Tag Archives for AARP

Rhode Island General Assembly Seeks to Assist State’s Caregivers

Published in Woonsocket Call on June 14, 2015

With the graying of America’s population, the profile of the typical family caregiver has changed, says a new report released by the National Alliance for Caregiving and AARP. The findings trouble aging advocates who warn that as care givers age they require more long term care support and community based care services.

Taking a Look at Today’s Caregiver

The report, “Caregiving in the United States 2015,” tells us that the “typical” family caregiver is a 49-year-old woman who takes care of a relative, caregivers on the whole are becoming as diverse as America’s population.

According to the 81 page report, today’s family caregiver also provides unpaid care for at least 21 hours a week, and has been care giving for an average of 5-1/2 years.  These individuals expect to continue providing care to their loved ones for another 5 years. Nearly half of these higher-hour caregivers report high emotional stress (46 percent), too.

Men, often stereotyped as failing to take on caregiving responsibilities, currently represent a whopping 40 percent of family caregivers, also providing an average of 23 hours a week being a caregiver to their loved ones, adds the report.

The study’s data indicates that today nearly a quarter of the nation’s caregivers are millennials between the ages of 18 and 34 and they are equally likely to be male or female. On the other end of the spectrum, 75 and older caregivers are typically the sole support for their loved one, providing care without paid help or assistance from relatives and friends.

Meanwhile, caregivers, with an average household income of $45,700, tell the researchers that they are not only emotionally strained, but financial strained as well. These higher-hour older caregivers report difficulty in finding affordable care giving services, such as delivered meals, transportation, or in-home health services, in their community, for themselves and their loved ones.

The report also notes that “Caregivers of a close relative—like a spouse or a parent—who are likely to provide care for 21 hours or more, indicate that being noted as a family caregiver in the medical records of the care recipient would be helpful in managing their caregiving responsibilities.”

Finally, the study’s findings indicate that caregivers who live more than an hour away from their care recipient also report higher levels of financial strain (21 percent), perhaps because 4 out of 10 long-distance caregivers report the use of paid help (41 percent).

Report Calls for Supporting Caregiver Needs

As previous AARP research has shown, we’re facing a caregiving cliff,” said Dr. Susan Reinhard, senior vice president and director, AARP Public Policy Institute; and chief strategist, Center to Champion Nursing in America. “By mid-century, there will be only three family caregivers available for each person requiring care. That means, to avoid putting them at higher risk as they age, we need to provide support for existing caregivers who are underserved by the current long-term services and support system.”

We’re especially concerned that not enough is being done to support family caregivers in the public or private sector as they age,” says Gail Gibson Hunt, president and CEO of the National Alliance for Caregiving. “There’s a double-edged sword when we fail to support caregivers, because we put both the caregiver and the care recipient at risk,” she warns.

Hunt observes, “Rhode Island is a unique state in that it has the highest percentage of persons over age 85. The data in this report speaks to some of the challenges of a graying population, particularly the needs of caregivers who are 75 or older.”

“We know from the data that the ‘typical’ caregiver over 75 is caring for a spouse or close relative, and spends about 34 hours a week providing care. This can be extremely challenging for an older person who may be managing their own mobility and health issues, as they help a loved one with basic needs like bathing or everyday tasks like grocery shopping,” said Hunt.

Hunt says, “Rhode Island has an opportunity to continue supporting older people and their caregivers, who are also growing older and need care.”

Lawmakers Posed to Pass Caregiver Law

           In June 4th, the Senate passed SB 481 A, the CARE (Caregiver Advise, Record  and Enable) Act, to provide caregivers with timely information to allow them to provide post-discharge care.  The House Chamber passed its measure, HB 6150 Sub A on June 10th.  Both chambers must now approve the legislation from the opposite chamber.  If passed, they go to the Governor for approval.  This legislation will be invaluable to the state’s 148,000 caregivers who provided 142 million hours of care for loved ones.

“We are delighted that – upon the CARE Act becoming law – Rhode Island will join seven other states that  have enacted CARE Act legislation, with bills in three other states awaiting their respective Governor’s signatures,” said AARP State Director Kathleen Connell.

“Together, AARP worked with a strong coalition of stakeholders, as well as the House and Senate sponsors, Representative Eileen Naughton, and Senator Gayle Goldin, and the members of the House’s Health, Education and Welfare Committee and the Senate’s Health and Human Services Committee,“ notes Connell.

“The passage of the CARE Act dovetails with the release of “Caregiving in the United States 2015,” which  presents a portrait of unpaid family caregivers today. It specifically addresses vulnerable groups of caregivers who face complex, high burden care situations. They tend to be older caregivers, who had no other option but to take on caregiving duties.” adds Connell.

Connell says, “It is sobering to conclude that in Rhode Island, with its above-average older population, we risk seeing more and more of old sick people caring for older sicker people. Clearly, that’s not a good thing and it needs addressing sooner than later.”

“One thing we noticed as the CARE Act made its way through the General Assembly was that a number of lawmakers shared their own personal caregiving stories. Some issues are harder to personally identify with than others, but when it comes to caregiving, it’s good to know we have this kind of attention. The report adds data and statistics that should help frame solutions,” says Connell.

 

Director Charles Fogarty, who oversees the state’s Division of Elderly Affairs (DEA), sees the value of AARP’s report highlighting the “critical role” of caregivers taking care of their loved one.  “Family support is essential to allow seniors to stay in their own homes and live as independently as possible, he says, noting that federal funds allows DEA to administer respite and care giver support programs.

“As the baby boomer generation ages, DEA will continue to seek out resources that provide support to family members who care for their loved one,” says Fogarty.

The CARE Act can provide assistance to those tirelessly care for their aged or disabled loved ones.   Kudos for the Rhode Island General Assembly giving them the tools to do a better job.

Herb Weiss, LRI ’12 is a Pawtucket-based writer covering aging, health care and medical issues.  He can be reached at hweissri@aol.com.

 

Bridging the Generations Through Multi-generational Trips

Published in Woonsocket Call on May 24, 2015

        For America’s 76 million baby boomers who spend $120 billion annually in leisure travel, three generation family vacations, including kids, parents, aunts/uncles and grandparents, are becoming a popular way to bond and create lasting memories, says a new AARP study about travel patterns of age 45 and over persons.

Researchers say that “a multi-generational trip is not typically inspired by a special event, but rather a desire to spend quality time together as a family.”  Although grandparents are more likely to pick up the tab for the trip, typically each family pays for their own expenses, they note.  Eighty one percent of travelers stayed at the same accommodation with their entire family.

The February 2015 research study on Multi-Generational Travel, offers insights into multi-generational vacations including why families are going, where they’re going, what they do on these family vacations, the challenges to plan them and why they create memories of a lifetime.

“Multi-generational family travel is becoming the new trend in family vacations. Our AARP 2015 Travel Trends found initial evidence that they would be popular in 2015 and now we know why,” said Stephanie Miles, Vice President, Member Value, AARP. “Our multi-generational travel research found 98 percent of travelers who took a multi-generational trip were highly satisfied and 85 percent are planning to take another one in the next 12 months.”

According to the study’s findings, 80 percent of the respondents traveled domestically in the U.S. and many chose active cities, beaches, amusement parks (Disney, too).  Also, California and Hawaii were two popular states to visit.  Domestic generational trips usually spans from 4 to 7 days.

Twenty percent traveled internationally with half heading to the Caribbean, Mexico or South America, says the findings.  Cruising is also a popular way to vacation for 25 percent of international travelers.  But, almost 40 percent chose nostalgic destinations to share a childhood memory.

The study finds that regardless of the location of the multi-generational trip, “dining out is the primary activity that engages the whole group.” While selecting and planning a trip may challenging, especially choosing the travel date, 98 percent of the multi-generational travelers were satisfied with their most recent trip.

Researchers found that traveling with parents, kids and grandparents can be positive in many ways.  Eighty three percent say that the trip brings the entire family together, while 69 percent stressed it helped to build special memories.  Fifty percent of the respondents noted that they were able to spend time with grandkids and 36 percent note the quality one-on-one time with family/spouse experienced during traveling.  Twenty nine percent say there were benefits of adult relatives spending time with younger generations.

The new research conducted by AARP Travel offers valuable insights into multi-generational travel, findings that Collette certainly can relate to, says Amelia Sugerman, Communications & Public Relations for Pawtucket-based Collette, a third-generation family-owned travel company.  “Over the past five years, Collette has witnessed an increase in family travel by about 20%,” she says, noting that this might be tied to age 65 and older adults who feel an urgent need to create ever lasting memories with their families.

“In a day and age where text messaging and face time has become the norm, it’s a unique chance to spend quality time together as one unit.  Although we do agree that bringing the family together and helping to build memories are top benefits of multi-generational travel, we have also identified many families who use the experience to celebrate a momentous occasion or event, says Sugerman, noting that the AARP study did not find special events triggering the planning of a Multi-Generation Vacation.

An older traveler, who took Collette’s National Parks tour, recently shared the details why this trip was so important to her family.  “My husband and I are getting older. Of course we think about the time we have left to spend with our grandchildren. This experience was the perfect way to celebrate our 50th wedding anniversary.”

Like many of Collette’s older travelers, this customer was ambivalent about the destination. adds Sugerman, noting that the older couple did not want to travel too far and wanted everyone to enjoy themselves, but the experiences were far more important than the sights of the destination.”

Sugerman says the benefits of touring organized by companies like Collette, is that guests of all ages can have a great experience and no one has to worry about the details of planning.  This reflects findings in the AARP study that found 20 percent of families identify the task of coordinating the trip to be the toughest.

“Guided travel takes the guess work out of it [traveling] and leaves valuable time for guests to simply enjoy their time together, says Sugerman.

Don’t forget to document your family multigenerational trips, suggests Patricia S. Zacks, proprietor of the Camera Werks, on Hope Street in Providence.   “While it’s trendy to be taking pictures on your cell phone or selfies documenting your vacation, people tend not to print these pictures,” she says, noting that statistics indicate that these pictures stay on a disk or memory card.

Taking special pictures of your family members on a trip will give you images that you can look at and reflect on, says Zacks. ‘There is nothing more special to look at than a 100 year old printed photo.  The younger generation geared to cell phones won’t have this experience.

For more information about Multi-Generational Travel vacations, go to http://www.gocollette.com

For details on planning a stress free family vacation, go to travel.aarp.org/articles-tips/articles/info-10-2013/how-to-plan-a-stressfree-multigenerational-trip.html.

Herb Weiss, LRI ’12 is a Pawtucket-based writer who covers aging, health care and medical issues.  He can be reached at hweissri@aol.com.

Palliative Care Can Provide Comfort to Dying Residents

Published in Woonsocket Call on May 10, 2015

           A recently published study, by Brown University researchers, takes a look at end-of-life care in America’s nursing facilities, seeking to answer the question, is knowledge and access to information on palliative associated with a reduced likelihood of aggressive end-of-life treatment?

Brown researchers say when a nursing facility resident is dying, oftentimes aggressive interventions like inserting a feeding tube or sending the patient to the emergency room can futilely worsen, rather than relieve, their distress. While palliative care can pull resources together in a facility to provide comfort at the end of a resident’s life, the knowledge of it varies among nursing directors.  A new large national study found that the more nursing directors knew about palliative care, the lower the likelihood that their patients would experience aggressive end-of-life care.

Susan C. Miller, professor (research) of health services, policy and practice in the Brown University School of Public Health and lead author of the study in the Journal of Palliative Medicine, published March 16, 2015, worked with colleagues to survey nursing directors at more than 1,900 nursing facilities across the nation between July 2009 and June 2010.  The researchers hoped to learn more about their knowledge of palliative care and their facility’s implementation of key palliative care practices.

Knowledge Is Power

According to the findings of the Brown study, the first nationally representative sample of palliative care familiarity at nursing homes, more than one in five of the surveyed directors had little or no basic palliative care knowledge, although 43 percent were fully versed.

“While the Institute of Medicine has called for greater access to skilled palliative care across settings, the fact that one in five U.S. nursing home directors of nursing had very limited palliative care knowledge demonstrates the magnitude of the challenge in many nursing homes,” Miller said. “Improvement is needed as are efforts to facilitate this improvement, including increased Medicare/Medicaid surveyor oversight of nursing home palliative care and quality indicators reflecting provision of high-quality palliative care,” she said, noting that besides quizzing the directors the researchers also analyzed Medicare data on the 58,876 residents who died during the period to identify the type of treatments they experienced when they were dying.

When researchers analyzed palliative care knowledge together with treatment at end of life, they found that the more directors knew about basic palliative care, the lower likelihood that nursing facility residents would experience feeding tube insertion, injections, restraints, suctioning, and emergency room or other hospital trips. Meanwhile, residents in higher-knowledge facilities also had a higher likelihood of having a documented six-month prognosis.

The study shows only an association between palliative care knowledge and less aggressive end-of-life care, the authors say, noting that knowledge leads to improved care, but it could also be that at nursing facilities with better care in general, there is also greater knowledge.  But if there is a causal relationship, then it could benefit thousands of nursing facilities residents every year for their nursing home caregivers to learn more about palliative care, the authors conclude.

Progress in Providing End-of-Life Care

Virginia M. Burke, J.D. President and CEO of the non-profit Rhode Island Health Care Association, said, “We were gratified that the authors found that most of the nursing directors who responded to their survey gave correct answers on all (43% of respondents) or most (36%of respondents) of the “knowledge” questions on palliative care.  We were also gratified to see that the number of hospitalizations during the last thirty days of life has declined significantly over the past ten years, as has the number of individuals who receive tube feedings during their last thirty days.  The need for continued progress is clear.”

Burke, representing three-quarters of Rhode Island’s skilled nursing and rehabilitation centers, adds, “It is not at all surprising that greater understanding of palliative care leads to better application of palliative care.”

The states’s nursing facilities are committed to providing person-centered end of life care, says Burke, noting that according to the National Palliative Care Research Center, Rhode Island’s hospitals are among the top performers for palliative care.  “We suspect that our state’s nursing facilities are as well.  We would be very interested in state specific results in order to see any areas where we can improve.”

Says spokesperson Director Michael Raia, of Rhode Island’s Health & Human Services Agency, “We need to provide the right care in the right place at the right time for all patients.”

When it comes to nursing facilities, Raia calls for reversing the payment incentives so that facilities are rewarded for providing better quality care and having better patient outcomes.  He notes that the Reinventing Medicaid Act of 2015 reinvests nursing home reimbursement rate savings into newly created incentive pools for nursing homes and long-term care providers that reward facilities for providing better quality care, including higher quality palliative care.

Bringing Resources to Families

With caregiving one of AARP’s most important issues, it’s no surprise that the organization provides a great deal of guidance on palliative care, stressing that “it involves organizations and professionals coming together to meet a person’s needs both in terms of pain management, along with emotional and spiritual perspectives,” said AARP State Director Kathleen Connell.

Connell says that “It’s is truly a team effort in which nursing home staff become key players. The resources are important to patient with chronic and terminal issues. Their families need help, too. So it is important any time we learn more about ways we can address this very important healthcare need.”

Adds Connell, “In Rhode Island, I’m confident that we have nursing homes that are dedicated to easing the difficulty of this particularly stressful stage of life. They give patients and their families enormous comfort. We certainly applaud their compassion and hope the report is helpful anywhere it identifies a need for improvement,” adds Connell.

AARP’s Caregiving Resource Center (http://www.aarp.org/home-family/caregiving/) includes an End of Life section. Check out a specific palliative care resource at  http://assets.aarp.org/external_sites/caregiving/multimedia/EG_PalliativeCare.html

To read the Brown Palliative Care Study go to http://online.liebertpub.com/doi/abs/10.1089/jpm.2014.0393.

Herb Weiss, LRI ’12 is a Pawtucket writer covering aging, health care and medical issues.  He can be reached at hweissri@aol.com.