Presentation Transcript

1. Noëlle Merrill, Eastern Area Agency on Aging Deborah Poulton, Eastern Area Agency on Aging Lenard Kaye, University of Maine Center on Aging Jennifer Crittenden, University of Maine Center on Aging

   Meeting the Challenges of the Rural Caregiver Through Collaboration and Innovation

2. Coös County  Grafton CountySullivan County  Monadnock RegionCaregiver Connections1.866.634.9412“Uniting Communities to Support Family Caregivers” Sarah Harpster Monadnock ServiceLink Aging and Disability Resource Center Kimberly Phillips UNH Center on Aging and Community Living
3. Background The Harry and Jeanette Weinberg Foundation have provided $8.1 million dollars to support family and informal caregiver projects countrywide. Three year grants, averaging $300,000 per year were awarded to 14 non-profits nationwide. Both the Eastern Area Agency on Aging (ME) and Monadnock Collaborative (NH) were funded beginning September, 2009 .
4. Site Visit
5. Serving Vacationland
6. The Service Area Large geographic area with no people 4,000 square miles with few roads Rural, isolated, high poverty rate and few services Average of 23 residents per square mile Islanders
7. Providing Caregiver Services in Maine is Challenging Oldest state based on median age Restrictive Nursing Home Eligibility Rural and economically disadvantaged regions as compared to other counties in Maine
8. Providing Caregiver Services in Maine is Challenging Lack of healthcare access High chronic disease burden Rapidly aging population Limited or no public transit “You can’t get there from here”
9. Realities of Caregiving 75% of all care received by older adults in the US is provided by family members and friends. Many do not consider themselves caregivers. Majority of caregivers are middle aged women. Unpaid caregivers will continue to be the largest source of long term care services in the United States. (Sources include National Alliance for Caregiving and AARP)
10. Caregiver Connections “Uniting Communities to Support Family Caregivers”
11. Caregiver Connections: Partnerships at Every Level Project Schematic Oversight: Steering Committee (leaders from each County); Monadnock Collaborative (fiscal agent); state level experts Management: ServiceLink Resource Center Managers, Evaluators (IOD), NH Bureau of Elderly and Adult Services (State Funder), Project Staff & Consultants Leadership Project Coordinator Monadnock SLRC (Monadnock Collaborative) Grafton Co. SLRC (Grafton Co. Senior Citizens Council, Inc.) Coos Co. SLRC (Tri-County CAP) Sullivan Co. SLRC (Monadnock Collaborative) Caregiver Specialist Caregiver Specialist Community Organizer Community Organizer Caregiver Specialist Caregiver Specialist Family Caregivers Implementation Community Networks Community Networks Community Networks Community Networks
12. “Uniting Communities to Support Family Caregivers” Direct Service Community Organizing Caregiver assessment, support Powerful Tools for Caregivers Flex Funds Network development Volunteer training Community-based supports Evaluation
13. A Most Difficult Privilege www.nhcaregiverconnections.org (Visit our website to see our 14-minute video)
14. Tackling the Rural Challengeby Collaborating Networking providers Training and Respite in Remote Regions High School and University student involvement Steering Committee made up of current and former caregivers and providers
15. The Steering Committee
16. Partners Area Agency on Aging Adult Day Programs Health/Palliative Care Providers University departments Community-based non-profits Volunteer Service Organizations Community Action Program Caregivers/community members Legislators Municipal and State entities High Schools
17. Partners
18. Unique Supports Mini Grants New partners New caregiver populations New service benefits All Inclusive Resource Exchanges Caregiver Trainings Basic Skills Dementia Specific (SAVVY)
19. Creating the most needed and sustainable services: Choice and opportunities through scholarship funds Incorporating the Senior Companion Program Reaching into high schools, universities and colleges Affordable case management
20. Creating Supports Increasing number of and access to caregiver training programs Affordable and sustainable adult day services Online health assessments for caregivers Resource center development Health center based discharge planning
21. Technology Media Outreach Webcasts Navigator Website Video Phones Internet Access Online Caregiver Self Assessment Online Caregiver Curriculum
22. Maine-Identifying Needs and Resources Needs and resources assessment work by Center on Aging to inform service delivery Input from a diverse group of community members, caregivers, and professionals Asset mapping based on findings
23. Survey Participants 148 surveys returned and 46 focus group participants 64 towns represented Survey respondents: 41% retired 6% are disabled 53% currently working: Home health staff Social workers Business/sales Clergy
24. Focus Group Participants Focus Group participants: 75% female; 25% male 1% grade school; 25% high school/GED; 50% college; 24% graduate degree Employment background: Psychotherapist School Librarian Teacher Farmer Truck Driver Boat Captain Executive Director Homemaker Chef Physician
25. Maine-Identified Needs and Impact Defining Caregiving It’spaid/unpaid Complex relationships It’s a 24/7 job You wear multiple hats/fill multiple roles Financial burden/fear of losing life savings Grieving all the time Play multiple roles-be yourself, doctor, lawyer, caregiver, executive assistant, housekeeper, etc. You are a “draftee” into service-thrust into role suddenly
26. Findings Transportation Large distances to services Door-to-door transportation needed Transferring into a car challenging Transportation programs rely on volunteers Lack of formal resources Resources located far away Insufficient funding to develop programs/services
27. Findings Caregivers don’t often know they are caregivers Need to educate community about this issue in general It’s all “on-the-job training” Need training and support to help family caregivers with techniques for hands-on care Education on specific medical disorders
28. Strengths & Facilitating Factors Resiliency and strengths of caregivers Crafting personal solutions Developing personal stress relief techniques Community Neighbors helping neighbors Formal and informal resources available
29. Formal resources Aging network-AAA, Legal Services for the Elderly, etc. Alzheimer’s Association Adult day programs CAP agency Key professionals Healthcare sites Homecare agencies Hospice agencies
30. Informal Resources Churches NeighborCare/Neighbors helping one another Faith in Action Community support groups Individual community members Local schools (students)
31. Asset Maps
32. Community Organizing
33. Community Education
34. Networks Year 1 Asset mapping / focus groups Years 2 & 3 Reconvene / establish networks
35. Networks
36. Training
37. Supports
38. Evaluation
39. Training evaluation
40. Dispersion of 328 attendees across 4 counties
41. Critical Incident Timeline
42. Maine-Impacts: Caregiver Training How to manage feelings of guilt How to deal with changes in dynamics between caregiver and care recipients How to understand “goobledeegook” (insurance, forms, planning etc.) Showering/hygiene/hands-on care Benefits/programs Practical information about Alzheimer’s-not medical or technical When to consider a nursing home
43. Training Results: Skills Building 93% of caregivers reported using skills they learned at caregiver trainings one month after attending. Most common skills used after training include: Transfer techniques Assisting loved one with walking/mobility Communication skills Understanding behaviors and how to respond
44. Training Results: Use of Resources 73% of caregivers reported using new resources and services one month after training. Including: Hospice Area Agency on Aging Elder attorney Support groups Caregiver guides and other resource materials
45. Impacts: Provider Perspectives Created new services where gaps once existed Providers report increased collaboration with other agencies and leveraging of resources Agencies are implementing policies and practices that better support caregivers and increase capacity for service provision Source: Process evaluation findings Yrs. 1 & 2
46. Areas for Improvement/Challenges: Provider Perspectives Continual outreach is needed to ensure caregivers and professionals are aware of services available Need for regular networking opportunities for current and potential partners Service gaps around flexible respite and transportation Source: Process evaluation findings Yrs. 1 & 2
47. Successes - Maine Reaching more caregivers earlier in their journey Fine tuning the scope of caregiver needs Streamlining access to services with strong partnerships Improved provider communications
48. Successes - Maine New diverse connections established Strong advisory board New funding source – fee for service Improved the Family Caregiver Title III E Program More useful tools for caregivers Were able to leverage other grants
49. Challenges Finding common ground with partners Finding caregivers to help advise a project Collecting the right data from the start Interpreting success from the data Technology limitations in a rural state Finding the right venue to offering trainings to caregivers
50. Sustainability Ongoing endowment fund for scholarships Care navigator fee for service by adding medicaid and insurance billing Student rotations – use of social work students in many other projects Adult day services 7 days week and replication activities region wide Mini grant project data able to leverage other revenue to continue and expand efforts
51. Adult Day and Resource Center
52. Lessons Learned Island people want information but prefer to retain their autonomy High speed broadband necessary Professionals don’t think people should pay Caregivers have a hard time finding time Small fixes can make a big difference Medical vs social model adult day service
53. Community Organizing Lessons Learned Individuality of locales Volunteers & finding our niche Network development is hard work
54. Questions & Discussion Friday March 30, 2012, 8-9:30 Caring for Caregivers :Fostering Innovative Support Networks Marriott Wardman Park, Washington Room 5 Friday March 30, 2012, 10-11:00 A Study of Caregiver Outcomes in the NH Family Caregiver Support Program Marriott Wardman Park, Balcony A