State Legislation, Policy & Reports

California: Three Caregiving Bills Arrive on Governor's Desk

The California Legislature passed three family caregiver bills, which now await Governor Arnold Schwargenegger's signature. A.B. 537 allows workers to take job-protected leave to care for seriously ill adult children, siblings, grandparents, grandchildren and parents-in-law. S.B. 727 allows workers to receive partial pay when they must miss work to care for their siblings, grandparents, grandchildren and parents-in-law, expanding on California's existing Paid Family Leave law. S.B. 836 adds "familial status" to the list of prohibited bases for employment discrimination under the California Fair Employment and Housing Act, which not only protects workers from discrimination, but provides greater clarity to employers about their legal obligations to their employees. For more information, visit:

California Legislature

Kentucky: Governor Proposes Increased Funding for Older Adult Programs, Caregiver Tax Credit

Kentucky Governor Ernie Fletcher has pledged that, if he is reelected this year, he will ask the 2008 General Assembly for an increase of $15 million in 2009 and 2010 for programs for older adults, including adult day services and in-home care, reported the Lexington-Herald Leader on September 6, 2007. The Governor also proposed the idea of a caregiver tax credit for family members who provide care to a dependent adult with Alzheimer's disease who is at least 60 years old and low-income. The plan also includes help for residents buying long-term care insurance. For more information, visit:

Lexington-Herald Leader

Federal Legislation, Policy & Reports

CMS Seeks Input on Information Collection Activities, Including Caregiver Assessment

The July 27, 2007 Federal Register (Volume 72, Number 144) posted the Centers for Medicare and Medicaid Services' (CMS) request for public comment on a number of the agency's information collection activities. Among the activities that CMS would like to hear about is the Medicare Continuity Assessment Record and Evaluation (CARE) Instrument, which measures patients' needs at discharge from acute and post-acute care settings. The CARE Instrument includes some questions for family caregivers to assess their willingness and ability to provide care. CMS is also asking for comment on the revised OASIS Instrument, which assesses and identifies patients' need for home care in accordance with their medical, nursing, rehabilitative, social and discharge planning needs. Comments are due to the Department of Health and Human Services on September 25, 2007. For more information, visit:

Federal Register

International News

EU: Paper Examines Long-Term Care Services in Europe

The European Centre for Social Welfare Policy and Research released a discussion paper by Manfred Huber in May 2007 called "Long-term care for older people: The future of Social Services of General Interest in the European Union." While the paper acknowledges that unpaid family members provide most of the long-term care in European countries, there are also a number of public programs and services provided to adults with chronic conditions or long-term care needs. The paper examines the financial sustainability of those programs, the quality of care provided, projected staff shortages and other long-term care issues, particularly as they are affected by the aging of the European population. For more information, visit:

European Centre for Social Welfare Policy and Research

Israel: Nearly One in Three Adults is a Family Caregiver

On September 17, 2007, the Jerusalem Post reported that 30% of Israel's adult population provides care to an elderly or sick relative or friend. The data comes from a study conducted by the Central Bureau of Statistics, which found that nearly half (46%) of family caregivers said that providing care "was emotionally, physically and socially stressful." At the same time, the majority of caregivers were very satisfied with providing care, reporting that they were proud of their caregiving role and felt appreciated by the care recipient. For more information, visit:

Jerusalem Post

Research Reports & Journal Articles

"Preserving Health of Alzheimer Caregivers: Impact of a Spouse Caregiver Intervention"

The results of a study by Dr. Mary Mittelman and her colleagues on family caregiver support interventions were published in the September 2007 issue of the American Journal of Geriatric Psychology (Volume 15). The article, "Preserving Health of Alzheimer Caregivers: Impact of a Spouse Caregiver Intervention," reveals that caregivers of spouses with Alzheimer's disease who received enhanced support services, including individual and family counseling and support group participation, reported better physical health outcomes compared to family caregivers who had not received the intervention. These are the latest results from ongoing research on caregiver interventions conducted over the past 20 years. These findings suggest that "enhancing caregivers' social support, fostering more benign appraisals of stressors, and reducing depressive symptoms may yield indirect health benefits." For more information, visit:

American Journal of Geriatric Psychology

"Job Satisfaction and Career Commitment Among Nursing Assistants Providing Alzheimer's Care"

A recent study revealed that nursing assistants and home care aides with previous experience as unpaid family caregivers for a friend or relative with Alzheimer's disease had higher levels of job satisfaction in their paid care work, but lower levels of career resilience, compared to those with no family caregiving experience. "Job Satisfaction and Career Commitment Among Nursing Assistants Providing Alzheimer's Care" by Dr. Constance Coogle and her colleagues was published in the American Journal of Alzheimer's Disease and Other Dementias (Volume 22, Number 4). The article suggests that "current or previous informal caregiving experience may enhance intrinsic job satisfaction by increasing personal commitment to pursue formal care work and providing a kind of inoculation against the demoralization that is too often suffered in these very challenging jobs." For more information, visit:

American Journal of Alzheimer's Disease and Other Dementias

Racial Segregation and Disparities in Quality Across U.S. Nursing Homes

An article in the September/ October 2007 issue of Health Affairs (Volume 26, Number 5) reveals that segregation and disparities in quality of care between African-American and white adults do exist in nursing homes across the United States. A study by David Barton Smith and his colleagues, "Separate and Unequal: Racial Segregation and Disparities in Quality Across U.S. Nursing Homes," found that "blacks are much more likely than whites to be located in nursing homes that have serious deficiencies, lower staffing ratios, and greater financial vulnerability." Racial segregation among nursing homes generally mirrors segregation among residential metropolitan areas, and it is blamed in large part for the disparities in quality of care. For more information, visit:

Health Affairs

"Women's Views of Caring for Family Members"

An article in the September 2007 issue of the Journal of Gerontological Nursing (Volume 33, Number 9) describes how a sample of wife and daughter caregivers in Finland felt about their caregiving role and their use of respite. The article, "Women's Views of Caring for Family Members" by Sirpa Salin and Dr. Paivi Astedt-Kurki, revealed that the use of respite invoked different feelings for different women, from emptiness to relief to guilt, dependent largely on the wife or daughter's perceptions about her caregiving role. The article challenges "health care professionals to commit themselves to family-centered work, in which knowing the family's history and current life situation is key to providing high-quality service." For more information, visit:

Journal of Gerontological Nursing

Conferences & Trainings

Pacific Northwest Brain Injury Conference October 5-6

The Fifth Annual Pacific Northwest Brain Injury Conference will be held October 5 and 6, 2007 in Portland, Oregon. The event, "Living with Brain Injury: Building Bridges," is sponsored by the Brain Injury Associations of Washington and Oregon. It will feature a medical/ VA track, a legal track, a consumer track and an Indigenous Peoples Education and Training Gathering. Registration is open until October 4, 2007. For more information, visit:

Brain Injury Association of Oregon

National Long-Term Care Symposium October 11

The second annual National Long-Term Care Symposium will be held in the Rayburn House Office Building, Room 2168 in Washington, DC from 8:30 a.m. - 12:00 p.m. on October 11, 2007. The event will include the book release of The Future of Long-Term Care in America, with chapters by various experts, and the release of public opinion poll data on long-term care issues and the 2008 election. All attendees must RSVP by October 11. To RSVP or for more information, email [email protected]

National Citizens' Coalition for Nursing Home Reform Annual Conference October 21-24

The National Citizens' Coalition for Nursing Home Reform (NCCNHR) is holding its Annual Conference and Meeting October 21-24, 2007 in Arlington, Virginia. The Conference, called "Quality Care No Matter Where," will feature sessions on building advocacy skills, speakers known for promoting quality long-term care, a Capitol Hill event commemorating the 20th anniversary of the Nursing Home Reform Law and much more. Register by September 21 to get the Early Bird Rate. For more information, visit:

National Citizens' Coalition for Nursing Home Reform

Funding, Media & Miscellaneous

Parade Magazine Covers Family Caregiving

The September 9, 2007 issue of Parade included an article by Gail Sheehy, "How Can We Help Our Nation's Caregivers?" about her personal experience as a family caregiver, as well as the challenges that face all family members suddenly thrown into the world of providing long-term care. Sheehy describes some of the policy and program innovations that exist to provide support for family caregivers, including paid family leave in California and caregiver training classes such as "Powerful Tools for Caregivers." She also points out the shortcomings in our long-term care system, including very limited Medicare and Medicaid coverage for people with chronic conditions. For more information, visit:

Parade