Cathy Cress

Expert in Aging Life and Geriatric Care Management

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Is Biden’s Caregiver Bill Really Infrastructure?

May 11, 2021

House Republicans Denounce Biden Caregiver Infrastructure Plan -Say It Is Not Infrastructure.

House Democrats defended President Joe Biden’s inclusion in his “American Jobs Plan” of $400 billion in support for caregiving, after Republicans criticized the package as stretching the definition of infrastructure and called on the White House to scale it back.

WHY CALL It INFRASTRUCTURE

The word “infrastructure” means something solid, essential, distributed and in the public interest. But as we have all learned in the pandemic year, care infrastructure is just that: UNPAID OR LOWGunnDadJacket.jpg PAID Caregivers are “rocks” and the solid foundation upon which the economy works. Without it, our families, our paychecks, our labor force participation, our workplaces all decline and we all suffer and collectively fall behind.

Like sagging bridges , unpaid women caregivers hold up the care infractstruce. In 2017, AARP found that about 41 million family caregivers in America perform roughly $470 billion worth of unpaid labor a year. Since then, the number of caregivers has increased to 53 million, meaning that more than one out of five Americans are unpaid  caregivers, according to AARP’s latest report.

 

The Care Infrastructure Collapsing

From February 2020 to January 2021  more than 2.3 million left their jobs, and that puts women’s labor force participation rate at 57%, the lowest it’s been since 1988. This was due to a lack ofchannel_caregiver_burnout.jpg childcare and closing of schools due to COVID  when 39% of   women family caregivers leave their job to have more time to care for a loved one.

Caregiving  for an elder reduces paid work hours for middle aged women by about 41 percent. In total, the cost impact of caregiving on the individual female caregiver in terms of lost wages and Social Security benefits equals $324,044. 34% leave because their work does not provide flexible hours. 

 

 

HOW MUCH WOULD IT COST GOVERNMENT IF FREE CAREGIVERS QUIT

Let’s put that free caregiving  into context.At $470 billion in 2013, the value of unpaid caregiving exceeded the value of paid home care and total Medicaid spending in the same year, and nearly matched the value of the sales of the world’s largest company, Wall-Mart ($477 billion). [AARP Public Policy Institute. (2015). Valuing the Invaluable: 2015 Update.]

So in 2013 the US Government would have to come up with $477 billion to replace free caregiving.

Let’s put that  free caregiving  into 2017 context.  AARP notes unpaid caregivers’ economic impact was more than  all out-of-pocket spending on U.S. health care in 2017($470 billion)and the total combined value added to the U.S. economy by the agriculture/forestry and mining sectors ($438 billion) that year.

So caregiving was not free, the US would have to come up with $477 billion in 2017 to replace it.

 

WHAT IF UNPAID CAREGIVERS  Totally COLLAPSED

If all these unpaid family caregivers stopped caring the national caregiving system would collapse, like dangerous American bridges .Then the US government would have to come up with $470 Billion to replace free caregivers or put all  elderly in nursing homes , which are havens for disease spread , which we know from the pandemic making them a holocaust of death. Congregate nursing homes and have become a broken national system since COVID.

So Biden has brilliantly found a way to avoid the $470,00 billion bill and instead create jobs that will keep elders at home cared for  through home health care paid through Medicare.

What Will Biden’s Investment  Create- in Jobs and the Economy

Sixty-five percent of the jobs — approximately 1.5 million jobs —resulting from Biden’s investment would be in child care, residential care, and home health care. An additional 225,000 jobs can be created or supported in sectors that support care work, and over 500,000 jobs would be supported in other sectors as direct care workers spend their wages on goods and services. 

Biden’s Plan of investing $77.5 billion per year would support over two million new jobs, at an average cost of $34,496 per supported job. Over 10 years, this translates to 22.5 million new jobs. Annually, a $77.5 billion investment in new jobs translates into $220 billion in new economic activity. 

So find your local representative and tell them to support Biden’s bill if you care about aging or caregivers or women or  shoring up the frayed- fraught care infrastructure.I have done a series of blogs on the bill . Check them out now 

Filed Under: Aging, Aging Life Care, aging life care manager, Biden's Caregiver Infastucure Paln, Blog, care economy, caregiver, caregiver infrastructure, Caregiver Infrastructure bill, Caregiver living wage, Caregiver low salary, caregiver mental health, CAREGIVER RESOUCES, Caregivers collapsing, Covid 19, Covid 19 Webinar, COVID Webinar, Families, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, nurse advocate, nurse care manager, Unpaid caregivers, unpaid family caregivers Tagged With: aging family, aging life care manager, aging parent care, aging parent crisis, Biden's infrastructure- Caregiver Bill, Care Economy, Care infrastructure, care manager, caregiver burden, caregiver burnout, caregiver low wage salary, caregiver stress, case manager, creating caregiver jobs, geriatric care manager, infrastructure Medicare jobs, Medicare non coverage LTC, nurse advocate, nurse care manager, Unpaid caregivers, unpaid family caregivers

Caregiver Assessment- What Does It Takes Professionally ?

March 30, 2021

Doing TWO Assessments

To meet the needs of the whole aging family, the care receiver, and the caregivers, GCMs need to begin assessing the caregiver as well as the care receiver. There is a synergy between the caregiver and client – they are interdependent. If the caregiver is stressed or weak the client does not receive good care. They both suffer without supports that a care manager can give them.

A caregiver assessment helps the GCM see this faltering interdependence by using a caregiver assessment. The National Center on Caregiving at the Family Caregiver Alliance calls this a process gathering information describing the caregiving situation and identifying the family caregivers’ particular problems, needs, resources, and strengths. This means that the care manager can see issues from a caregiver’s perspective and can focus on what supports they need to give them the best care. The GCM compares this to the client’s assessment of needs. The result of doing two assessments is discovering both the client/ care receiver needs and restore health and well-being, prevent poor care, client injury or illness, caregiver burnout, trauma or quiting, and unnecessary placement in a nursing home.

Create a Circle of Care

One resource that a GCM can bring to a caregiving family is what Gail Sheehy calls a circle of care. To create this supportive connection, the GCM needs to take her or his coaching skills and put together a support system around the formerly isolated, solitary family caregiver. The GCM can coach the family caregiver to ask for help so the GCM can assist in reorganizing the family so adult siblings can share in the care of the older client with the identified family caregiver. The GCM is what Sheehy calls a compassionate coach who can help the beleaguered caregiver attract and assemble a platform to keep on giving the care she or he wants to give the aging person.

Caregiver Resources

A circle of care includes emotional resources for the direct family caregiver. These emotional resources could and should include adult siblings. Reconnecting midlife brothers and sisters, through the circle of care, is an important GCM task, as siblings are the longest and deepest relationships in any person’s life. The GCM may have to depend on his or her clinical skills in helping siblings with forgiveness or reconnecting siblings who live long distances apart to add them to a circle of care. Midlife siblings have often spent the last 30 years tending to their own families, so the point of reconnection of midlife brothers and sisters often happens when they are in middle age in the midst of a crisis in parent care. This is where the GCM needs to employ clinical skills in midlife sibling work or to find the resources for the family to help with this healing sibling reconnection.

Filed Under: Aging, Aging Family, aging family crisis, aging life business, Aging Life Care, Aging Life Care Assocaition, aging life care manager, care manager, caregiver, caregiver assessment, Caregiver Burn Out, CAREGIVER RESOUCES, case manager, CIRCLE OF CARE, estranged siblings, GCM COACHING SKILLS, Geriatric Care Management Business, Geriatric Care Manager, geriatric care manager, geriatric social worker, midlife siblings, nurse advocate, nurse care manager, Siblings Tagged With: caregiver assessment, CAREGIVER RESOURCES, caregiver strain, caregiver stress, Circle of Care, family caregivers, geriatric care manager

What are the 3 Steps to Do a Caregiver Assessment?

October 12, 2019

 

Where Do You Do A Caregiver Assessment? 

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Caregiver assessment is best done in the care receiver’s home so you can actually observe the care. It is best completed out of earshot of the older person who is cared for so the caregiver can feel free to talk openly. As caregivers suffer high levels of stress, giving them a separate space to share their feelings is an important part of the caregiver assessment. However, the caregiver assessment should be done in a place that is convenient to the caregiver, which could be a donut shop, the home, or any comfortable venue. If to do the caregiver assessment the GCM must arrange respite, like bringing in another family member or paid caregiver, then that is another way to make this assessment go forward.

 

How Will A Genogram Help A Caregiver Assessment? ChiCheng_hmpgHdr.jpg

A genogram also helps the GCM assess whether any extended family and friends will make suitable and emotionally appropriate caregivers or not. For example, if a son has a historically strained relationship with his father, is he a good choice as a caregiver? The genogram helps to assess this old family tension and helps the GCM decide with the family as to who can really be good caregivers.

How Does a Psychosocial Assessment Bolster a Caregiver Assessment?

In addition, a psychosocial assessment, done at intake or updated as more care is needed, assesses key abilities and availability of the extended network of family caregivers. The psychosocial assessment illuminates the client’s financial status, including income, assets, benefits currently being received, health and long-term care insurance coverage, and eligibility or potential eligibility for entitlement programs. This information helps the GCM assess whether outside paid care providers can be afforded if needed to replace a family caregiver. The psychosocial assessment also tells about the family, formal and informal support networks, present and potential caregivers, and cultural variables.

Find out more in the YouTube from My Geriatric Care 1 Channel.

 

Filed Under: Adult children, Aging, Aging Family, aging family crisis, Aging Life Care, Aging Life Care Assocaition, aging life care manager, Blog, care manager, caregiver, caregiver assessment, Caregiver Burn Out, caregiver burnout, caregiver mental health, CAREGIVER RESOUCES, case manager, CIRCLE OF CARE, elder care manager, Geriatric Care Manager, geriatric care manager, geriatric social worker, nurse advocate, nurse care manager Tagged With: aging family, aging life care manager, care manager, caregiver assessment, caregiver burden, caregiver burnout, caregiver overload, caregiver overwhelm, caregiver stress, case manager, geriatric care manager, nurse advocate, nurse care manager

Caregiver Assessment- Can it Prevent Caregiver Burnout?

October 3, 2019

Caregiver Burnout is Big Federal Problem

Family caregivers are so many times in a complete state of caregiver burnout. From a policy perspective, the federal government and the long-term care system in the United State cannot afford to neglect the burnout and strain of millions of Americans caregivers any longer.

Despite the rewards caregivers get from giving care we know from years of research that being a family caregiver results in brutal losses. These degradations and deficits include role conflict and overload from the never-ending tasks demanded of a caregiver. Left in a permanent state of worry and anxiety much of the time, caregivers are working in a deteriorating and unpredictable situation.

Caregivers Feel Trappedchannel_caregiver_burnout.jpg

Caregivers can feel entrapped by there the restrictions on their own life. They are often beset by fiscal worries because they are not paid except in some states, like California under Medicaid. Yet the caregiving situation explodes in cost through medical bills, medical equipment and informal care that must be brought in, if the family can afford it.

Caregivers Are Not Attorneys

Family caregivers face a quagmire of legal problems including untangling wills, trusts, and inheritance issues which generally complicate care both emotionally and physically. Many times these family caregivers compound their fiscal woes by having to quit their job, running the risk of never being hired again, and that is if they can eventually return to work.

Caregivers Mental Health Ravaged

The caregivers own physical and mental health is often ravaged. They have to do medical tasks that years ago family caregivers never had to do. If they were paid by an agency, this would be a workman’s compensation nightmare for the company, yet these family caregivers are never even paid. So it is time that geriatric care managers and other professionals in aging started to respond to this family caregiver nightmare and use a caregiver assessment every time they assess an older client tended by a family caregiver.

Find out more in the YouTube below from My Geriatric Care 1 Channel.

 

 

Filed Under: Aging, Aging Family, aging family crisis, Aging Life Care, Aging Life Care Assocaition, aging life care manager, care manager, caregiver assessment, caregiver burnout, caregiver mental health, CAREGIVER RESOUCES, elder care manager, Geriatric Care Management Business, Geriatric Care Manager, geriatric social worker, nurse advocate, nurse care manager, Webinar Tagged With: aging parent care, aging parent crisis, assessing the caregiver, caregiver, caregiver assessment, caregiver burnout, caregiver overload, caregiver overwhelm, caregiver stress, caregiving family members, case manager, elder care crisis, Functional Assessment, geraitric assessment, Geriatric Assessment, geriatric care management, geriatric care manager, informal caregiver, Marriage and Family Therapist, My Geriatric Care Management Operations Manual, stress and burden

Caregiver Assessment- When The Caregiver Loses Sense of Self

September 22, 2019

One Homeostatic SystemChiCheng_hmpgHdr.jpg

When you assess an older client with a family caregiver, you really have two clients. The needs of the family caregiver are different than the needs of the care receiver and the geriatric care manager or aging professional must differentiate those needs to make sure the care receiver’s functional and psychosocial needs are met. The care receiver and the family caregiver are one homeostatic system encompassing the whole aging family. To keep that family healthy and whole, in the middle of swirling care crisis, the care manager must first recognize that there are multiple clients including the person who gives or supervises care. In a health care insult, family members who give care are often referred to by the inanimate wooden term “ resources”. They have also been referred to as “ informants “.

 

Stripping Caregivers Personhood

This stripping of personhood denudes them of their status as individuals and melts them into the caregivers, thus breeds professional ignorance, like the crowd who watched the emperor with no clothes. We are blind to caregiver’s humanity and thus their own needs.

Seld-Esteem Vanishes With Caregiving

Many family caregivers lose their self-esteem because they fail at so many other parts of their lives when their whole life seems to be taken up by caregiving. They do not get vacations as the care-receiver does not take a break from illness and aging. Often there are few others to give them respite. Caregivers, often they just do not know where to find help or even ask for it. If family caregivers have children and husbands, they are often squeezed between their needs, the needs of the care receiver – thus have no room for their own needs. They are breathless and slogging forward.

Find out more in the YouTube from My Geriatric Care 1 Channel.

Filed Under: Aging, caregiver, caregiver assessment, Caregiver Burn Out, caregiver burnout, caregiver mental health, CAREGIVER RESOUCES, case manager, elder care manager, geriatric care manager, geriatric social worker, nurse advocate, nurse care manager Tagged With: aging parent, aging parent care, assessing the caregiver, caregiver assessment, caregiver burden, caregiver burnout, caregiver overload, caregiver overwhelm, caregiver stress, geraitric care manager, Geriatric Assessment, Geriatric care management operations manual, geriatric care manager, informal caregiver, long distance care provider, National Assocaition of Geraitric Care Managers

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