A no-brainer solution to help Maine’s older adults and their family caregivers

Lenard Kaye, University of Maine

Originally published in the Bangor Daily News on April 28, 2015

It was former first lady Rosalynn Carter who said there are only four kinds of people in this world — those who have been caregivers, those who are caregivers, those who will be caregivers and those who will need caregivers. Our spouses, partners, children and grandchildren are usually the first and last lines of defense during times of need. The vast majority of older Mainers turn to them before asking for help from health professionals and other service providers. And, relatives and friends have always responded. It’s natural, expected and virtuous.

The National Alliance for Caregiving estimates that more than 65 million people in the United States provide unpaid care to friends or family members who are chronically ill, frail or disabled. Some 15 million of these caregivers are providing vital assistance to love ones with Alzheimer’s disease and dementia-related disorders. Alzheimer’s caregivers alone provide 17 billion hours of unpaid care annually in this country. AARP estimates that nearly 200,000 family caregivers in Maine help their loved ones to live independently, avoiding costly nursing home and other kinds of institutional care. Maine’s population currently stands at 1.3 million, which means that 15 percent of residents — more than one in seven — are caring for loved ones. These family caregivers save the state of Maine more than $2.5 billion annually and reduce the burden that would otherwise have to be shouldered by our already stressed formal network of home, community and long-term care services. These caregivers are America’s unsung heroes, dedicating themselves sometimes for years at a time and at great personal cost in terms of their own physical, mental and financial well-being.

Any legislation that recognizes and supports the extraordinary efforts of Maine’s family caregivers deserves our enthusiastic support.

LD 666, The Caregiver Advise, Record, Enable Act, is one such bill. The CARE Act is intended to recognize and support family caregivers in their efforts to keep their elder relatives at home and out of costly institutions. It includes three extremely practical and helpful provisions that will make the work of caregivers easier and enable safer and more seamless transitions of older Mainers in and out of health and long-term care facilities. Three important provisions are featured in the bill: 1) recording the name of the family caregiver when the elder relative is admitted to a hospital or rehab facility; 2) notifying the family caregiver when the elder relative is going to be discharged to another facility or back home; and 3) having the facility explain and provide live instruction of the medical tasks that family caregivers will need to perform at home, including medication management, wound care, transfers and injections.

Almost half of all family caregivers need to perform medical and nursing tasks for relatives suffering from a wide variety of chronic illnesses including, most commonly, the management of medications and the administration of intravenous fluids and injections. Unfortunately, these well-meaning caregivers do not always receive adequate training to ensure these procedures are carried out safely. LD 666 would increase dramatically the preparedness of these individuals.

It stands to reason that better-prepared family caregivers will increase the likelihood that vulnerable older Mainers will be able to live for extended periods of time more safely and comfortably in their own homes and outside of long-term care institutions. Caregivers that are well informed will also be able to perform their jobs more effectively. This, in turn, should result in reduced levels of frustration, stress and strain that they experience.

Sounds like a win-win-win proposition to me, since family caregivers, their frail elders and the already overburdened and extremely costly long-term care service delivery system stand to gain. LD 666 is a no-brainer!

Lenard W. Kaye is a professor at the School of Social Work and director of the Center on Aging at the University of Maine. He is a member of the Maine chapter of the national Scholars Strategy Network, which brings together scholars across the country to address public challenges and their policy implications. Members’ columns appear in the BDN every other week.

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