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STATE LEGISLATION & POLICY
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1. California analysis of proposed cuts in HCBS services
Two researchers have analyzed the impact of proposed cuts to home and community-based service (HCBS) programs providing key supports to frail elders and their families - the In-Home Supportive Services (IHSS) program and Adult Day Health Care programs. Included is a discussion of the cuts to the "residual" program within IHSS, which provides payment to family members, including spouses or parents, for care provided to a loved one. Download: http://www.directcareclearinghouse.org/download/
CaliforniaBudgetIssues2004.pdf
2. Florida to increase funds for caregiving, HCBS
Florida's governor and the Department of Elder Affairs have proposed increases in key home and community-based services (HCBS) that provide support to consumers and families. Programs receiving the additional funding include the Alzheimer's Disease Initiative, Home Care for the Elderly (HCE) and Home and Community Based Medicaid waivers. The $17.4 million funding would help more than 2,200 frail elders receive care. Details: http://elderaffairs.state.fl.us/doea/News/PressReleases/
2004/Jan-May/jan2103.html
3. Maryland report on Alzheimer's care
Maryland's Attorney General has published a major study of the legal and policy issues related to Alzheimer's disease. "Policy Study on Alzheimer's Disease Care" covers health care decision making, including advance care planning, guardianship, and participation in medical research; financial planning; Medicaid issues; regulation of nursing homes and assisted living facilities; patient abuse and financial exploitation; long-term care insurance; and driver licensing. One of the major public policy goals identified in the report is to support both family and professional caregivers as they respond to the changing needs of people with Alzheimer's disease. Read:
http://www.oag.state.md.us/Healthpol/Alzheimers.htm
4. Montana brief on aging parents and finances
The Montana State University Extension Service has developed a fact sheet on how to talk to an aging parent about finances. The brief offers a variety of strategies as well as major issues in financial planning including conservatorships, guardianships and power of attorney. Download:
http://www.montana.edu/wwwpb/pubs/mt9324.html
5. Texas to consolidate family caregiving, long-term care agencies
As a result of H.B. 2292, many Texas departments and agencies providing long-term care services will begin consolidation or reorganization. Of interest to caregiving families, the New Department of Aging and Disability Services consolidates mental retardation and state school programs of the Department of Mental Health and Mental Retardation, community care and nursing home services of the Department of Human Services, and aging services programs, including the National Family Caregiver Support Program, of the Texas Department Integrated operations will begin Spring/Summer 2004. Details:
http://www.hhsc.state.tx.us/Consolidation/HB_2292/110303_HB2292TP.html
FEDERAL LEGISLATION & POLICY
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6. Fiscal Year 2004 NFCSP funding approved
The U.S. House of Representatives and Senate have approved an omnibus funding measure for many government agencies and programs, including the National Family Caregiver Support Program (NFCSP). For Fiscal Year 2004 (the current federal fiscal year), the NFCSP would receive $159 million, which includes a required across-the-board cut of 0.59%. The funding is an increase of $3.8 million from FY 2003 funding levels. Other Older Americans Act programs, like the Alzheimer's Disease Initiative, were cut. Details:
http://www.ncoa.org/content.cfm?sectionID=65&detail=514
7. Senators call for hearing on Medicaid institutional bias
U.S. Senators Tom Harkin (D-IA), Arlen Specter (R-PA) and Gordon Smith (R-WA) sent a letter to Senate Finance Committee Chairman Charles Grassley (R-IA) and Ranking Democrat Max Baucus (D-MT) calling for a hearing on the institutional bias in the Medicaid program. The Medicaid program requires that states provide nursing home care, although states can also provide many home and community-based services, including respite and family training and education, through home and community-based waivers. More information:
http://harkin.senate.gov/news.cfm?id=217238
RESEARCH & REPORTS
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8. NCSL report on tobacco settlement and HCBS
The National Conference of State Legislatures (NCSL) has released "State Management and Allocation of Tobacco Settlement Revenue 2003." The report analyzes the various uses of these funds, and also highlights which states have allocated a portion of these funds for respite care in particular, and home and community-based services (HCBS) generally. Download:
http://www.ncsl.org/programs/press/2003MSA.pdf
9. NCSL report on health care priorities
The Health Policy Tracking Service at the National Conference of State Legislatures (NCSL) has made available "2004 State Health Care Priorities Survey Report." One key finding in the report is that family caregiving has been identified by 29 states as a priority in long-term care planning and legislation. Read:
http://www.hpts.org/HPTS97/home04.nsf
JOURNAL ARTICLES
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10. End-of-life caregiving
"End-of-life caregiving: what helps family caregivers cope?" is included in the December 2003 edition of the Journal of Palliative Medicine. Researchers found that "caregivers who accepted their loved one's illness, redefined illness-related problems in a more manageable way, and felt capable of solving illness-related problems had less caregiver strain than caregivers who used less of a reframing coping style." Journal information:
http://www.liebertpub.com/pagedisplay/Toc.asp?id=41
11. The Gerontologist article on caregiver interventions
The January 2004 edition of The Gerontologist includes "Effects of a Caregiver Intervention on Negative Caregiver Appraisals of Behavior Problems in Patients With Alzheimer's Disease: Results of a Randomized Trial." With a sample of 406 spousal caregivers of patients with Alzheimer's disease, researchers wanted to assess the impact of a multi-component counseling and support intervention. Results indicate that "although the intervention did not affect the frequency of patient behavioral problems, it did significantly reduce caregivers' reaction ratings. Because caregiver appraisals have been found to mediate the impact of caregiving stress on depression and to predict nursing home placement rates, they deserve greater attention as an important target of intervention services." Abstract:
http://gerontologist.gerontologyjournals.org/
12. "Does Caregiving Stress Affect Cognitive Function in Older Women?"
The January 2004 edition of the Journal of Nervous and Mental Disorders includes "Does Caregiving Stress Affect Cognitive Function in Older Women?" Because women frequently provide care to ill or disabled spouses, researchers were interested in examining the possible effects of caregiving stress on cognitive function. Researchers "found a moderately increased risk of poor performance on several cognitive tests among women who provided care to their disabled or ill husbands." View abstract:
http://www.jonmd.com/
13. Family caregivers and renal disease
The February 2004 edition of the Journal of Clinical Nursing includes "Chronic renal failure: assessing the Fatigue Severity Scale for use among caregivers." The authors find that "physicians, nurses and allied health professionals will be called on more frequently to assess and intervene with fatigued and overburdened caregivers in addition to patients themselves. A more thorough understanding of the nature of caregiver fatigue may drive changes or innovations with caregivers who are too often overlooked in the current era of scarce resources. Accordingly results of the study suggest that the direction in intervention may focus more on rest and respite as opposed to a need for psychosocial support or counseling." Abstract:
http://www.blackwell-synergy.com/links/doi/10.1046/
j.1365-2702.2003.00860.x/abs/
CONFERENCES
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14. Aging conference alert website
A website has been developed which offers a list of gerontology conferences worldwide. Included in the listing is the Aging and Public Health conference in Fresno, California (February 2004); the Southern Gerontological Society meeting in Atlanta (April 2004); and the National Respite Conference in Australia (May 2004). Access: http://www.conferencealerts.com/aging.htm
15. Carework conference call for presentations
The Carework Network, a national organization engaged in research and policy related to the work of caregiving, has issued a call for presentations for their August 2004 conference. The conference will bring together researchers, policymakers, and advocates involved in various aspects of paid and unpaid caregiving. Deadline for submission is March 1, 2004. Details: http://www.soc.iastate.edu/carework/
FUNDING, MEDIA & MISCELLANEOUS
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16. Family caregiving coalition to release "Principles for Change"
The National Center on Caregiving at Family Caregiver Alliance in collaboration with the National Alliance for Caregiving, the National Respite Coalition, the Families and Healthcare Project of the United Hospital Fund, Americans for Better Care of the Dying, and the National Family Caregivers Association have worked together to create a statement of principles on caregiving designed to serve as a foundation document for caregiving policy initiatives. The principles will be formally introduced at a Town Hall meeting in Washington, D.C. in February, 2004. Further information: http://www.caregiving.org/principles04.pdf
17. Assisted living guide
"Thinking of Moving to an Assisted Living Residence: A guidebook for finding choice and independence" has been made available the Coalition of Institutionalized Aged and Disabled and the Nursing Home Community Coalition of New York State. The guide - aimed at persons needing long-term care and their family caregivers - is geared towards making informed decisions about assisted living options, and promoting older adults' rights to make decisions about their own lives as they choose an assisted living setting. Read: http://www.assisted-living411.org/
18. Online workshops on caregiving, eldercare
The Gerontology Center at Boston University has begun registration for Spring 2004 online workshops for continuing professional education in eldercare. Topics include: End of Life Issues; Middle Aging and Eldercare: Boom or Bust?; Psychology of Caregiving, including a "matrix" of Caregiving Model; and Living with Disabilities. Details: http://www.bu.edu/gerontology
19. Training CD-ROM and video on bathing and dementia
"Bathing Without a Battle" has been developed to teach person-centered techniques for bathing people with dementia. While geared towards formal care providers, the training may also be useful for families who are having difficulties when providing care for a loved one with dementia. Order the training: http://directcare.c.tep1.com/maabTj5aa3UE0a9ZvXKb/
20. Family caregiving at life's end - free training
The Hospice Institute of the Florida Suncoast will continue their series of free train-the-trainer workshops for caregiving at life's end. The 2004 training has been scheduled for March 1 - 5, 2004. Registration and more information: http://www.thehospice.org/caregiv/caregivingbrochure.pdf
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For questions or further information about Family Caregiver Alliance's National Center on Caregiving, contact us at [email protected].
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Caregiving PolicyDigest is a publication of the National Center on Caregiving, a program of Family Caregiver Alliance. The Digest is funded by the Archstone Foundation.
©2004 Family Caregiver Alliance
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