Gail Gibson Hunt is President and CEO of the National Alliance for Caregiving. Established in 1996, the National Alliance for Caregiving is a nonprofit coalition of national organizations focused on advancing family caregiving through research, innovation and advocacy. To learn more, please visit www.caregiving.org.
You’ve gathered your closest friends and family and the table is set for Thanksgiving. This is a moment of gratitude. Consider, in that moment, that someone around the table may one day be your family caregiver. Maybe you will care for them. (Maybe you already do.)
Each year, we give thanks for caregivers during November as part of National Family Caregivers Month. This month in particular we’ve been thinking about what happens when “Care Comes Home.” We talk about the benefits of home- and community-based care in reducing costs and meeting patient demands. But have we discussed the impact on family caregivers when health systems move to home-based care?
Many families rely on home-based care, including the short-term Medicare Home Health Benefit and long-term programs like the Veterans Administration’s Home-Based Primary Care. Others depend heavily on home health aides and telehealth to provide in-home care support. These are critical tools that help aging and medically complex patients live with dignity and independence in their homes.
But as demand continues to grow, policymakers should be aware of the need to better support caregivers who are the backbone of these models. Research has shown that a majority of caregivers help with at least one Activity of Daily Living (such as the daily bathing or dressing of a loved one). Many help with more. Caregivers have also reported that they conduct medical tasks within the home, which can be a source of tremendous anxiety. If the goals of healthcare reform include better managing care transitions, avoiding hospitalizations, and improving chronic care management, then it’s time to start talking about how family caregivers can be part of the answer.
There are several high-impact solutions for policy makers to consider:
- Include family caregivers as part of the healthcare team. This means implementing “patient-and-family centered care”, collecting caregiver-reported outcomes, and noting the family caregiver in the medical record (both electronic and paper).
- Assess the caregiver and provide training for caregivers during care transitions. Caregivers are often expected to provide support for health needs, personal and household care, and emotional support following the discharge of a loved one from the hospital. Clinicians should be cognizant of the role that caregivers are being asked to play and be sure to assess the willingness and ability of the caregiver to take on this role before discharge.
Develop better technologies to support patient health at home. Two key areas to think about:
medication management and care coordination. Family caregivers can be partners in this, but teaching them how
to use the tools and communicate with clinicians will be key to making telehealth programs more
Next year is the 2015 White House Conference on Aging and the 50th anniversaries of the Medicare and Medicaid programs. It’s a perfect time to start talking about whole-system health that addresses not just the needs of the patient, but those family and friends who support them. Let’s show our thanks by recognizing both the contributions that caregivers make to our society and how these contributions can enable better healthcare at lower costs.