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1 Supporting Family Caregivers Staff Development Presented by Susan Wenberg Aging and Adult Services/DHS 2005.

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Presentation on theme: "1 Supporting Family Caregivers Staff Development Presented by Susan Wenberg Aging and Adult Services/DHS 2005."— Presentation transcript:

1 1 Supporting Family Caregivers Staff Development Presented by Susan Wenberg Aging and Adult Services/DHS 2005

2 2 Four Kinds of People In This World Those who have been caregivers Those who currently are caregivers Those who will be caregivers Those who will need caregivers Source: Rosalynn Carter Institute for Caregiving www.rosalynncarter.org

3 3 Who is the Family Caregiver? A family (or informal) caregiver is a spouse, family member, friend or others who provides unpaid care for a frail older adult. Caregiver services focus on the needs of the caregiver (not the recipient) and are reimbursable through the waiver. Caregiving impacts people of all races, ethnicities, lifestyles and incomes.

4 4 Characteristics of Caregivers CG is a 46 year old Baby Boomer Working woman who provides 18 hours of weekly care for her mother who is 77 yrs. of age Ave. length of care is 4.5 years Average income is $35,000/year More than one-third have children under 18 yrs 61% female, 39% male 59% are employed Pays $171/month out of pocket expenses 15% have physical or MH issues, 25% stressed Source: 2004 CG study by National Alliance for Caregiving and AARP

5 5 How Do Caregivers Help? Caregivers play an essential role in helping older adults manage chronic care: ADLs (Activities of Daily Living) - dressing, bathing, toileting, feeding and mobility IADLS (Instrumental Activities of Daily Living) - transportation, groceries, errands, housework, finances, meals, medications Supervision Arranging care and services, advocating for medical care and insurance coverage Home modifications and assistive devices Emotional well-being and support

6 6 What’s the Value of Caregiving ? Family caregivers are an essential element of long-term care. Estimated value of family caregiving provided to seniors in Minnesota is: $4.58 Billion, or $4,580,000,000

7 7 Value of Family Caregiving For every 1% decline in the proportion of care provided by families in Minnesota The cost to the state is $30,000,000 per year We can’t afford to lose it! Public and Private Financing of Long-Term Care: Options for Minnesota A Report to the Minnesota Legislature – Jan. ‘05

8 8 Benefits of Supporting Family Caregivers √ Increase knowledge, skills and confidence of family caregivers in providing care √ Prolong the length of time that families care for older adults √ Improve the quality of life of older adults; most older adults prefer to receive care from family or friends √ Alleviate labor shortage issues √ Provide cost savings $$

9 9 A Caregiver’s Story Debra is a 51 year old baby boomer, single mom, who works full-time as an electrician and cares for her 12 year old son with special needs. She also cares for her 88 year old mom who moved in with her after suffering a heart attack. She dealing with her son’s school, her mother’s health and doctor appointments, as well as her job. “On a good day I would get home at 7 pm, make dinner, help with homework, and then settle in at night. I had periods of crying, not knowing what to do or where to turn, I was desperate for help!” Source: Pioneer Press Newspapers – October 9 th, 2005

10 10 Minnesota’s Family Caregiver Support Program The DHS and the Minnesota Board on Aging have developed a statewide strategy to preserve, enhance and prolong the role of family caregivers. VISION: To build capacity that affects lives by improving the quality and duration of the care provided by family caregivers. Impact: To keep older adults living in the community longer and reduce LTC expenditures from facility-based care.

11 11 Minnesota’s Family Caregiver Support Program Locally caregiver services are growing through collaborative development: Area agencies, Title III providers, health plans, counties, Eldercare Development Partners, faith-based and voluntary organizations and consumers. Minnesota’s spending on family caregivers: Approx. $12.1 Million Older Americans Act $2.4 million Waiver/AC $ State Respite/Community Service $1.0 million Local/Private $.445 In-kind $.855 More than 44,000 caregivers were served through publicly funded programs in 2004. Many more are served through faith based and voluntary organizations.

12 12 Minnesota’s Family Caregiver Support Program Minnesota has developed a five point strategy to support family caregivers: #1Develop a diverse menu of service options to address the changing needs of caregivers New respite options – overnight, evening, culturally specific New caregiver coach service, consumer directed models #2Promote easy access to information and service options, regardless of age and income Multiple access points for entry and referral. Examples: clinics, employers, LTCC/Case managers, providers and faith-based organizations

13 13 Minnesota’s Family Caregiver Support Program #3 Integrate services across funding streams Caregiver services are available and utilized across waivers, Alternative Care, Title IIIE, state funded grants, and private pay resources #4 Support working and long distance cgs On-line training & education Senior LinkAge Line, Consumer decision tool, virtual caregiver support program #5 Partner with health care professionals for better management of chronic disease Increase physician referral to caregiver services Co-locate caregiver services at clinic settings (information, assistance and cg coaches)

14 14 Getting Results for Caregivers - What do they want? To have the skill and knowledge to provide the care To stay healthy and continue their current lifestyle To direct the care and make informed decisions To provide quality care and support as long as they can

15 15 Assessment Goal: Connecting Caregivers with the Help They Need Focus on the needs of the caregiver and not the care recipient. Eliminate prior personal biases what caregivers should be able to do and for how long. Move away from trying to fit people into pre- existing "slots" in pre-designed models of care. Move towards flexible wrap-around supports; individualized and customized help.

16 16 Example #1: Judy needs respite on Thursday nights The Slotting Approach We don’t have any agencies/individuals that provide evening in-home respite. We can set you up with adult day or out- of-home respite. Wrap-Around Approach Case manager contacts variety of agencies to develop requested services. Senior Companion is identified who can provide respite every Thursday night.

17 17 Example #2: Janet Needs Help Transferring her Dad Slotting Approach Case Manager suggests nursing home placement where they have the staff and equipment to transfer dad safely. Wrap-Around Approach Case Manager works with CIL to get modifications to the bathroom. Authorizes hospital bed and lift through lease to buy.

18 18 Things to Know Before Assessing Caregivers Support the expert caregiver role: Focus on caregiver goals and whether needs are being addressed. Allow adequate time for talking with caregiver; contact by phone as needed. Stay connected, provide follow-up or find those who can. Refer to specific organizations, if needed. Help them identify a network of support.

19 19 How Can LTCCs and Case Managers Help Caregivers? Key Role: Identify caregivers early on Provide on-going assessment of caregiver needs and wants. Identify readiness to accept help; continue to track; encourage early acceptance of help. Encourage caregivers to do on-going planning and make decisions about future needs/options. Connect with good information and help Give feedback of needs and service gaps to providers, DHS or Area Agencies on Aging.

20 20 Examples: LTCC Assessment Questions What would make things easier for you as a caregiver? What would you like others to help with? Who will you let help you? What would help keep you happy and healthy? What are your goals for yourself and the person you care for?

21 21 Community Resources for Supporting Caregivers Long-Term Care Consultation, Assessment and Planning Supports Available Through AC/EW Area Agencies on Aging, Title IIIE Older Americans Act services, Senior Linkage Line® Faith-based initiatives – Faith in Action, parish nurse programs

22 22 Caregiver Services and Supports Available Through AC/EW Respite Care Adult Day Services Caregiver Training, Education and Consultation Home Assessment and Modifications Functional Assessment and Adaptive Equipment

23 23 Formal Services with a Respite Outcome Companion Services – non-medical care, supervision and socialization. Not billed as respite but helps caregivers. Home Care/Personal Care Assistance/Rehab Therapies Transportation Chore

24 24 Respite Services Definition: Provides relief to the unpaid caregiver on a short-term basis. Service Includes: Individualized supervision, personal care or nursing care in the absence of primary caregiver for a functionally impaired person. Provider Options: In-home option Out-of-home option New self-directed option

25 25 In-home Respite Care Providers Registered or licensed practical nurses. Home health aides. Personal care assistants or other professionals; or Persons able to demonstrate to the case manager that they can provide the care on a temporary short-term basis. In home respite care providers who are required to be licensed or certified must meet the licensing or certification standard specific to the level of care they are providing and receive supervision as required by their respective license or service standard.

26 26 Out-of-home Respite Care options Licensed adult foster care home. Medicaid certified hospital, a Medicaid certified nursing facility. Currently registered housing with services establishment when services are delivered by a licensed home care agency. Out-of-home respite care may also be provided in a private residence that is identified by the recipient or their legal representative and approved by the local agency case manager. Group respite is an unlicensed service that provides companionship, supervision, socialization and meals. It is not billable under EW/AC but provides an alternative form of respite. Available through churches, senior housing and faith- based orgs.

27 27 New Respite Option Consumer Directed Community Supports Approved in Fall 2004 for waivers. For persons with unmet needs, cultural or language barriers, or areas with provider or worker shortages. Informal caregivers (family, friends and neighbors) provide respite. Excludes spouses and minors. Bill service as CDCS.

28 28 Caregiver Education and Training Provided to an informal caregiver who provides direct and ongoing services to individuals served by this waiver. Training includes instruction about treatment regimens, disease management and caregiver roles use of equipment specified in the plan of care Counseling includes coaching guidance or instructions directly related to providing care to the person on the waiver.

29 29 Caregiver Education and Training Standardized Curriculum Counties contract with caregiver education providers for AC/EW. Contact your AAA to identify education programs in your area.

30 30 Caregiver Education and Training Providers include Health care professionals who have had at least one year of experience in providing home care,or long term care service to the elderly, or at least one year of experience providing training or education to caregivers of elderly persons. Vocational and technical colleges and Certified nursing assistant training National chapters of chronic disease organization Alzheimer’s Association, Minnesota Stroke Association, Struthers Parkinson Center

31 31 Adult Day Services Coordinated set of services Nutrition Health Social service Regularly Scheduled Two or more hours per day One or more days per week Bath optional Two options for development Licensed Family Adult Day Services (FADS) – not corporate Center-based adult day services

32 32 Area Agencies on Aging New Federal Title IIIE National Family Caregiver Support Program provides: Information and assistance Caregiver training, education and consultation Consumer directed options underway Respite - in-home and out-of-home Supplemental Services – home modification, technology (on a limited basis) Call your local Area Agency on Aging at 1-800-333- 2433 to learn what’s available in your area.

33 33 Next Steps: Effective Planning of Support for the Caregiver What will your approach to service planning be with the caregiver? What is the best way to help the caregiver? What is he/she willing to accept and when? Were you able to help the caregiver?

34 34 Resources Senior LinkAge Line: 1-800-333-2422 www.minnesotahelp.info Www.mnaging.org/caregivers http://www.caregiving.org/ http://www.nfcacares.org/ Bulletins: #01-25-09; #03-25-06 Disease associations Comments, questions email or call me: sue.wenberg@state.mn.ussue.wenberg@state.mn.us or (651) 431-2587


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