1. 1 Integrating Cash & Counseling into a Caregiver Respite Program: Early Outcomes PIs: Noreen Shugrue & Julie Robison Researcher: Irene Reed Project Manager: Melissa Morton Funding provided by the Administration on Aging Community Living Program through a subcontract with the Connecticut Department of Social Services.

2. 2 Background Connecticut implemented its C&C program “Choices at Home” through two caregiver respite programs –National Family Caregiver Program –Statewide Alzheimer’s Respite Program Caregivers given flexibility & control re services and method of delivery: may hire and pay care providers (“C&C group”) or remain with traditional services (“TS group”)

3. 3 Background (cont’d) Designed for sustainability: Utilizes funds from the Respite Programs to provide consumers with flexible service options Contracted with a Fiscal Intermediary (FI) to administer C&C option In addition, Supplemental Services (SS) expanded: $750 cap raised to $4,000 for Caregiver program

4. 4 Evaluation Process UConn Center on Aging engaged to evaluate For every C&C client, program manager identifies comparison TS group member Caregivers from C&C and TS groups interviewed at baseline, 3 months, and termination Supplemental Services caregivers interviewed at baseline and 6 months (no comparisons)

5. 5 Interviews Completed

6. 6 Demographics: Care Recipients

7. 7 Baseline Measures Use and unmet need for –personal care –household activities –transportation CES-D depression scale Zarit burden scale (4-item screening version) COPE index (4 items measuring benefits/positive aspects of caregiving)

8. 8 Baseline Results Percent with unmet needs: –Personal Care36% –Household Activities39% –Transportation25% Scale Scores –CES-D depression (range 0-10) 2.8 –Zarit burden (range 4-16) 8.2 –COPE benefits (range 4-16)12.8

9. 9 Unmet Need – 3 Months

10. 10 Depression, Burden, Benefits at 3 Months

11. 11 C&C Group: Baseline vs 3 mos

12. 12 TS Group: Baseline vs 3 mos

13. 13 Satisfaction Scores Measured several aspects of satisfaction at 3 months Scores high and not significantly different Percent “very” satisfied C&CTS Services received8995 Caregiver schedule7279 Relationship with caregiver 10090

14. 14 Other Caregiver Questions Percent responding “always” C&CTS Schedule meets needs6174 Caregiver comes as scheduled 8379 Caregiver completes assigned tasks 9489

15. 15 Nursing Home Likelihood

16. 16 Supplemental Services Fifty-one clients received stair glides, ramps, bathroom modifications, etc. Mean age 80 (range 60-96) Female 68 percent No comparison group Extremely high satisfaction levels Six-month interviews just beginning

17. 17 Nursing Home Likelihood

18. 18 Conclusions High levels of satisfaction across the board for C&C, TS, and supplemental services One third to one half expressed high likelihood of entering NH without service Short surveys easy to administer and yield useful results – nearly 100% response rate Greater consumer direction through C&C yields similar, positive outcomes Beneficial addition to respite programs for those seeking to direct their own care

19. 19 The Research Continues…