Review of the CY 2018 2019 Medicare Home Health Rule Mary K. Carr William A. Dombi NAHC CY2018 Proposed Medicare Home Health Rate Rule and Much More Published July 25, 2017 https://www.cms.gov/medicare/medicare
More informationThe Number of People With Chronic Conditions Is Rapidly Increasing
Section 1 Demographics and Prevalence The Number of People With Chronic Conditions Is Rapidly Increasing In 2000, 125 million Americans had one or more chronic conditions. Number of People With Chronic
More informationCaregivers and Digital Health: A Survey of Trends and Attitudes of Massachusetts Family Caregivers
Caregivers and Digital Health: A Survey of Trends and Attitudes of Massachusetts Family Caregivers June 27, 2017 info@massincpolling.com MassINCPolling.com @MassINCPolling 11 Beacon St Suite 500 Boston,
More informationCAP/DA Services - NEW Request
CAP/DA Services - NEW Request * = Required Request Date * Beneficiary Demographics Beneficiary's First Name Last Name Beneficiary has Medicaid? * Yes Pending Medicaid MID Social Security Number Medicare
More informationDEMONSTRATED NEED FOR SKILLED CARE FOR MEDICARE PATIENTS: SKILLED NURSING SERVICES
DEMONSTRATED NEED FOR SKILLED CARE FOR MEDICARE PATIENTS: SCOPE: All Ascension At Home, LLC colleagues. For purposes of this policy, all references to colleague or colleagues include temporary, part-time
More informationMEMBER HANDBOOK. My Choice Family Care. Phone: Fax: Toll Free: TTY: 711
M MEMBER HANDBOOK My Choice Family Care Template provided by the WI Department of Health Services Phone: 414-287-7600 Fax: 414-287-7704 Toll Free: 1-877-489-3814 TTY: 711 www.mychoicefamilycare.com APPENDICES
More informationELDER CARE CONSULTATION REQUEST
ELDER CARE CONSULTATION REQUEST Complete this application form and return it to Sister Anna Marie Tag, RSM. Sister Anna Marie Tag, RSM Phone: 610/688-6886 517 E. Lancaster Avenue # 316 E-mail: NRROconsult-AMTag@usccb.org
More informationA Focused Look at Those Caring for Someone Age 18 to 49
RESEARCH REPORT RESEARCH REPORT: CAREGIVING IN THE U.S. 2015 A FOCUSED LOOK AT CAREGIVERS OF YOUNGER ADULTS JUNE 2015 Caregivers of Younger Adults: A Focused Look at Those Caring for Someone Age Conducted
More informationToday s educational presentation is provided by. The software that powers HOME HEALTH. THERAPY. PRIVATE DUTY. HOSPICE
Today s educational presentation is provided by The software that powers HOME HEALTH. THERAPY. PRIVATE DUTY. HOSPICE At Kinnser, we believe post-acute care businesses need the right software solution for
More informationTHE PITTSBURGH REGIONAL CAREGIVERS SURVEY
THE PITTSBURGH REGIONAL CAREGIVERS SURVEY S U M M A R Y R E P O R T E X E C U T I V E S U M M A R Y Nearly 18 million informal caregivers in the United States provide care and support to older adults who
More informationNew Federal Regulations for Home and Community-Based Services Program: Offers Greater Autonomy, Choice, and Independence
New Federal Regulations for Home and Community-Based Services Program: Offers Greater Autonomy, Choice, and Independence The Centers for Medicare and Medicaid Services (CMS) has published a Final Rule
More informationHOME AND COMMUNITY CARE POLICY MANUAL
SECTION: PAGE: 1 OF 9 For the purpose of this document, the following definitions have been used: adult day services are provided through an organized program of personal care, health care and therapeutic
More informationUnpaid individuals who provide care and/or assistance to the person
Caregiver About this Domain (Caregiver) Assessment Domains To assess the capacity of an informal caregiver to provide care and support to the individual and to identify resources to assist in the caregiving
More information6/26/2016. Community First Choice Option (CFCO) Housekeeping. Partners and Sponsors
Community First Choice Option (CFCO) Mark Kissinger, Director Division of Long Term Care Office of Health Insurance Programs New York State Department of Health (DOH) School of Public Health June 27, 2016
More informationLong-Term Care Glossary
Long-Term Care Glossary Adjudicated Claim Activities of Daily Living (ADL) A claim that has reached final disposition such that it is either paid or denied. Basic tasks individuals perform in the course
More informationDesigning a Medicare Help at Home Benefit: Lessons from Maryland s Community First Choice Program
ISSUE BRIEF JUNE 2018 Designing a Medicare Help at Home Benefit: Lessons from Maryland s Community First Choice Program Karen Davis, Amber Willink, Ian Stockwell, Kaitlyn Whiton, Julia Burgdorf, and Cynthia
More informationHOSPICE POLICY UPDATE
#02-56-13 Bulletin June 24, 2002 Minnesota Department of Human Services # 444 Lafayette Rd. # St. Paul, MN 55155 OF INTEREST TO County Directors Administrative contacts AC, EW, CAC, CADI, TBI DD Waiver
More informationAlberta First Nations Continuing Care Needs Assessment - Health and Home Care Program Staff Survey -
Alberta First Nations Continuing Care Needs Assessment p. 1 Alberta First Nations Continuing Care Needs Assessment - Health and Home Care Program Staff Survey - Definition of Terms Continuing Care: As
More informationTest bank PowerPoint slides for each chapter Instructor guides for each chapter (with answers for discussion questions and case studies)
This is a sample of the instructor materials for Dimensions of Long-Term Care Management: An Introduction, second edition, edited by Mary Helen McSweeney-Feld, Carol Molinari, and Reid Oetjen. The complete
More informationPolicy & Providers. for Managing Chronic Care Patients. Mary Alexander Strategic Alliances Director - Home Instead, Inc. Kelly Funk.
Policy & Providers Lessons From The Health Care Arena for Managing Chronic Care Patients Producer: Bob Bua President - CareScout Panel: Peter Sosnow VP Corporate Development - Humana / SeniorBridge Mary
More informationIntegrated Licensure Background and Recommendations
Integrated Licensure Background and Recommendations Minnesota Department of Health and Minnesota Department of Human Services Report to the Minnesota Legislature 2014 February 2014 Minnesota Department
More informationWho are caregivers? What is caregiving? Webster s Dictionary persons who provide direct care to another individual
Presented at SaddleBrooke, April 5, 2013 by: Carol Wilson Director of Independent Living Services Pinal Gila Council for Senior Citizens Area Agency on Aging, Region V Who are caregivers? Webster s Dictionary
More informationDear Family Caregiver, Yes, you.
Dear Family Caregiver, Yes, you. If you re wondering whether the term caregiver applies to you, it probably does. A caregiver is anyone who helps an aging, ill, or disabled family member or friend manage
More informationHOME AND COMMUNITY CARE POLICY MANUAL
CHAPTER: 4 HOME HEALTH SERVICES NUMBER: 4 SECTION: CHAPTER CONTENTS PAGE: 1 OF 1 SUBSECTION: EFFECTIVE: JUNE 19, 2018 4.A General Description and Definitions 4.B Home Support Services 4.B.1 Service Needs
More information2006 Strategy Evaluation
Continuing Care 2006 Strategy Evaluation Executive Summary June 2015 Introduction In May 2006, the Department of Health and Wellness (DHW) released the Continuing Care Strategy entitled Shaping the Future
More informationDuals Demonstration. An Overview for Home Medical Equipment Providers
Duals Demonstration An Overview for Home Medical Equipment Providers Overview Background Medi-Cal Delivery Models State Budget Coordinated Care Initiative Duals Demonstration Overview Goals Population
More informationNOVA SCOTIA DEPARTMENT OF HEALTH AND WELLNESS RISK MITIGATION - CONTINUING CARE BRANCH. Caregiver Benefit Program Policy
NOVA SCOTIA DEPARTMENT OF HEALTH AND WELLNESS RISK MITIGATION - CONTINUING CARE BRANCH Subject: Caregiver Benefit Program Policy Original Approved Date; July 27, 2009 Revised Dates: December 7. 2010/ 0ctober
More informationPresented by. Elaine Poker-Yount Visiting Angels East Valley
Presented by Elaine Poker-Yount Visiting Angels East Valley WHY I AM HERE TODAY. Top 10 List La la la. I m not listening I don t want to.. Role adjustment? Role reversal? Recognition Anticipation Homework
More informationAGING & PEOPLE WITH DISABILITIES 4 ADL CA/PS ASSESSMENT POST 10/1/17
Activities of Daily Living (ADLs) Mobility Ambulation: Even with assistive devices, the individual requires assistance from another person to ambulate. B. Requires HANDS-ON assistance from another person
More informationProgram of All-inclusive Care for the Elderly (PACE) Summary and Recommendations
Program of All-inclusive Care for the Elderly (PACE) PACE Policy Summit Summary and Recommendations PACE Policy Summit On December 6, 2010, the National PACE Association (NPA) convened a policy summit
More informationDEPARTMENT OF HUMAN SERVICES SENIORS AND PEOPLE WITH DISABILITIES DIVISION OREGON ADMINISTRATIVE RULES CHAPTER 411 DIVISION 34 PERSONAL CARE SERVICES
DEPARTMENT OF HUMAN SERVICES SENIORS AND PEOPLE WITH DISABILITIES DIVISION OREGON ADMINISTRATIVE RULES 411-034-0000 Purpose (Amended 10/5/2007) CHAPTER 411 DIVISION 34 PERSONAL CARE SERVICES (1) These
More informationPersonal Support Worker
PROGRAM OBJECTIVES The Personal Support Worker program prepares students to deliver appropriate short or longterm care assistance and support services in either a long-term care facility, acute care facility,
More informationCaring for an Aging Population
Caring for an Aging Population Karen Donelan, ScD, EdM Associate Professor, Harvard Medical School Senior Scientist in Health Policy, Massachusetts General Hospital April 6, 2018: Bozeman, MT Today Increasing
More informationA Care Plan Guide. (Simple Steps To Caring For Your Loved Ones)
A Care Plan Guide (Simple Steps To Caring For Your Loved Ones) The personal journey as a caretaker can be very rewarding yet overwhelming at times. When we are instantly put into a situation of caring
More informationHospital Transitions: A Guide for Professionals.
Hospital Transitions: A Guide for Professionals 2017 www.medicarerights.org Medicare Rights Center The Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure
More informationAlzheimer s/dementia. Senior Guides. Staying in the Home
Caregiver Alzheimer s/dementia Tips Senior Guides FREE PUBLICATIONS Just Call 800-584-9916 Idaho Elder Directory A FREE comprehensive statewide listing of more than 500 independent retirement facilities
More informationNational Coalition on Care Coordination (N3C) Care Coordination and the Role of the Aging Network. Monday, September 12, 2011
National Coalition on Care Coordination (N3C) Care Coordination and the Role of the Aging Network Monday, September 12, 2011 Washington, DC Hyatt Regency on Capitol Hill Yellowstone/Everglades 4:00 PM
More informationWashington State LTSS System, History and Vision
Washington State LTSS System, History and Vision Bea Rector, Director, Home and Services Aging and Long Term Support Administration Washington State Department of Social and Health Services For Northwest
More informationRecommendations to Improve Data Collection to Monitor, Track, and Evaluate State Approaches to Family Support Services
Recommendations to Improve Data Collection to Monitor, Track, and Evaluate State Approaches to Family Support Services Introduction March 2016 Joe Caldwell National Council on Aging Katie Arnold, Evelyn
More informationTherapy STARS Project: Medical Necessity
Therapy STARS Project: Medical Necessity Presented By: Cindy Krafft MS PT President Home Health Section APTA Director of Rehabilitation Consulting Services and Nancy Buseth PT, RN Senior Rehabilitation
More informationOregon Community Based Care Communities Adult Foster Homes Survey
Oregon Community Based Care Communities Adult Foster Homes - 2014 Survey License No. Address of Foster Home Original License Date Operator Name Name of Home _ Home s Phone Fax Email Owner s Phone (if different)
More informationV. NURSING FACILITY RESIDENT PROFILE KEY POINTS
KEY POINTS As people age they are more likely to endure greater acute illness, such as, heart disease, stroke, cancer and advanced dementia. These illnesses and other factors cause limitations in Activities
More informationNorth Carolina Division of Medical Assistance
North Carolina Division of Medical Assistance Medicaid Clinical Policy and Programs Update on Medicaid In-Home Personal Care Services (PCS) Presented Larry Nason, Ed.D. Chief, Medicaid Facility by: and
More informationCouncil on Aging. Independence. Resources. Quality of Life. Guide to Programs and Services
Council on Aging Independence. Resources. Quality of Life Guide to Programs and Services About Council on Aging As the Area Agency on Aging for Butler, Clermont, Clinton, Hamilton and Warren counties,
More informationFraming San Francisco s Post-Acute Care Challenge
Framing San Francisco s Post-Acute Care Challenge S a n F r a n c i s c o P o s t - A c u t e C a r e P r o j e c t i ACKNOWLEDGMENTS Special thanks go to the San Francisco Department of Public Health,
More informationLong-Term Care Services for the Elderly
INFORMATION BRIEF Research Department Minnesota House of Representatives 600 State Office Building St. Paul, MN 55155 Danyell Punelli, Legislative Analyst 651-296-5058 Updated: January 2017 Long-Term Care
More informationMaking the Most of Your Florida Medicaid and ibudget Services
Making the Most of Your Florida Medicaid and ibudget Services Information for Individuals, Families, and Service Providers Created by the Florida Developmental Disabilities Council, Inc. Table of Contents
More informationUNIVERSAL INTAKE FORM
Agency Name: Funding Identifier: Los Angeles County Area Agency on Aging UNIVERSAL INTAKE FORM Title IIIB Title C1 Title C2 Title IIIE Title IIIE(G) Linkages IDENTIFICATION DEMOGRAPHICS 1a Date: Applicant
More informationQuestion Patient #1 Patient #2 Patient #3 Patient #4 Patient #5 Number of days between the last discharge and this readmission date?
Worksheet A: Chart Reviews of Patients Who Were Readmitted Conduct chart reviews of the last five readmitted patients. Reviewers should be physicians or nurses from the hospital and community settings.
More informationSupporting MLTSS Consumers through Problem Resolution and Advocacy
Supporting MLTSS Consumers through Problem Resolution and Advocacy James David Toews, Becky A. Kurtz, Eliza Bangit September 11, 2013 Risks of Managed Long-Term Services and Supports (MLTSS) Many managed
More informationStatistical Portrait of Caregivers in the US Part III: Caregivers Physical and Emotional Health; Use of Support Services and Technology
Statistical Portrait of Caregivers in the US Part III: Caregivers Physical and Emotional Health; Use of Support Services and Technology [Note: This fact sheet is the third in a three-part FCA Fact Sheet
More informationPROVIDER POLICIES & PROCEDURES
PROVIDER POLICIES & PROCEDURES EXTENDED NURSING SERVICES The purpose of this document is to provide guidance to providers enrolled in the Connecticut Medical Assistance Program (CMAP) on the requirements
More informationBenefits Of Hiring A Home Care Agency
Preserving Dignity Through Independence at Home Benefits Of Hiring A Home Care Agency Are you noticing changes in your aging parents that make you concerned about their safety at home? Are they chronically
More information