The LTSS Center recommends that you put these 5 articles on your reading list for July.
THE STRANGE POLITICAL SILENCE ON ELDER CARE
An article in the July/August issue of Washington Monthly asks questions about why policy makers have ignored the looming elder care crisis for decades, despite the fact that 34 million Americans, most of whom are middle-aged women, provide unpaid care to an older adult.
“You might expect that a problem that affects so many people so profoundly would become a major political issue,” writes author Grace Gedye. “Yet even though American women today are politically organized and running for office in record numbers, elder care remains widely viewed as a purely personal matter. You could be a news junkie, following the 2020 race closely, and have heard nothing about it.”
Congress, think tanks, and commissions explored the long-term care crisis throughout the 1970, 1980s, and 1990s, Gedye acknowledges. But the issue remains unaddressed for a variety of reasons. Gedye explores these reasons, and then examines how, in May 2019, Washington state was able to pass the country’s most sweeping long-term care bill.
Universal long-term care insurance will be expensive, acknowledges Gedye. But that shouldn’t stop us from trying to implement it.
“One way or another, society is already bearing these costs—mostly in the form of care provided by stressed-out, uncompensated women who have the misfortune of having a family member who needs care and can’t afford to pay for it,” she writes. “What we need is a way to distribute that burden more equitably.”
AGING TOGETHER: ADULT CHILDREN AND THEIR PARENTS
Because of longer life spans, many adult children and their parents are now “aging together,” according to Kathrin Boerner, an associate professor of gerontology at the University of Massachusetts Boston and a fellow at the LeadingAge LTSS Center @UMass Boston.
“People in their late 60s and early 70s thought this would be a time of life when some of their responsibilities would drop off,” Boerner told The New York Times in late June. “Even though it may be a gift to still have your parents, it can be really rough.”
Boerner is studying the relationships of 120 parents who are 90 and older and have children who are 65 and older. She found that many older caregivers suffer from their own failing health, which can worsen with the stresses of caregiving. In addition, the financial picture of these caregivers can become “dire” when parents outlive their resources, says Boerner.
HOW TO SUPPORT UNPAID CAREGIVERS IN YOUR WORKFORCE
A new study from researchers at Baylor University, Louisiana State University, and the University of Iowa sheds light on the supports that employees may need to fulfill elder caregiving responsibilities in their personal lives.
The researchers analyzed data from 642 workers at a large public university who were informal caregivers for an older adult. They report in the Journal of Aging and Health that workers with unmet needs for caregiving support were more likely than other employees to adjust work hours, move from a full-time to a part-time position, take a leave of absence, or retire early.
Matthew Andersson, chief author of the study, suggests some ways employers can support their employees in a July 1 article in McKnight’s Senior Living.
HEALTH-RELATED TASKS PERFORMED BY PAID CAREGIVERS
A study published in the June issue of Health Affairs provides evidence that paid caregivers perform a wide range of health-related tasks that are often not part of their formal training. Robyn Stone, co-director of the LTSS Center, co-authored the article.
“Even when state-level requirements are present, training often covers basic skills rather than health-related tasks,” write the authors. “Furthermore, guidance from home care agencies about allowed or expected tasks might not match the lived experience of paid caregivers, who are on their own when they confront complex patient needs in the home.”
Paid caregivers interviewed by researchers reported performing a variety of health-related tasks, only half of which are included in the basic training for Medicaid-funded paid caregivers in New York.
“The large and growing workforce of paid caregivers spends hours each day with patients with functional impairment and witnesses their chronic health needs, changes in health status, and psychosocial stressors,” write the authors. “As a result, paid caregivers have the potential to serve as valuable members of patients’ multidisciplinary health care teams and influence health outcomes.”
In order to reach this potential, the authors conclude, training for paid caregivers “should embrace the breadth of tasks that affect patient health and ensure that paid caregivers have the skills to perform them.”
BUILDING CONSUMER ENGAGEMENT IN HEALTH CARE
Dr. Ann Hwang, director of the Center for Consumer Engagement in Health Innovation at Community Catalyst, used a July 2 blog in Health Affairs to describe a transformational model of consumer engagement that “strategically and deliberately builds the power of consumers.”
The Consumer Voices for Innovations program invested almost $1 million over 2 years to help 6 state and local advocacy organizations “engage, organize, and build the leadership skills” of consumers. Policy and programmatic changes reflecting consumer input occurred in each state.
The second phase of the initiative, called Consumer Voices for Innovation 2.0, aims to apply the model of transformational engagement to expand connections between health programs and social services.