State Legislation, Policy & Reports
Texas: Bill Would Create Lifespan Respite Pilot Program
On April 25, 2007, the Texas Senate passed a bill (S.B. 1865) which would create a lifespan respite pilot program for family members and friends who provide ongoing care to people with a chronic illness or disability. Respite services include in-home services, adult day services and facility-based services. Funding would be provided for community-based organizations or local government entities to provide access to respite services, to recruit, train and maintain a directory of service providers, to implement public awareness activities regarding respite services, and other activities. The bill is now pending in the House of Representatives. For more information, visit:
Texas Legislature
Washington: State Increases Funding for Family Caregiver Support Services and Kinship Navigator
The Washington state legislature recently approved an increase in funding for family caregiver support services, including respite and online caregiver assessment, and the Kinship Navigator program, allowing both programs to expand their reach in Fiscal Years (FY) 2008 and 2009. Funding for caregiver support services was increased by $2.4 million over the next two years, a 33% increase over the FY 2007 appropriation of $3.5 million. Funding for the Kinship Navigator program, which provides grandparents and other relatives who are raising children with information about and access to resources and services for children, as well as themselves, was increased by $800,000 to a total of $1 million over the next two years. That increase will not only fully fund the two existing Kinship Navigator programs, but will allow the state to implement four new programs in different regions in the state. For more information, contact Hilari Hauptman at (360) 725-2556 or [email protected] or visit:
Washington State - Family Caregiver Support Services
Washington State - Kinship Care Program
Federal Legislation, Policy & Reports
US Administration on Aging Releases Strategic Plan for 2007-2012
The U.S. Administration on Aging (AoA) recently released its Strategic Plan for 2007-2012. The Plan establishes five goals that support the continual modernization of Older Americans Act services, with particular attention to implementing the new provisions from the Older Americans Act Amendments of 2006. One of those goals is to "Enable seniors to remain in their own homes with high quality of life for as long as possible through the provision of home and community-based services, including supports for family caregivers." In that vein, AoA will promote consumer-directed options within long-term care and other efforts to help keep older adults out of institutional care. For more information, visit:
US Administration on Aging
GAO Study on the Impact of New Medicaid Long-Term Care Eligibility Criteria
In March 2007, the U.S. Government Accountability Office (GAO) released a study called "Medicaid and Long-Term Care: Few Transferred Assets Before Applying for Nursing Home Coverage; Impact of Deficit Reduction Act on Eligibility is Uncertain." The study examined how new asset requirements for Medicaid long-term care applicants, as specified in the Deficit Reduction Act (DRA) of 2005, have affected eligibility and access to the benefit. The study also examined financial characteristics of nursing home residents across the nation, demographic and financial characteristics of a sample of Medicaid nursing home applicants, and the extent to which applicants transferred assets at less than fair market value. The study found that most nursing home residents are unlikely to have sold off assets below market value to qualify for long-term care coverage from Medicaid; that the real affect of the DRA on applicants' eligibility for Medicaid long-term care coverage is "uncertain"; and that nursing home residents covered by Medicaid had fewer assets, lower incomes, and were less likely to have reported transferring cash than residents not covered by Medicaid. For more information, visit:
GAO
International News
Canada: Ontario Human Rights Commission Defines Family Relationships in Human Rights Context
The Ontario Human Rights Commission in Canada recently examined and defined family relationships and responsibilities in the context of human rights. On May 2, 2007, the Commission released two reports, The Cost of Caring: Report on the Consultation on Discrimination on the Basis of Family Status and the Policy and Guidelines on Discrimination Because of Family Status. These papers highlight the results of the Commission's public consultation on family status, and they provide employers, landlords and service providers with guidance on rights and responsibilities under the Ontario Human Rights Code. The Commission found that family caregivers are under increasing pressure, given the aging of the population, and that they are "often at a significant disadvantage in accessing employment, housing and services." While the Human Rights Code currently prohibits discrimination because of family status, it is limited to parent-child relationships and does not protect family members caring for aging or disabled siblings, grandparents, or other relatives. For more information, visit:
Ontario Human Rights Commission
Japan: Preparing for Rise in Number of People with Dementia
An editorial in the Japan Times on May 1, 2007 described Japan's response to the rising number of people with dementia in the country. The article explained that the number of people age 65 and older who are suffering from dementia will nearly double by 2025. In response, by 2009, the government plans to train one million "dementia supporters," or people who can help dementia patients and their families with daily activities and provide information about various social and health services. The government also hopes to establish networks between hospitals, nursing-care facilities and other health-service organizations to address the needs of dementia patients. For more information, visit:
Japan Times
"In Europe, Care for Elderly Is Being Transformed"
Reporter Dale Fuchs wrote a story for the International Herald on April 13, 2007 which described new trends in how Europeans are retiring and living out their later years. While older Europeans traditionally had two options for being cared for as they grew older - either living with and being cared for by family members or going into "hospital-like residences" - today many would like to maintain some independence and are less likely to move in with adult children. Fuchs describes how government policies are responding by paying for more home- and community-based services, and private businesses are establishing more consumer-friendly retirement communities. For more information, visit:
International Herald
Research Reports & Journal Articles
Report Finds Increasing Burden on Family Caregivers and Institutions as Baby Boomers Age
On May 1, 2007, the Urban Institute released a report called "Meeting the Long-Term Care Needs of the Baby Boomers: How Changing Families Will Affect Paid Helpers and Institutions." The report analyzes how the growing numbers of older and disabled adults, as well as projected changes in financial resources, adult children's availability, and other factors, will affect the demand by older adults for paid and unpaid long-term care services over the next three decades. The report found that "even under the most optimistic scenario long-term care burdens on families and institutions will increase substantially." It projected that the number of older adults receiving paid home care or going into nursing homes will increase between now and 2040, and that the share of older adults receiving unpaid help from their children will fall slightly, due in part to rising divorce rates, increasing childlessness, and declining family sizes. For more information, visit:
Urban Institute
Study Finds Respite Has Small Positive Affect on Caregivers, Does Not Delay Entry to Residential Care
The Journal of the American Geriatrics Society published an article in its February 2007 issue (Volume 55, Issue 2) called "The Effectiveness and Cost-Effectiveness of Respite for Caregivers of Frail Older People." Anne Mason and her colleagues at the Health Technology Assessment Programme in the United Kingdom analyzed the results of 22 studies to determine the impact of different models of community-based respite care for frail older people and their caregivers. "For all types of respite, the effects upon caregivers were generally small, with better-controlled studies finding modest benefits only for certain" groups of caregivers. While the analysis was limited in its scope, the authors reported that "no reliable evidence was found that respite care delays entry to residential care or adversely affects frail older people." For more information, visit:
Journal of the American Geriatrics Society
Study Reveals Common Experiences among Spousal Caregivers of Stroke Survivors
An article by Ursula Eileen Coombs in the April 2007 issue of the Journal of Neuroscience Nursing (Volume 39, Number 2), "Spousal Caregiving for Stroke Survivors," described the results of a small study that examined the experiences of eight spouses caring for their partners who had survived a stroke. Interviews with the caregivers revealed six interrelated themes: "experiencing a profound sense of loss, adjusting to a new relationship with a spouse, taking on new responsibilities, feeling the demands of caregiving, having to depend on the support of others, and maintaining hope and optimism." For more information, visit:
Journal of Neuroscience Nursing
Conferences & Trainings
ASA Autumn Series on Aging
The American Society on Aging (ASA) will host its Autumn Series on Aging from September 17-20, 2007 in Philadelphia, and from October 8-11, 2007 in San Francisco. The series offers regional training for professional who work with older adults, their caregivers and their families. For more information, visit:
American Society on Aging
Funding, Media & Miscellaneous
AHRQ Produces Two New Audio Podcasts about Care Coordination and Transitions
As part of its Healthcare 411 series, the Agency for Healthcare Research and Quality (AHRQ) at the U.S. Department of Health and Human Services produced two audio podcasts, one for consumers and one for providers, on quality issues during health care transitions. Both podcasts are interviews with AHRQ Director Carolyn M. Clancy, M.D., discussing patient transitions in care from one setting or clinician to another. The "Consumer Insider" podcast is 10 minutes and provides tips for patients and their families, and the "Provider Insider" podcast is 14 minutes and gives providers some ways to improve the problems with handoffs, including sending care reports to the patient's primary care provider and using non-medical terms with patients. To access the podcasts or for more information, visit:
AHRQ Healthcare 411
"Warning: Caregiving Can Be Hazardous to Your Health"
On April 30, 2007, Carol Levine, director of the Families and Health Care Project at the United Hospital Fund in New York City, wrote a commentary on caregiver health for the online Bioethics Forum. She wrote about her own experiences neglecting her health throughout the years that she was a caregiver for her husband, despite all the advice to caregivers to take care of themselves and the data to show that caregiver health suffers to the point that it has become a public health concern. She explained two reasons caregivers may neglect their health: they may be depressed or they may want to avoid the tremendous challenges that come with dealing with their own illness at the same time they are caring for a family member. Yet, despite having to overcome barriers, she encourages caregivers to take care of themselves - because they just might outlive caregiving itself. For more information, visit:
Bioethics Forum
"When Forgetting Is a Gift"
On May 7, 2007, the Los Angeles Times published as article by freelance writer Kathleen Clary Miller about her decision to place her father in an Alzheimer's care facility, despite her promise never to do so. Clary Miller explained that, while her father may not have approved if he was aware of the decision, she believed he was more at peace in a place that could care for him and had no expectations of him, as opposed to the agitation and anxiety he exhibited when he lived with her. She would like her daughter to make the same decision for her when she gets older, should it ever come to that. For more information, visit:
Los Angeles Times
Film about Alzheimer's Disease, Marriage and Memories Now Playing
Away From Her, a film based on a short story by Alice Munro, stars Julie Christie as a woman with Alzheimer's Disease. It portrays the trials in her marriage as she enters a nursing home, befriends a male resident and forgets her husband. Described as a love story, the film also features Olympia Dukakis, Michael Murphy and Gordon Pinsent. For more information, visit:
NPR
USA Today
