1. Geriatric Education Series
Presented in partnership with:
Funded in part by a grant from the EJC Foundation

2. Caregiver Support & Resources
January 6, 2016
Kelley R. Macmillan, Ph.D., LSW
Director Community & Social Services
Sanford Center for Aging

3. Objectives
OBJECTIVE 1: Administer and score a caregiver burden screening instrument OBJECTIVE 2: Encourage family caregiver self-care OBJECTIVE 3: Discuss referral options to community programs serving older adults and family caregivers

4. What is Caregiving? Hands on personal care
Helping with household tasks
Night-time or 24-hour supervision
Financial management
Care coordination
A caregiver is any person, age 18 and older, who provides assistance with one ADL or IADL to any person with a physical and/or mental disability, regardless of age.

5. Who are Caregivers? Women (60%) Adult Children (36%)
Sole Caregiver (44%)
Work Full-time (60%)
Caregivers of Older Adults: A Focused Look a Those Caring for Someone Age 50+; June AARP and National Alliance for Caregiving
The number of older adults age 85 and older is expected to quadruple by 2030.
Risk of functional impairment increases with age, from 19% for year olds to 40% for adults 91 and older.
More adult children will become caregivers due to demographic changes

6. Why Assess the Caregiver?
A caregiver assessment helps us understand what may support the caregiver in their role which benefits our client to maintain community residence.
We need to concern ourselves with the caregiver because if they are unable to provide the care to the adult, the adult is at risk of institutional care or needing limited community based social services.
The social service system is often complex and fragmented.
Direct social service to the client indirectly support the caregiver.
Social services are frequently sought at a time of crisis and may be too little to late.
A third of caregivers say a health care provider, such as a doctor, nurse, or social worker has asked them what was needed to care for their recipient, but only 16% report similar conversations about self-care. A greater percentage of 50+ caregivers find these conversations helpful than the percentage who report having had them. (National Alliance for Caregiving and AARP)

7. Why are Caregivers Important?
In the US there are 34.2 million (14.3% of pop.) people providing care (50 & >)
The estimated cost for caregiving is $470 billion per year! (2013 data)

8. What are Caregivers Providing?
Approximately 60% of care recipients ONLY receive care from informal caregivers
CG provide 24.1 hrs/wk on average
22% of CG provide 40 hrs or more/wk
A caregiving career lasts 3.7 years
AARP and NACG report

9. Risks for Caregivers - 1
Caregivers are at greater risk of health problems:
Infectious disease, such as flu
Heart problems
Diabetes
Cancer

10. Risks for Caregivers - 2
Caregivers are at greater risk of mental health emotional problems:
Depression (two times as common)
Stress and burden
Interpersonal problems
Anxiety

11. Risks for Caregivers - 3
Caregivers are at greater risk of social problems:
Isolation
Reduced leisure activities/time
Restricted social roles

12. Caregiver Stress Balancing caregiving, family and work
Balancing the relationship with the care recipient
Making decisions regarding care
Women experience more stress because of societal expectations of women's roles
Men see the caregiver role as a series of tasks
Men more likely to delegate & seek formal services
INTRODUCE THE CAREGIVER STRESS DOCUMENTS

13. Benefits of Caregiving - 1
A natural support system
A meaningful & satisfying role
The relationship between the adult and the caregiver may be enhanced

14. Benefits of Caregiving - 2
An opportunity to ‘give back’ to a parent
Satisfaction in knowing the adult has a good quality of life
Autonomy & self-determination
Remain in home/familiar surroundings
Trusting relationship with caregiver

15. Strategies for Caregivers - 1
Social and Health Services
Case management
Respite care
Medicaid services (HCBS)
Medicare services (home health)

16. Strategies for Caregivers - 2
Psychosocial support - reduces isolation & permits ventilation of feelings with other caregivers
Psychosocial support - reduces anxiety, guilt, depression & psychosomatic complaints
Social Support Groups
Peer led groups - increase social networking and support
Professionally led groups - techniques on stress reduction and problem-solving
Professional counseling - relationship issues, personal coping

17. Strategies for Caregivers - 3
Psycho-education about caregiving
The aging process
Coping with caregiving
Communication strategies
Problem-solving
Information regarding community services

18. Strategies for Caregivers - 4
Immunizations - influenza, pneumococcal, tetanus
Health screenings - cervical cancer, mammogram, blood sugar and blood pressure
Mental health screening - stress, depression and anxiety

19. Strategies for Caregivers - 5
Encourage planning for future needs (caregiving can last for > 4 years)
Living Will
Advance Directive
Durable Power of Attorney

20. Strategies for Caregivers - 6
Family member keeps copies of person’s important records.
Direct deposit of person’s check(s)
Automatic bill-pay
Joint access to a bank account

21. Strategies for Caregivers - 7
Utility party notification
Decide what to do about checkbook, credit cards
Develop a system for handling mail
Consider Volunteer Rep Payee Program

22. Interaction with Caregivers
Give information in small doses
Tackle one issue at a time
Limit the length of your visits
Verify that families understand
Give manageable “homework” assignments and write them down!

23. Resources Family Caregiver Alliance
Nevada ADRC
Aging and Disability Resource Center (National)
Eldercare Locator
AARP

24. Sanford Center Geriatric Specialty Clinic
Kelley R. Macmillan, Ph.D., LSW (775)