1. 1 Caregiver Adaptations to Reduce Environmental Stress (CARES): The Role of Environmental Coping Strategies (ECS) Dory Sabata, OTD, OTR Co-Author Julie Overton, MHA, MSG AoA National Summit: Creating Healthy and Caring Communities September 23, 2003

2. 2 Overview Importance of ECS for Caregivers Project Overview & Findings Problematic Activities in the Home & Low-Tech Solutions NFCSP and Funding for ECS Summary and Recommendations

3. 3 Importance of ECS for Caregivers Environmental coping strategies (ECS):  changes made to the home environment that enhance care and reduce physical stress of caregivers Home Modifications (HM) Assistive Devices (AD)

4. 4 Goal of CARES To create and stimulate improved systems of support services that increase caregiver utilization of ECS to reduce physical burden

5. 5 Objectives of CARES 1. Assess caregivers 2. Educate service providers on ECS 3. Stimulate aging network activities 4. Evaluate and disseminate strategies

6. 6 Caregiver Focus Groups Convenience sample 4 groups, N=29 (6, 5, 9, 9) Primarily live with the care recipient (CR) CR: parent, spouse, other relative Average 4-6 yrs. as caregiver

7. 7 Lessons from Caregivers Most physically demanding  Lifting, transferring, and bathing Most frequent HM  Grab bars  Homemade strategies Most problematic room  Bathroom

8. 8 Lessons from Caregivers (cont.) Concerns of community mobility  Getting out  Transportation Limited use of ECS  Cost prohibitive  Benefits not understood

9. 9 Lessons from Caregivers (cont.) Perception of financial assistance  Funding only for institutional care  Deplete own finances at home Where to go?  Hardware Stores  Retail stores

10. 10 Problematic Activities & Low Tech Solutions Toileting Bathing

11. 11 Problematic Activities & Low Tech Solutions (cont.) Using steps

12. 12 Problematic Activities & Low Tech Solutions (cont.) Moving around in the home Getting in and out  Of the home  Of a vehicle

13. 13 NFCSP & Funding for ECS AAA’s identify funding as #1  Informational need for ECS  Challenge to caregiver services Piece together funding  Orange County AAA and Rebuilding Together

14. 14 NFCSP & Funding for ECS (cont.) Sub-contract services Reimburse families Utilize community service groups Train Care Managers

15. 15 Recommendations Utilize NFCSP Supplemental Services for HM and AD services Provide Caregivers information on ECS  Outreach  Support groups Raise awareness of ECS benefits  To Policymakers  To Caregivers  Through community partnerships

16. 16 Summary We cannot ignore the physical stresses placed on CGs who provide daily assistance to their CRs. ECS can help care for the CG by making caregiving activities less stressful, more convenient, and easier.

17. 17 Contact Information National Resource Center on Supportive Housing and Home Modification University of Southern California Andrus Gerontology Center Los Angeles, California 90089-0191 www.homemods.org sabata@usc.edu (213) 740-1364