Graphic courtesy of Administration for Community Living
In late September, the U.S. Department of Health and Human Services released its 2022 National Strategy to Support Family Caregivers. It’s the first time such a national strategy has been proposed. While it’s long overdue, addressing the needs of family caregivers in a coordinated national effort is a positive development.
“Supporting family caregivers is commonsense, since most people will at some point in their lives be a family caregiver, need a family caregiver, or both. Caregivers are sacrificing for their loved ones and often are standing in the health care gap by providing that care,” said Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure.
Your feedback is critical to the success of the strategy. The commenting period opened Oct. 1 and will be accepting comments for a 60-day period. The strategy will be updated every two years as required by law.
One aspect of the pandemic that could be seen as a benefit to family caregivers is the embrace and expansion of technology that assists with basic tasks in our daily lives. While some of us were already utilizing such services before the pandemic, many others learned the convenience of having groceries delivered to their home, for example.
A sandwich caregiver interviewed by MarketWatch recounted what a major benefit it was to have groceries delivered. She used to spend a good chunk of her day off taking her elder parents to the grocery store. When the pandemic struck, she shifted to grocery delivery and signed up her own family as well. Sometimes it is the simple things that can make all the difference. A caregiver reclaiming a few hours of her life each week can have a major impact on her wellbeing and those in her care.
Of course, there is always a price to pay for that convenience, and I never forget the fact that there is a human being who is picking out my groceries and delivering them, putting their own lives at risk to complete a chore for me. I always make sure to tip well.
Zoom and other video calling tools also exploded in popularity during the pandemic. While some are understandably suffering from Zoom fatigue at this point, for those families who were able to get their elder loved ones comfortable with the technology, video calls served as an important lifeline for those separated during the pandemic. Being able to check in on an elder loved one from afar with a simple video call helped put a family caregiver’s mind at ease. Of course it’s not the same as being able to hug and socialize in person, but for elders who otherwise may have been completely isolated, video calls kept the connection to family intact.
Remote tools, whether for working, socializing, or caregiving, are now receiving greater public interest, which is sparking investments from major technology companies like Amazon, who has developed a caregiving hub called Alexa Together. While there are security, privacy, and ethical concerns when it comes to monitoring technology, overall I think these tools can be helpful for the long-distance caregiver.
From my experience, I found tools such as a cellphone designed for older people, fall-sensing technology, and automated shipping of supplies to be of great help as a long-distance caregiver. As I wrote in my book, The Reluctant Caregiver, I was able to convince my mother, long skeptical of high-tech gadgets, to embrace these tools to help keep her living at home safely, versus having to enter assisted living.
As I grow older, I will be watching this growing field of technology with interest.
A “lost” film from the late, great horror film director George Romero was released this month and has people talking about its contributions to ageism and how society treats its elders.
Romero is perhaps best known for the zombie classic, “Night of the Living Dead.” In the early 1970s he was commissioned by the Lutheran Society to create a PSA of sorts that would deal with ageism and society’s poor treatment of older people. The organization was displeased with Romero’s surreal yet gritty take on the subject matter, so the film was shelved until recently, where it is now streaming on Shudder.
I found the film to offer a more accurate take on what it feels like to grow old in this country than one might think at first glance. The film follows the main character as he navigates his way through a bureaucratic nightmare of an amusement park, where elders find themselves charged exorbitant prices, banned from certain rides and harassed as nuisances. There is a speech by the main character at the beginning of the film that offers this ominous line: “Remember as you watch the film, one day you will be old.”
It’s sad to say that in the decades since this film was made, we haven’t progressed that far in the way we care for our elder population. The release of this film now as we grapple with the fallout from the pandemic only reinforces the importance of elder care and how it reflects upon a society.
Good tips! It’s so easy to overlook all of the alterations needed to keep an elder loved one, especially one with dementia, safe in the bathroom. My mother did not have dementia, but she fell and broke her shoulder while using the toilet in the middle of the night. She never fully recovered from that injury, and her mobility was limited because of it. Falls in the bathroom are all too common, so beware the risks and take action to keep your loved one safe.
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I’m always on the lookout for nontraditional elder care options. As we face a growing elder population, we are going to need some out of the box thinking and smart innovation to meet the high demand for elder care and elder-friendly housing.
A recent New York Times article highlighted one such option: continuing care at-home, an offshoot of the more well-known continuing care retirement communities. The NYT refers to the at-home option as a CCRC without walls. The goal is to keep people living comfortably and safely in their homes for as long as possible and for as long as the person desires, but with the option to move into assisted living if needed.
Instead of moving into an independent living apartment on a CCRC campus, people remain at home. Members are assigned a “care navigator” who monitors their health daily living needs. This hybrid aging at home with the option for supportive home care services and residential care could be attractive to baby boomers.
However, there are some downsides. The main one is cost. While the at-home version of the CCRC is cheaper than the traditional format, it’s still requires a hefty entrance fee (typically tens of thousands of dollars) plus monthly fees. In many cases, elders sell their home and move into more affordable housing in order to cover the costs. This is not a financial option for everyone.
There are also medical requirements to enter such programs, with a dementia or Parkinson’s diagnosis, among others being disqualifiers.
So it’s not for everyone, but it could be a good compromise for those who can afford it and want to remain in their homes as long as possible.
I was recently introduced to a resourceful website called StayorMove.org. The site focuses on what is are the most crucial questions as we grow older, such as do we stay put in our current homes or do we move on to a different location or live in an assisted living facility?
It’s questions we all should ask ourselves, but many people wait until a health issue makes the decision for them. That’s why I like the approach found on the StayorMove website, which is easy to navigate and uses a series of videos to address the pros and cons of a variety of housing options.
I also appreciated the fact that growing old in a rural environment was addressed. Those who follow this blog know this is an issue that’s important to me, because my parents’ health care was compromised by living in a small town with limited medical resources. They have a series of videos on the Village movement, which seeks to connect neighbors and volunteers to help elders age in place, while valuing the contributions of elders to the community. I’d love to see this concept expand.
The videos are brief but informative, and hopefully will encourage the “stay or move” conversation to continue. The more people are educated, the better decisions they can make about their own aging and housing choices.
While many people, including myself, would prefer to age in place, for financially strapped communities throughout America, the trend is straining limited resources.
An article about my mother’s home state of Tennessee and its struggle to care for a rapidly growing older population is a scenario taking place in many states. Many state, county and city budgets are already overwhelmed with issues ranging from high unemployment to the opioid epidemic. I read one article that said older people calling 911 due to falls at home was straining EMS budgets. While the federal government contributes money to elder care each year via the Older Americans Act, it’s simply not enough to address the needs of a growing elder population.
In Tennessee, thousands of older people are on waiting lists for government assistance programs. The organizations do the best they can, but those cited in the article said more resources are needed, and officials are going to have to address the issue soon.
Transportation was listed as a major issue. While some older people may be physically healthy and not need in-home assistance, they may no longer be able to drive and need transportation options to maintain their quality of life and independence. This of course was an issue for my parents. Thankfully, they did have a county-funded shuttle service that they used for years. (Most county officials were against the idea of the shuttle, however. Its funding is always on the verge of being cut.)
Meal delivery was another major need. The meal delivery service also serves as a status check on the older person, so it has a dual purpose. For those in rural areas, this can be a lifeline.
In Tennessee, supporting someone staying in their home costs $3,000-$15,000 annually, while putting a person in a facility costs over $50,000 annually. You don’t have to be a math whiz to see what is the financially efficient solution. Unfortunately, the federal government has not been proactive in addressing the issue. Tennessee reports some success at the state level, working with community organizations.
Has your community addressed aging in place issues? I’d love to hear about programs that are working in your area.
While the concept that “it takes a village” has become a platitude in popular culture, there are people out there actually putting the village concept to the test. I’m now following the village concept in earnest, and will be interested in seeing how it develops.
I first heard of the concept through Kay Bransford, who has the excellent Dealing with Dementia blog. She lives in McLean, Virginia, which is home to an active village community. The village is volunteer-based, and supports the needs of its inter-generational community members, with an emphasis on the aging population and the special needs of those with disabilities.
The idea of a grassroots movement that allows one to age-in-place without heavy government involvement is intriguing. The local, community-based approach makes the most sense to me, because neighborhoods have their own individual challenges and opportunities. We also shouldn’t hold our breath that the federal government is going to address the needs of our rapidly aging population anytime soon, no matter who’s in office.
The village movement began over 15 years ago, and the Village to Village Network was established in 2010. Over 200 villages now exist in 45 states. Members help each other by looking out for one another, making sure those who need help aging in place have access to affordable, dependable services for things like home repairs and running errands. Village communities work with existing government and community agencies to address any gaps in care and resources.
I think about how much a strong village model could have helped my parents as they dealt with medical issues and aging concerns.
Today, my mom and her roommate were complaining about some of the things that were not being done around the nursing home. The complaints didn’t involve serious infractions, but it did make me think about how little control you have once you have to check into a nursing home.
Both Mom and the roommate said their bedsheets hadn’t been changed in two weeks. With my mom’s colostomy accidents, I would think you would need to be changing the sheets much more frequently. They also did not receive a fresh set of towels for the past two days. Again, little things, but both of these women are with it enough to want to maintain good hygiene, so it’s a shame to see their efforts thwarted by a shortage of clean supplies.
In the dining hall, I saw a woman in a wheelchair struggle to pick up her napkin, which had fallen on the floor. She almost fell out of her wheelchair trying to get it! I was about to get up to help her but then I saw an aide come to her table. But she ignored the poor old woman, assisted someone else, and left. Her tablemate noticed her struggling and helped her get her napkin.
I don’t blame the staff members, they are so busy trying to hand out the correct meals, then feed the many who can’t feed themselves. A dropped napkin is obviously not a priority.
But it goes back to dignity. And though ideally the nursing home is about restoring your health, which can boost your self-esteem, it also can be a place that kills your spirit.
Luckily, I’ve been able to help Mom out with some of the stuff she has needed. But I think about my father at the nursing home, and those long hours and days alone, when his needs may have been ignored as well. Not intentionally, but just as a side effect of being short staffed and my dad being a very quiet guy with dementia.
So many of the elderly’s struggles go unseen and unheard within the walls of the nursing home. While of course it’s depressing, I’m glad I’ve had the opportunity to witness the good and the bad of elder care firsthand.
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