ManagedCareSupplement3

A Primer on Managed Care: Multiple Chronic Conditions

Healthcare Providers Can Help to Connect Family Caregivers to Resources and Supports By Donna Benton and Kylie Meyer

Services cannot truly “wrap around” care recipients unless caregivers are brought into the loop.

W hen his wife, Helen, was diagnosed with Alzheimer’s disease a year ago, Gary prom- ised to “be her memory.” Their children, scattered across the country, suggested their parents should move to an assisted living community. But Gary told them, “We get by just fine!” That changed suddenly when Helen slipped in her sock-clad feet, fell, and broke her hip. When she returned home from the hospital, Gary became overwhelmed. Helen needed help showering, needed reminders to use her new walker, and assis- tance with changing her bandages. As there was no one else to look after Helen, Gary couldn’t get a break to play cards with his friends anymore. When his daughter called, Gary admitted, “I’m not sure I can take care of mom anymore at home. I’d ask your mom’s doctor for help, but what can she do? Anyway, the last time I spoke to her, she just told me I was a great husband. Now, my doctor told me my blood pressure is bad and I should exer-

cise more. How am I going to do that? (Note: This is a fictionalized case, meant to highlight issues frequently encountered by family caregivers.) The foundational role of family caregivers to the U.S. long-term supports and services (LTSS) system cannot be overstated. Caregivers like Gary annually contribute an estimated $470 bil- lion worth of support, and make it possible for people with an illness or disability to remain members of their communities (Reinhard et al., 2015). At any one time, 17.7 million Americans provide informal care to an older family member, including families of choice, or a friend (Schulz et al., 2016). The demands placed on caregivers today are unlike those experienced by previous cohorts of caregivers. Today’s caregivers attend to a pop- ulation of older adults who are reaching more advanced ages, but who are not necessarily in good health (Crimmins and Beltrán-Sánchez,

abstract Family caregivers today face new and challenging caregiving demands. Community-based resources can reduce risks to caregivers’ health and well-being, but are limited by low funding levels. Healthcare providers can step in to support caregivers by administering person- and family-centered care. This article encourages healthcare providers to engage family members during appointments where appropriate; respect that caregivers may not be willing or able to provide care; screen for caregiver needs, capacity, and willingness to provide care; and advocate for reimbursement codes for caregiver supports and services through Medicare and Medicaid. | key words : family caregiving, community-based organizations, care transitions

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