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New Medicare Proposal Would Cover Training

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New Medicare Proposal Would Cover Training

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For the first time in U.S. history, centers for Medicare are authorizing payments to healthcare professionals to train informal caregivers. This has been an issue in the past that has been overlooked. With failure to support family, friends and neighbors who care for ill older adults, yet they have no experience in providing care. This new Medicare proposal will hopefully help informal caregivers who manage medications and give assistance to loved ones with activities of daily living(ADL's).

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Even with extensive caregiving experience, Patti LaFleur was unprepared for the crisis that hit in April 2021, when her mother, Linda LaTurner, fell out of a chair and broke her hip.

LaTurner, 71, had been diagnosed with early-onset dementia seven years before. For two years, she'd been living with LaFleur, who managed insulin injections for her mother's Type 1 diabetes, helped her shower and dress, dealt with her incontinence and made sure she was eating well.

In the hospital after her mother's hip replacement, LaFleur was told her mother would never walk again. When LaTurner came home, two emergency medical technicians brought her on a stretcher into the living room, put her on the bed LaFleur had set up and wished LaFleur well.

That was the extent of help LaFleur received upon her mother's discharge.

She didn't know how to change her mother's diapers or dress her since at that point LaTurner could barely move. She didn't know how to turn her mother, who was spending all day in bed, to avoid bedsores. Even after an occupational therapist visited several days later, LaFleur continued to face caretaking tasks she wasn't sure how to handle.

"It's already extremely challenging to be a caregiver for someone living with dementia. The lack of training in how to care for my mother just made an impossible job even more impossible," said LaFleur, who lives in Auburn, Washington, a Seattle suburb. Her mother passed away in March 2022.

A new proposal from the Centers for Medicare & Medicaid Services addresses this often-lamented failure to support family, friends and neighbors who care for frail, ill and disabled older adults. For the first time, it would authorize Medicare payments to health care professionals to train informal caregivers who manage medications, assist loved ones with activities such as toileting and dressing, and oversee the use of medical equipment.

The proposal, which covers both individual and group training, is a long-overdue recognition of the role informal caregivers - also known as family caregivers - play in protecting the health and well-being of older adults. About 42 million Americans provided unpaid care to people 50 and older in 2020, according to a much-cited report.

"We know from our research that nearly 6 in 10 family caregivers assist with medical and nursing tasks such as injections, tube feedings and changing catheters," said Jason Resendez, president and CEO of the National Alliance for Caregiving. But fewer than 30% of caregivers have conversations with health professionals about how to help loved ones, he said.

Even fewer caregivers for older adults - only 7% - report receiving training related to tasks they perform, according to a 2019 report in JAMA Internal Medicine.

Nancy LeaMond, chief advocacy and engagement officer for AARP, experienced this gap firsthand when she spent six years at home caring for her husband, who had amyotrophic lateral sclerosis, a neurological condition also known as Lou Gehrig's disease. Although she hired health aides, they weren't certified to operate the feeding tube her husband needed at the end of his life and couldn't show LeaMond how to use it. Instead, she and her sons turned to the internet and trained themselves by watching videos.

"Until very recently, there's been very little attention to the role of family caregivers and the need to support caregivers so they can be an effective part of the health delivery system," she told me.

Several details of CMS' proposal have yet to be finalized. Notably, CMS has asked for public comments on who should be considered a family caregiver for the purposes of training and how often training should be delivered.

(If you'd like to let CMS know what you think about its caregiving training proposal, you can comment on the CMS site until 5 p.m. ET on Sept. 11. The expectation is that Medicare will start paying for caregiver training next year, and caregivers should start asking for it then.)

Advocates said they favor a broad definition of caregiver. Since often several people perform these tasks, training should be available to more than one person, Resendez suggested. And since people are sometimes reimbursed by family members for their assistance, being unpaid shouldn't be a requirement, suggested Anne Tumlinson, founder and chief executive officer of ATI Advisory, a consulting firm in aging and disability policy.

As for the frequency of training, a one-size-fits-all approach isn't appropriate given the varied needs of older adults and the varied skills of people who assist them, said Sharmila Sandhu, vice president of regulatory affairs at the American Occupational Therapy Association. Some caregivers may need a single session when a loved one is discharged from a hospital or a rehabilitation facility. Others may need ongoing training as conditions such as heart failure or dementia progress and new complications occur, said Kim Karr, who manages payment policy for AOTA.

When possible, training should be delivered in a person's home rather than at a health care institution, suggested Donna Benton, director of the University of Southern California 's Family Caregiver Support Center and the Los Angeles Caregiver Resource Center. All too often, recommendations that caregivers get from health professionals aren't easy to implement at home and need to be adjusted, she noted.

Nancy Gross, 72, of Mendham, New Jersey, experienced this when her husband, Jim Kotcho, 77, received a stem cell transplant for leukemia in May 2015. Once Kotcho came home, Gross was responsible for flushing the port that had been implanted in his chest, administering medications through that site and making sure all the equipment she was using was sterile.

Although a visiting nurse came out and offered education, it wasn't adequate for the challenges Gross confronted. "I'm not prone to crying, but when you think your loved one's life is in your hands and you don't know what to do, that's unbelievably stressful," she told me.

For her part, Cheryl Brown, 79, of San Bernardino, California - a caregiver for her husband, Hardy Brown Sr., 80, since he was diagnosed with ALS in 2002 - is skeptical about paying professionals for training. At the time of his diagnosis, doctors gave Hardy five years, at most, to live. But he didn't accept that prognosis and ended up defying expectations.

Today, Hardy's mind is fully intact, and he can move his hands and his arms but not the rest of his body. Looking after him is a full-time job for Cheryl, who is also chair of the executive committee of California's Commission on Aging and a former member of the California State Assembly. She said hiring paid help isn't an option, given the expense.

And that's what irritates Cheryl about Medicare's training proposal. "What I need is someone who can come into my home and help me," she told me. "I don't see how someone like me, who's been doing this a very long time, would benefit from this. We caregivers do all the work, and the professionals get the money? That makes no sense to me."
This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF. It has been published with permission.

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A New Medicare Proposal Would Cover Training for Family Caregivers

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The federal government is proposing having Medicare pay professionals to train family caregivers how to perform tasks like bathing and dressing their loved ones, and properly use medical equipment.

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When looking for support while being a caregiver can be quite hard. With the famous app TikTok, looking for support can be right at your fingertips. According to this article, over 4 billion people have used this app as a way to get information and insight about dementia. All you have to do is search #dementia and people with the same struggles or someone who is in the same boat as you can be found that easily.

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It all changed on a Saturday night in New York City in 2016. Jacquelyn Revere was 29 and headed out to attend a friend's comedy show. She was on the subway when her phone rang. It was a friend of her mom's, back in Los Angeles. That's weird, Revere thought. She never calls.

"And while I was on the subway, my mom's friend said, 'Something is wrong with your mom,'" Revere said. "'We don't know what's going on, but your mom got lost driving home. What should have been a 15-minute drive ended up taking two hours.'"

Revere flew to L.A. At her mom's home in Inglewood, she found foreclosure notices, untreated termite damage on the porch, and expired food in the kitchen. Her mother, Lynn Hindmon, was a devout evangelical who worked for her church. A slim, regal self-declared "health nut," Hindmon was now forgetting to pay bills and couldn't remember whom she was talking to on the phone.

Revere did not know it then, but that tough time would lead her to find - and help build - a community of caregivers who support one another on social media. TikTok has been an especially helpful platform. Content with the hashtag "dementia" has racked up more than 4 billion views on TikTok, as younger generations, already accustomed to sharing their lives online, now find themselves caring for aging loved ones - often with little preparation and no idea how to do it. Over the past few years, Revere's account, @MomofMyMom, has become wildly popular, with more than 650,000 followers. Ardent fans have told her they feel like they personally know her and her mom.

It would take nearly a year to get the diagnosis that confirmed what Revere already suspected: Her mother - still in her 50s - had Alzheimer's disease. Barely 10 years since Revere left home, she found herself moving back in to become a full-time caregiver for her mom and her grandmother, diagnosed with Alzheimer's years earlier.

"That first year and a half, I was just filled with fear: What if I lose the house?" Revere said.

Because of the stress, she said, "I went through bouts of migraines. My hair, right in the middle, fell out completely."

"I had to figure out how to get control of all the banking, figure out the passwords, make sure the bills are paid, make sure everything's taken care of."

Photos of Jacquelyn Revere as a child hang in the home of her mother, Lynn Hindmon. In one video on her TikTok channel, @MomofMyMom, Revere says seeing the pictures prompted Hindmon to call her "Mommy." (Lauren Justice for NPR)

In 2017, her grandmother died. Revere's grief and isolation felt overpowering. Her friends in their 20s either couldn't relate or thought she was "wallowing in pity," Revere said.

Trying to make them understand what her daily life was like now seemed impossible. "I just wanted to find people I didn't have to explain everything to," she said.

Revere tried a support group for caregivers, an hour's drive away. But the other attendees were decades older and had more financial resources. "[They] would say, 'And now I have to take equity out of our house,' or 'I'm thinking of reaching into our 401(k).' And then I would tell my story, and people would be looking at me like ... a charity case, or like my problem is unsolvable. ... I just felt worse."

These days Revere no longer feels so alone. She's a celebrity of sorts on TikTok, at least among the hundreds of thousands of people who post about the difficulties of caring for a loved one with dementia.
Daughters Are Often Dementia Caregivers
Alzheimer's is the most common form of dementia. Others include vascular, Lewy body, frontotemporal, and mixed dementia, says the Centers for Disease Control and Prevention. Nearly all forms worsen over time, and there is no cure, although there are some treatments.

The task of caring for people with dementia usually falls on family members. Every year, an estimated 16 million Americans provide more than 17 billion hours of unpaid care for relatives or friends suffering from Alzheimer's disease or other dementias, according to the CDC. About 60% of these caregivers are women.

"Unfortunately, there is not a very strong system of paid support for people with dementia," said Elena Portacolone, an associate professor who studies aging and cognitive impairment at UCSF's Institute for Health & Aging. "And so the most common way of supporting persons with dementia is the daughter."

Like Revere, many of the women who become caregivers end up quitting their jobs. They often find themselves financially vulnerable and "extremely isolated," said Portacolone.

Subscribe to KFF Health News' free Morning Briefing.

Another expert, Teepa Snow, said too many caregivers are struggling. Snow, an occupational therapist in North Carolina, runs a company that trains caregivers of people with dementia. Her own how-to videos about practical, compassionate caregiving rack up millions of views. "TikTok is where people are expressing an unmet need," she said.

Because there's no cure for dementia, the medical community often treats it the way previous generations of practitioners treated cancer - like "a big black box," Snow said. Decades ago, when people got cancer, "we didn't say anything; we didn't talk about it. We said, 'Oh, gosh, that's horrible.' And people were like, 'How long have they got?'"

What family members need from the medical system, Snow said, is more understanding of symptoms and how to handle them, more help setting up long-term support systems, and knowledge about how patients can be helped by changes to their dietary, sleep, and exercise habits.

All too often, however, caregivers are left to muddle through the complex tasks of keeping a patient safe. "That's pretty lonely," Snow said.

The covid pandemic disrupted or closed down much in-person support for caregivers, including the adult day care center Revere's mom had been attending five days a week. Desperate to find social connection, Revere did what so many others did as the pandemic stretched on: She got on TikTok. The short video format has attracted caregivers, who find they can document and share the vivid moments of their worlds at home in ways that would be less visceral on text- or photo-centric platforms.

You can watch a woman's "day in the life" video of caring for her husband with early-onset Alzheimer's or one of Revere's @MomofMyMom posts from 2020, which walks viewers through their bath routine.

"It's bath day," Revere says at the start of the post, while still lying in bed. "I try my best not to make this an emotionally draining experience," she sighs. "So let's begin."

Bathing someone with dementia can be difficult, even dangerous. They can get disoriented, or feel threatened when someone takes off their clothes or maneuvers them into a wet tub. They may slip and fall, or try to fight their caregiver. Revere has created a soothing, predictable routine for her mother. At the time of this video, Hindmon is 63, and it's about five years after her Alzheimer's diagnosis. She's not speaking much. Lynn Hindmon is tall, with great cheekbones. This day she's wearing neon-blue leggings and a purple beanie.

Revere starts off by promising her mom a present - which she'll get after the bath.

Revere walks her audience through the process, sharing what works for them. She turns on some soul music, plugs in the space heater, puts the dog outside, and lays out all her mom's clothes. "Lure her into my cave," she says, as her mom enters the bathroom.

The video then cuts to after the bath is over: Mother and daughter are celebrating with a bathroom dance party.

The video got more than 20,000 views. Hundreds of people left comments, saying how they can relate. One comment read: "My mother-in-law passed a year ago this week. This was the most frustrating part of caring for her. Devoted a whole day to getting this done." Another commenter told Revere, "God Bless you! I know it's hard. I see you and send so much love your way."

Revere posted a follow-up right away:

"How many of us are on here?" she said into the camera. "I've been, like, looking for people my age that I can relate to, who have the same experience."

Revere's following soared from just a couple of thousand followers to more than 650,000. Many people used the comments to talk about their own caregiving struggles. They wanted to see the little victories, like Revere's gentle, joyful tricks for getting through bath time. They also listen to Revere's candid confessions.

"Y'all, I have never been so emotionally drained in my life," she shared in one video. "Caregiving eats your soul. It kills your spirit. It's constant mourning for years. ... And it's beautiful."

Revere's mother died in March, after six years of living with Alzheimer's. Revere received an outpouring of support from viewers of her videos on TikTok. Since then, she's been figuring out what her life will be after years of caregiving. Now she has time to devote to herself and her dog, Dewey.(Lauren Justice for NPR)

Content Creators Weigh Ethics of Going Public
The intimate, unvarnished depictions of dementia on TikTok have raised ethical issues surrounding privacy, dignity, and consent. There are videos on the internet of adults who haven't consented to their most vulnerable moments being shared with millions of strangers.

In one TikTok, a woman chronicles her grandmother's aggression, filming as the elderly woman chases her through the house, fists swinging wildly. Other content creators film the verbal abuse that caregivers can experience.

Beth Kallmyer, vice president for care and support for the Alzheimer's Association, doesn't think the people posting these videos intend to be exploitative. "You could tell that the caregivers just felt isolated and frustrated and at their wits' end, with no resources," she said.

"If I were talking to a family member ... considering doing this," Kallmyer said, "those are the questions I would pose to them: Would they [the person with dementia] be comfortable with this? Is there a way for you to film something that gets the idea across but maintains their dignity?

"Should we have a video of somebody that isn't fully clothed? Or maybe [before Alzheimer's] they only went outside when they were dressed to the nines or really put together, and you've got them in pajamas or sweatpants or whatever, and they don't have makeup on. I'm not sure that's the best way to go about using TikTok."

Revere has a video that, in retrospect, she now feels ambivalent about posting. It's the most-watched video on her channel, with 27 million views. In it, her mother is walking around the living room with an open bottle of mouthwash. She somehow got past the locks on the bathroom cabinets.

Lynn Hindmon thinks the mouthwash is a drink, like juice or milk. She looks frustrated and dazed as Revere tries to explain why she can't drink mouthwash.

With some negotiation, Revere gets her mom to hand it over in exchange for an ice pop.

Some comments on that post call her mom an alcoholic, or say she looked scary. The experience made Revere feel protective - like she needed to be more careful, as she didn't want to post anything that might put her mom in a bad light. Still, after much consideration, she decided to keep the mouthwash video up. She said it's a good example of "redirecting" away from a risk - something other caregivers would understand.

On March 9, Jacquelyn Revere posted another video on TikTok, letting her followers know her mother had died. She was 65.

On TikTok, the messages of surprise and condolence poured in.

Revere, an only child, had always assumed that when her mom died she'd mourn her alone. Instead, people were checking in on her, sending her gifts, sharing memories of their favorite videos of Hindmon.

"It's been the least lonely I've ever been throughout this experience, actually," she said.

Revere has continued to post on @MomofMyMom, talking about what it feels like to miss her mom, and to mourn the life she didn't live while she was caring for her.

Now she has time to go on dates, get a pedicure, or drive by the ocean.

After six years of caring for her mom, starting when she was just 29, Revere is now trying to figure out who she is now - and what she wants. She knows she wants to stay connected with dementia caregivers.

"I just want them to know that they're being thought about," Revere says. "Because that's what I needed most. Just to know that life isn't passing me by, and I'm not seen.

"I just want to make sure that they feel seen."
This story is part of a partnership that includes Michigan Radio, NPR, and KHN.

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Family Caregivers Find Support on #dementia TikTok - KFF Health News

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The TikTok hashtag "dementia" has billions of views. Caregivers of people with Alzheimer's and other dementias have been using the site to swap tips and share the burdens of life with dementia.

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CNA's are hired and trained to preform ADL tasks such as feeding, cleaning, bathing, etc.. They also help perform limited medical tasks that the caregiver is unable to do. To become a CNA you must complete at least 75 hours worth of training and at least 16 hours of clinical training.

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My name is LaShayah (call me Shay), and I have been a Certified Nursing Assistant (CNA) for six years. I honestly love what I do! Although some people may look at me as the poop cleaner or waitress, I see myself as an important part of the health care team. With pride I assist the nurse with wound care, collecting blood, and performing EKGs among other tasks. With pride, I lend an ear for concerns, fears, and uncertainties to my patients. With pride, I help with urinals, bedpans, baths, and changing linen. These are important things to be done and if I am on your team, believe that it will be done well and with a smile. Most people do not look at those "little things" as being significant, but imagine having to do my tasks on top of educating, medicating, and nursing your patient back to health.

I often see or hear nurses say they are "glad they are not the CNA" because we have to clean poop. Yet, there are so many other things that we do! So many times patients have expressed their dislike for the nurse or the care they are receiving to me. I then need to inform the nurse so hopefully the matter can be cleared up. Many times I have encouraged a patient to take medication, because they gave the nurse a hard time. (Just to be clear, I have never administered medication.) I always encourage my patients to ask questions because they do not understand certain things and are afraid to bother the nurse or doctor. While wound care is being done, I remind the patient to hang in there and remain strong. Do you know how good it feels to have someone say they are glad you worked the shift with them because they do not know what they would have done without you? The nurse cannot do everything, and I just love being the support that they desperately need some nights. Key word: support; not servant or personal runner.

These days, I work on a heart failure and thoracic unit at a hospital. This was one of the best decisions I could have ever made. Cardiology is one of my passions. It can definitely be hard seeing people so sick, but learning how to interpret EKGs, and seeing positive changes in patients after they come back from procedures such as cardiac catheterizations and pacemaker placements is amazing. I work the night shift, which in itself can be hard, but I really love it. When I come on shift at 19:00, I receive report and begin rounds. Vital signs are done every four hours on this unit at 20:00, 00:00, and 04:00. Every morning, heart failure patients are weighed and EKGs are done for those who had procedures done the day before. I often care for patients with LVADs (left ventricular assist devices) and chest tubes. With LVAD patients, blood pressures are not obtained with the automatic cuff of a blood pressure machine. A MAP must be obtained with a sphygmomanometer and Doppler. This is a skill that I am proud to have. Around 21:00, I check blood sugars. By 23:00, I prepare to recheck vital signs and say goodnight to my patients. Throughout the night, I answer call bells, pick up blood for transfusions, assist with turning patients to offload pressure, and encourage my team that we can make it through to 07:00. From 04:00 to end of shift, I am checking vital signs again, giving baths, performing EKGs, and checking weights.

Being the support that the nurses (and sometimes doctors) need is rewarding to me because some nights can be truly hard. Although not very often, we have rapid responses and code calls. Patients have incontinence accidents because they are not used to taking diuretics. Sometimes patients go into funky dysrhythmias in the middle of the night and need one or two EKGs per the nurse's or doctor's instruction. Often, a nurse is in one patient's room for literally the whole night because he or she is in really bad shape. I enjoy being there for my nurses providing them with encouragement and support.

Currently, I am finishing prerequisites for nursing. I can now apply for a program next fall. I am so excited and look forward to learning the skills that RNs possess. I am grateful for the great nurses that have answered my questions, and encouraged me to continue into nursing. I am also grateful for the good and bad examples of nursing that I have seen because although everyone has a unique style of care, they have shown me what to do and what not to do. I am grateful to be a CNA because I see things from this point of view, and this experience will keep me humble when I become a registered nurse.

On a final note, please appreciate your CNAs! Do not over delegate and remember that it is okay to help us out sometimes, too! We are supposed to be a team and when everyone is on the same page for the patient, the shift moves along smoothly. Some of us may be rough around the edges, but remember that we have quite a bit to complete throughout our shift. Oftentimes, the CNA-to-patient ratio is greater than that of the nurse-to-patient ratio and each patient has different needs. The different color of our scrubs should not change the fact that the patient is the number one person in the room. Not the nurse or CNA. Do not look down upon CNAs because at any given moment, it could be you that has to help a patient get cleaned up if the CNA is tied up in another room or not there at all. No matter what your view is of the CNA, we are an important asset to the health care team and the patient. After all, who else is going to lift a butt cheek up for you to place a dressing?

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My name is LaShayah (call me Shay), and I have been a Certified Nursing Assistant (CNA) for six years. I honestly love what I do! Although some people may look at me as the poop cleaner or waitress, I see myself as an important part of the health care team.

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In-home health aide providing care for older adult(Getty Images). 

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Hiring aide is a great solution if you are not fully able to care for your loved ones. Reasons for hiring a health aide could potentially be because of job or family needs, traveling distance and/or caregiver burnout. Hiring aide does not set a bad rep towards yourself, it simply means you are struggling somehow and need help making sure your loved one is getting all the care they insist. Home health Aide duties are very similar to CNA's, yet they cannot provide any medical assistance.

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Paid Caregivers come from various backgrounds, and they can be anyone who chooses to pursue a career in caregiving. They may include certified nursing assistant(CNA), home health aides, personal care aides, and licensed practical nurses(LPNs).

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As a caregiver, providing the best care for your loved one is crucial. Training programs are both beneficial to the caregiver and their loved ones. While caregiving mostly requires basic skills, you might need certain skills to handle medication schedules or become a medical professional. Training programs can also provide you with cooking and housekeeping skills and you can get trained on how to be a physical therapist. Above is a link to get certified for home care!

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Get Certified Today for Texas

Caregiver training in the senior care industry for professional caregiver employment meets the state of Texas health department guidelines. Training requirements for senior home care agencies and assisted living and residential assisted living communities protect both seniors and caregivers. Training can be completed in English, Spanish, Tagalog, or Hindi.

Get Certified Train Your Staff

Texas Caregiver Training Requirements

Course includes Training Videos, Glossary of Terms, Care Plan Notes and Exam
* hours may vary by state

Stay Certified With Our Yearly Training

Committed to you, helping you to get certified and stay that way with our annual training

Texas 8-Hour Caregiver Training Course

The course includes training videos along with a glossary, care plan notes, and exam to fulfill the 8 hours of annual training as outlined in Title 77, Section 245.71 Texas State Qualifications and Requirements for Home Services Workers.

1. Caregiver Job Requirements and Protocol

2. Senior Caregiver Job Description

3. Communication Skills

4. Care Plan and Care Plan Notes and Activities

5. Personal Care and Toileting

6. Adaptive Equipment for Transfers (Gait Belts and Lifts)

7. Basic Hygiene and Basic Infection Control

8. Maintaining a Clean, Safe, and Healthy Environment

9. Basic Personal and Environmental Safety Precautions

10. Emergency Procedures, Including Basic First Aid and Client's Emergency Preparedness Plan

11. Confidentiality of Client Personal, Financial, and Health Information (HIPAA)

12. Understanding Abuse and Neglect

13. Stroke Care for Seniors Rehabilitating after Experiences a Stroke

Caregiver Testimonial

"I signed up for a course at a college campus and studied to get a caregiving certificate. It took me the whole summer. I learned more with Caregiver Training University's course than in the college campus course. You really do understand caregiving in the home."

- A. Nova, Palo Alto, California

"Since I was certified as a caregiver for your company as of August, 2017, just before my husband went into hospice care, I can tell you that certification helped me with the hospice staff. My husband was going in and out of the hospital before he went into hospice. When I said to them "I am a certified caregiver", it really made a difference in how the medical staff engaged with me. The nurses in the hospital room even began showing me how to read his medical chart on the room's computer."

- M.E. Forbes, Virginia

"Thank you for the training! I PASSED with a 92%. I'm so proud of it! My Mom would have been proud of me. Thank you! Thank you! Thank you!!! I really love the course. I cared for my Mom before she passed away from kidney cancer and diapering was a chore. She was on hospice. I want to be prepared and I do enjoy working with the elderly and am learning so much in the Caregiver Training University courses."

- R S. Metcalfe

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Keep In Touch Stay up to date on what is going on in our community. Get updates on blog posts, senior care legislation and supportive tips for the caregiving journey.

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Texas Caregiver Training & Certification for Home Care

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Texas caregiver training and certification courses online for home care professionals. Meet your requirements and get certified today!

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When reaching out for help, talking to someone who is going through similar issues helps resolve the feelings of isolation. Knowing you are not alone in your situation can better help you take care of your loved one. It can also boost your confidence and give you motivation to keep on pushing through. Support groups are also beneficial when seeking advice for certain situations.

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The National Family Caregiver Support Program(NFCSP) which was established in 2000, gives caregivers the opportunity to request a grant from supports that provide help to family and informal caregivers to older adults.

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National Family Caregiver Support Program

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The National Family Caregiver Support Program (NFCSP) provides grants to states and territories to fund various supports that help family and informal caregivers care for older adults in their homes for as long as possible.

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Tenets of caregiving distress can include the following:

Caregiver burnout, conscious caregiving, compassion fatigue, caregiver identity theory or ambiguous loss. No one wants to experience any type of emotional or mental pain, but it happens and taking the right actions towards the pain can improve your mindset.

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Tired of Being a Caregiver? Tips for Caring for Elderly Parents or Spouses are Here

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As a caregiver you are put in a vulnerable position and it is not always easy. When caring for an older adult, they do not put in the effort to help caregivers help them. Loved ones do not have the ability to maintain their own life, so as a caregiver you have the responsibility to set their alarms, give medications at the correct time, feed, clean, change their clothing and shower. When there is no support, no talking it can be hard to find the motivation to keep being a caregiver.

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When you feel the laughter and smile start to fade it might be the right time to reach out for help. Joining private or public support groups is a great way to get all the anger and frustration out that has been built up from caregiving. Talking to anyone or anything that listens is better than lashing out on your loved from all the emotions you have kept inside. Because even if you think you have it all under control, the emotions will come out eventually, and making sure it isn't towards your loved one needs to be the first priority.

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As a paid caregiver for a family member, you are with them a lot if not 24/7. With being around them for a lot of your time, it can help stronger bonds be created and create a sense of unity among the family.

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While caring for a loved one, it can often be hard and difficult. But you have to know that what you are doing is something that not everyone can succeed in. You are providing life and love to this individual who would probably not be alive if it weren't for your caretaking abilities. You are the one making a positive impact on your loved ones life and that is a rewarding feeling.

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As a caregiver you have an older adults' life in your hands, and while it may seem scary when you put it like that, it creates many beneficial resources for you. You are put through many emotional, physical, and mental tests. These tests help teach you how to deal with situations when they become difficult. You also learn time management skills from having to give out medications on restricted time limits and feeding, cleaning, and bathing schedules.

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Family caregivers fill an essential role in our fractured long-term services and supports (LTSS) system. In 2021, the estimated economic value of family caregivers' unpaid contributions was approximately $600 billion, based on about 38 million caregivers providing an average of 18 hours of care per week for a total of 36 billion hours of care, at an average value of $16.59 per hour. This conservative estimate does not consider the financial cost of care (out-of-pocket and lost wages) or account for the complexity of care provided (i.e., medical/nursing tasks). This $600 billion estimate for 2021 is up from $470 billion in 2017 and continues a 25-year trend of increasing economic value. It also corresponds to studies that have found that the value of unpaid family care vastly exceeds the value of paid home care.

This report pulls from multiple sources to profile who family caregivers are and the challenges they face and includes several first-person accounts of the experience. It takes a detailed look at recent developments and promising federal and state policies that support family caregivers, as well as promising practices in the public and private sectors, including the positive representation of caregivers in popular media. It concludes with specific recommendations.

PROMINENT ISSUES IN FAMILY CAREGIVING
By the year 2034, adults ages 65 and older will outnumber children under the age of 18, and the share of potential caregivers is projected to continue shrinking relative to the number of older adults potentially at risk for needing long-term care. Demographic trends of population aging, shifts in fertility and timing of first births, and the increasing racial and ethnic diversity of the US population all help explain the key prominent issues in caregiving: sandwich generation caregivers, working caregivers, direct care workforce shortage, diverse caregivers.

The balancing act of "sandwich generation" caregivers
In 2019, roughly 30 percent of family caregivers of older Americans lived in a household that also includes children or grandchildren. They are increasingly Gen Z and millennial caregivers and are more likely than other caregivers to be working while performing their caregiving responsibilities.

The impacts of caregiving on employment for working caregivers
Sixty-one percent of family caregivers work either full or part time. Working caregivers face financial risks such as lost income, reduced career opportunities and savings, and subsequently lower Social Security and retirement benefits.

The impact of post-pandemic shortages in the direct care workforce on family caregivers and care recipients
Direct care workforce shortages, exacerbated during the pandemic, result in more hours of care and higher-intensity care by family caregivers. While the workforce is expected to grow from 4.6 million in 2019 to 5.9 million by 2028, the challenge is in retaining workers in a field with an average turnover rate of 40 to 60 percent each year and providing sufficient pay and training.

Meeting the needs of Black/African American, Hispanic/Latino, Asian American, and Native Hawaiian and Pacific Islander family caregivers
The trend of growing diversity is highly relevant to family caregiving because Black/African American, Hispanic/Latino, Asian American, Native Hawaiian and Pacific Islander, and American Indian and Alaska Native family caregivers report distinct care experiences and specific support needs. Their care recipients likewise have distinct care needs and health trajectories. In addition, LGBTQ family caregivers make up roughly nine percent of all caregivers in the country and face a distinctive set of challenges in caring for LGBTQ partners, friends, and older family.

PROMISING POLICY AND PRACTICE SUPPORTING CAREGIVERS
Significant federal and state policy developments and meaningful steps, in both the public and private sectors, have taken place in the four years since the 2019 release of the last Valuing the Invaluable update, some spurred by the pandemic. This report reviews many of those advancements in detail. It reviews policies and practices that continue pre-pandemic efforts as well as those that stemmed from the COVID-19 Public Health Emergency (PHE).
Major Federal Initiatives
The National Strategy to Support Family Caregivers
The National Strategy came out of the RAISE Family Caregivers Act (enacted in 2018) and offers a unified approach to improving recognition of and support for family caregivers. It highlights hundreds of actions at all levels of government and the private sector, including some already underway, to recognize family caregivers and give them the help they need.

Public Health Emergency (PHE) Acute Hospital Care at Home (AHCaH) Waiver
This CMS waiver expanded Hospital at Home (HaH)-a long-standing US care model providing acute hospital care in patients' homes.

Supplemental benefits under Medicare Advantage
In 2019, Medicare Advantage plans included additional flexibility to offer beneficiaries new and expanded supplemental services, such as LTSS and support services for family caregivers of enrollees.

American Rescue Plan Act of 2021
The Act included a temporary increase for certain Medicaid home- and community-based services (HCBS) expenditures to address HCBS workforce issues, expand service capacity and help family caregivers and their care recipients on an HCBS waitlist, among other things.

Spousal impoverishment protections
Ensure the spouse of a person receiving Medicaid HCBS isn't required to spend down all of their assets in order for the spouse to receive supportive services.

Expanded supports for caregivers of veterans
The VA MISSION Act, enacted in 2018, expanded the Department of Veterans Affairs (VA) Program of Comprehensive Assistance for Family Caregivers (PCAFC) to include family caregivers of veterans who served prior to September 11, 2001.
State Level Initiatives
Financial Relief
Many states are exploring ways to offset the financial costs of caring for a family member including caregiver tax credits or other reimbursement programs.
Workplace Flexibility Policies

Paid family leave: 11 states and the District of Columbia have enacted paid family leave programs.

Paid sick leave: A total of 14 states now require paid sick leave, and an additional two have enacted general paid time off laws that allow for paid sick leave.

Caregiver Advise, Record, and Enable Act
A total of 45 states and territories now have CARE Act laws in place, which support family caregivers when their relatives go into the hospital and as they transition home.
RECOMMENDATIONS
Policies should not only enable training for providers, direct care workers, and families but also support the economic well-being of family caregivers. Three areas of focus should be:

1. The National Strategy to Support Family Caregivers offers a unified, clear plan for implementing coordinated supports for family caregivers across a range of areas-health care, social support, and economic-and highlights an array of actions at all levels of government and in the private sector, including some that are underway. Steps must be taken to build on the actions, goals, and outcomes in the National Strategy while ensuring that all publicly funded programs and caregiver support services account for the diverse needs of diverse family caregivers.

2. To ease the financial costs of caregiving, policymakers should provide financial assistance and relief to family caregivers through a federal or state tax credit. Policymakers should also consider reforms that would protect and, if possible, improve Social Security benefits for people who provide caregiving to children, older adults, and others. Additionally, publicly funded HCBS programs should use participant-directed (sometimes referred to as consumer-directed) service models that permit payment to family caregivers.

3. Policymakers should strengthen the federal Family and Medical Leave Act (FMLA) and state FMLAs, including expanding protections to apply to all workplaces and all primary caregivers, including those caring for kin or longtime friends. Family and medical leave needs to be paid so caregivers can afford to take time off. Working caregivers also need earned sick days that workers can use for short-term personal or family illness or to take relatives to medical appointments, workplace flexibility policies, and protection from discrimination based on their caregiving responsibilities.

Reinhard, Susan C., Selena Caldera, Ari Houser, and Rita B. Choula. Valuing the Invaluable 2023 Update: Strengthening Supports for Family Caregivers. Washington, DC: AARP Public Policy Institute. March 8, 2023. https://doi.org/10.26419/ppi.00082.006
Previous Reports 2011 2008 2006

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Valuing the Invaluable 2023 Update: Strengthening Supports for Family Caregivers

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Care provided by millions of unpaid family caregivers across the U.S. is valued at a staggering, estimated $600 billion annually. An estimated 36 billion hours of care annually is provided by family caregivers for older parents, spouses, partners, and friends with chronic, disabling, and serious health conditions.