RWJF

Caring for the Caregiver
Many Americans with chronic conditions, including millions of frail elders, require some assistance with the activities of daily living, such as bathing and getting dressed. This help is often provided by paid paraprofessional caregivers, such as nursing assistants, home health aides and personal care attendants. However, research conducted in 2002 shows that most states (42) reported difficulties in recruiting and retaining people for these positions. These caregivers, while they assist with the most necessary tasks, are often underpaid, left out of care decisions involving the patient, and receive little to no training or support to do their jobs. As the shortages of paraprofessional caregivers worsen, and the American baby boomers age, the quality and availability of care for people with chronic conditions will be significantly affected.

To address this looming crisis, the Foundation, together with the Atlantic Philanthropies, launched a new program in 2002 called Better Jobs, Better Care. The $15.5-million effort will support improved recruitment and retention of direct care workers—nursing assistants, home health aides, and personal care attendants—who provide care and support to elderly people and those with chronic diseases or disabilities.

Planning for the Aging of America
Adults 80 and older make up the fastest growing demographic group in America today. As adults in America age, their needs for services—such as medical care and assistance with basic tasks such as grocery shopping—increase.

To better prepare communities to care for their aging populations, the Foundation’s $20-million initiative, Community Partnerships for Older Adults, awarded grants of $150,000 each to 13 community coalitions. The coalitions will develop plans to improve the range and coordination of services for older adults in their area, with the goal of allowing them to remain in their homes and communities whenever possible.

Although the elderly and disabled receive care through organizations and from family members, more and more communities have been tapping into volunteer faith networks for help. The Foundation’s Faith in Action^® program, which funded 164 new sites in 2002, remains at the forefront of this movement. The program gives organizations from a broad spectrum of religious affiliations grants to support volunteer programs for people with long-term health care needs or disabilities. These volunteers help with quality-of-life essentials—such as grocery shopping, paying the bills and companionship. Faith in Action supports programs in 42 states and the District of Columbia.

Many of the Foundation’s programs emphasize the values of patient choice and autonomy in determining the type of care patients receive. The Cash and Counseling program, which expanded beyond the demonstration model phase in 2002, allows Medicaid beneficiaries to receive direct cash allowances to pay for home care, rather than simply providing standard agency services. Beneficiaries therefore have greater flexibility and freedom to design their own care plans. Cash and Counseling operated as a three-state demonstration project in Arkansas, Florida and New Jersey since 1995. Many participants have used funds to pay caregivers who are family members, friends or neighbors and can help at times when they are most needed. Others have used their cash allowances to modify their homes and cars, or to pay for devices such as touch lamps that enable them to live more independently. The success of the Cash and Counseling program is becoming more widespread. In 2002, the Centers for Medicare and Medicaid Services announced Medicaid waivers allowing other states to replicate this individualized model of chronic care support.

The Foundation also embarked on a major research effort to better understand the needs of Americans, particularly African Americans, Hispanics and Asians, among others, in the areas of long-term care and caregiving. The first phase of the research took place in 2002. The next phase will involve a national survey of several ethnic groups. The results will be used to inform current and future RWJF programming.

Page 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | >>