ManagedCareSupplement3

GENERATIONS – Journal of the American Society on Aging

and resources to help professionals support fam- ily caregivers (see tinyurl.com/yayrsrhd).

‘Healthcare providers should engage family caregivers in health settings.’ aware that some family members do not want to provide care, and should not assume the extent to which families can and are willing to provide assistance (Gershon and Carlson, 2018). Conclusion Family caregivers are faced with new and changing demands, and often experience declines to their health and well-being while performing the caregiver role. Caregivers may be the foundation to the provision of long-term ser- vices and supports, but healthcare providers can lighten caregivers’ loads through a commitment to person- and family-centered care. Donna Benton, Ph.D., is research associate professor of Gerontology at the University of Southern California (USC) Leonard Davis School of Gerontology in Los Angeles. She can be contacted at benton@usc.edu . Kylie Meyer, Ph.D., is a post-doctoral researcher at the University of Texas Health Science Center at San Anto­ nio. She can be contacted at kylienmeyer1@gmail.com. to do this is by asking a patient’s permission for his or her trusted family member to be present during cognitive assessments. When this is done, it is important to ensure the relative is there to observe and not to answer questions for the person. What can emerge from this engagement is a health provider’s new understanding, as communicated by a family member, of the per- son’s strengths and challenges. For some family members, such engagement during an assess- ment may be the first time they fully realize their loved one has a cognitive impairment. Some healthcare providers make themselves available to caregivers when the care recipient is not present. This can provide an opportunity for caregivers to openly share concerns about the care recipient and their own ability to pro- vide care. At the same time, providers should be

Advocate for Medicare and Medicaid reimbursement for caregiver services Also recommended is that providers advocate for Medicare and Medicaid reimbursement for caregiver interventions and supports. Despite demonstrated benefits to care recipients, until recently, neither federal program extended reim- bursement for caregiver support services. An exception to this is the recent addition of Medi- care reimbursement code 99483. This billing code enables some health service providers to be reimbursed for identifying caregivers; assessing caregiver resources, support needs, and willing- ness to provide care; and medication reconcilia- tion (Alzheimer’s Association, 2018). While the addition of this code is ground- breaking, its application remains limited. The code applies to caregivers to people with Alzheimer’s disease and related dementias—a caregiver cohort representing only about a third of caregivers to individuals older than age 50 (NAC and AARP, 2015). It also does not provide reimbursement for high-intensity, multi-session caregiver interventions for family caregivers with high needs. As telehealth options become more inte- grated into the healthcare system, healthcare providers should be aware of the potential of these tools to support family caregivers, and also encourage reimbursement for digital services. In 2016, the Family Caregiver Alliance (FCA) launched FCA CareJourney, a Web-based and assessment-driven online support tool for family caregivers (see www.caregiver.org). In addition to providing tailored resources for caregiv- ers, the program serves as an “electronic health record” for caregivers’ well-being and needs. Involve relatives in appointments, with permission and where appropriate Finally, healthcare providers should engage fam- ily caregivers within health settings. One way

46 | Spring 2019

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