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Noëlle Merrill, Eastern Area Agency on Aging Deborah Poulton, Eastern Area Agency on Aging Lenard Kaye, University of Maine Center on Aging Jennifer Crittenden,

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Presentation on theme: "Noëlle Merrill, Eastern Area Agency on Aging Deborah Poulton, Eastern Area Agency on Aging Lenard Kaye, University of Maine Center on Aging Jennifer Crittenden,"— Presentation transcript:

1 Noëlle Merrill, Eastern Area Agency on Aging Deborah Poulton, Eastern Area Agency on Aging Lenard Kaye, University of Maine Center on Aging Jennifer Crittenden, University of Maine Center on Aging

2 Coös County  Grafton County Sullivan County  Monadnock Region Caregiver Connections 1.866.634.9412 “Uniting Communities to Support Family Caregivers” Sarah Harpster Monadnock ServiceLink Aging and Disability Resource Center Kimberly Phillips UNH Center on Aging and Community Living

3  The Harry and Jeanette Weinberg Foundation have provided $8.1 million dollars to support family and informal caregiver projects countrywide.  Three year grants, averaging $300,000 per year were awarded to 14 non-profits nationwide.  Both the Eastern Area Agency on Aging (ME) and Monadnock Collaborative (NH) were funded beginning September, 2009.

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6  Large geographic area with no people  4,000 square miles with few roads  Rural, isolated, high poverty rate and few services  Average of 23 residents per square mile  Islanders

7  Oldest state based on median age  Restrictive Nursing Home Eligibility  Rural and economically disadvantaged regions as compared to other counties in Maine

8  Lack of healthcare access  High chronic disease burden  Rapidly aging population  Limited or no public transit  “You can’t get there from here”

9  75% of all care received by older adults in the US is provided by family members and friends.  Many do not consider themselves caregivers.  Majority of caregivers are middle aged women.  Unpaid caregivers will continue to be the largest source of long term care services in the United States. (Sources include National Alliance for Caregiving and AARP)

10 Caregiver Connections “Uniting Communities to Support Family Caregivers”

11 Oversight: Steering Committee (leaders from each County); Monadnock Collaborative (fiscal agent); state level experts Management: ServiceLink Resource Center Managers, Evaluators (IOD), NH Bureau of Elderly and Adult Services (State Funder), Project Staff & Consultants Monadnock SLRC (Monadnock Collaborative) Coos Co. SLRC (Tri-County CAP) Grafton Co. SLRC (Grafton Co. Senior Citizens Council, Inc.) Sullivan Co. SLRC (Monadnock Collaborative) Community Organizer Leadership Implementation Caregiver Connections: Partnerships at Every Level Project Schematic Caregiver Connections: Partnerships at Every Level Project Schematic Family Caregivers Community Networks Project Coordinator Caregiver Specialist Community Networks Caregiver Specialist

12 Direct Service Community Organizing Evaluation Network development Volunteer training Community-based supports Caregiver assessment, support Powerful Tools for Caregivers Flex Funds “Uniting Communities to Support Family Caregivers”

13 A Most Difficult Privilege www.nhcaregiverconnections.org (Visit our website to see our 14-minute video)

14  Networking providers  Training and Respite in Remote Regions  High School and University student involvement  Steering Committee made up of current and former caregivers and providers

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16  Area Agency on Aging  Adult Day Programs  Health/Palliative Care Providers  University departments  Community-based non-profits  Volunteer Service Organizations  Community Action Program  Caregivers/community members  Legislators  Municipal and State entities  High Schools

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18  Mini Grants  New partners  New caregiver populations  New service benefits  All Inclusive Resource Exchanges  Caregiver Trainings  Basic Skills  Dementia Specific (SAVVY)

19  Choice and opportunities through scholarship funds  Incorporating the Senior Companion Program  Reaching into high schools, universities and colleges  Affordable case management

20  Increasing number of and access to caregiver training programs  Affordable and sustainable adult day services  Online health assessments for caregivers  Resource center development  Health center based discharge planning

21  Media Outreach  Webcasts  Navigator Website  Video Phones  Internet Access  Online Caregiver Self Assessment  Online Caregiver Curriculum

22  Needs and resources assessment work by Center on Aging to inform service delivery  Input from a diverse group of community members, caregivers, and professionals  Asset mapping based on findings

23  148 surveys returned and 46 focus group participants  64 towns represented  Survey respondents:  41% retired  6% are disabled  53% currently working: ▪ Home health staff ▪ Social workers ▪ Business/sales ▪ Clergy

24  Focus Group participants:  75% female; 25% male  1% grade school; 25% high school/GED; 50% college; 24% graduate degree  Employment background: Boat Captain Executive Director Homemaker Chef Physician Psychotherapist School Librarian Teacher Farmer Truck Driver

25 Defining Caregiving  It’s paid/unpaid  Complex relationships  It’s a 24/7 job  You wear multiple hats/fill multiple roles  Financial burden/fear of losing life savings  Grieving all the time  Play multiple roles-be yourself, doctor, lawyer, caregiver, executive assistant, housekeeper, etc.  You are a “draftee” into service-thrust into role suddenly

26  Transportation  Large distances to services  Door-to-door transportation needed  Transferring into a car challenging  Transportation programs rely on volunteers  Lack of formal resources  Resources located far away  Insufficient funding to develop programs/services

27  Caregivers don’t often know they are caregivers  Need to educate community about this issue in general  It’s all “on-the-job training”  Need training and support to help family caregivers with techniques for hands-on care  Education on specific medical disorders

28  Resiliency and strengths of caregivers  Crafting personal solutions  Developing personal stress relief techniques  Community  Neighbors helping neighbors  Formal and informal resources available

29  Aging network-AAA, Legal Services for the Elderly, etc.  Alzheimer’s Association  Adult day programs  CAP agency  Key professionals  Healthcare sites  Homecare agencies  Hospice agencies

30  Churches  NeighborCare/Neighbors helping one another  Faith in Action  Community support groups  Individual community members  Local schools (students)

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32 Caregivers Community Education NetworksSupports Training Community Organizing

33 Community Education

34 Networks Year 1 Asset mapping / focus groups Year 1 Asset mapping / focus groups Years 2 & 3 Reconvene / establish networks Years 2 & 3 Reconvene / establish networks

35 Networks

36 Training

37 Supports

38 Evaluation

39 Training evaluation How knowledgeable are you about: BEFORE THIS PROGRAMAFTER THIS PROGRAM Not Very Knowledgeable Very Knowledgeable Not Very Knowledgeable Very Knowledgeable The Aging Process □□□□□□□□□□ The Responsibilities of Family Caregivers □□□□□□□□□□ The Impacts of Caregiving on Family Caregivers □□□□□□□□□□ Ways Volunteers Can Support Family Caregivers □□□□□□□□□□ Types of Community Resources That Can Help □□□□□□□□□□

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44 Dispersion of 328 attendees across 4 counties

45 Critical Incident Timeline

46  How to manage feelings of guilt  How to deal with changes in dynamics between caregiver and care recipients  How to understand “goobledeegook” (insurance, forms, planning etc.)  Showering/hygiene/hands-on care  Benefits/programs  Practical information about Alzheimer’s-not medical or technical  When to consider a nursing home

47  93% of caregivers reported using skills they learned at caregiver trainings one month after attending.  Most common skills used after training include:  Transfer techniques  Assisting loved one with walking/mobility  Communication skills  Understanding behaviors and how to respond 47

48  73% of caregivers reported using new resources and services one month after training. Including:  Hospice  Area Agency on Aging  Elder attorney  Support groups  Caregiver guides and other resource materials 48

49  Created new services where gaps once existed  Providers report increased collaboration with other agencies and leveraging of resources  Agencies are implementing policies and practices that better support caregivers and increase capacity for service provision Source: Process evaluation findings Yrs. 1 & 2 49

50  Continual outreach is needed to ensure caregivers and professionals are aware of services available  Need for regular networking opportunities for current and potential partners  Service gaps around flexible respite and transportation Source: Process evaluation findings Yrs. 1 & 2 50

51  Reaching more caregivers earlier in their journey  Fine tuning the scope of caregiver needs  Streamlining access to services with strong partnerships  Improved provider communications

52  New diverse connections established  Strong advisory board  New funding source – fee for service  Improved the Family Caregiver Title III E Program  More useful tools for caregivers  Were able to leverage other grants

53  Finding common ground with partners  Finding caregivers to help advise a project  Collecting the right data from the start  Interpreting success from the data  Technology limitations in a rural state  Finding the right venue to offering trainings to caregivers

54  Ongoing endowment fund for scholarships  Care navigator fee for service by adding medicaid and insurance billing  Student rotations – use of social work students in many other projects  Adult day services 7 days week and replication activities region wide  Mini grant project data able to leverage other revenue to continue and expand efforts

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56  Island people want information but prefer to retain their autonomy  High speed broadband necessary  Professionals don’t think people should pay  Caregivers have a hard time finding time  Small fixes can make a big difference  Medical vs social model adult day service

57 Community Organizing Lessons Learned Individuality of locales Volunteers & finding our niche Network development is hard work

58 Questions & Discussion Friday March 30, 2012, 10-11:00 A Study of Caregiver Outcomes in the NH Family Caregiver Support Program Marriott Wardman Park, Balcony A Friday March 30, 2012, 8-9:30 Caring for Caregivers :Fostering Innovative Support Networks Marriott Wardman Park, Washington Room 5


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