1. GERIATRIC EDUCATION SERIES Presented in partnership with: Funded in part by a grant from the EJC Foundation

2. dhs.unr.edu/aging Caregiver Support & Resources January 6, 2016 Kelley R. Macmillan, Ph.D., LSW Director Community & Social Services Sanford Center for Aging

3. Objectives OBJECTIVE 1: Administer and score a caregiver burden screening instrument OBJECTIVE 2: Encourage family caregiver self- care OBJECTIVE 3: Discuss referral options to community programs serving older adults and family caregivers

4. What is Caregiving? Hands on personal care Helping with household tasks Night-time or 24-hour supervision Financial management Care coordination

5. Who are Caregivers? Women (60%) Adult Children (36%) Sole Caregiver (44%) Work Full-time (60%)

6. Why Assess the Caregiver? A caregiver assessment helps us understand what may support the caregiver in their role which benefits our client to maintain community residence.

7. Why are Caregivers Important? In the US there are 34.2 million (14.3% of pop.) people providing care (50 & >) The estimated cost for caregiving is $470 billion per year! (2013 data)

8. What are Caregivers Providing? Approximately 60% of care recipients ONLY receive care from informal caregivers CG provide 24.1 hrs/wk on average 22% of CG provide 40 hrs or more/wk A caregiving career lasts 3.7 years

9. Risks for Caregivers - 1 Caregivers are at greater risk of health problems: Infectious disease, such as flu Heart problems Diabetes Cancer

10. Risks for Caregivers - 2 Caregivers are at greater risk of mental health emotional problems: Depression (two times as common) Stress and burden Interpersonal problems Anxiety

11. Risks for Caregivers - 3 Caregivers are at greater risk of social problems: Isolation Reduced leisure activities/time Restricted social roles

12. Caregiver Stress Balancing caregiving, family and work Balancing the relationship with the care recipient Making decisions regarding care

13. Benefits of Caregiving - 1 A natural support system A meaningful & satisfying role The relationship between the adult and the caregiver may be enhanced

14. Benefits of Caregiving - 2 An opportunity to ‘give back’ to a parent Satisfaction in knowing the adult has a good quality of life – Autonomy & self-determination – Remain in home/familiar surroundings – Trusting relationship with caregiver

15. Strategies for Caregivers - 1 Social and Health Services – Case management – Respite care – Medicaid services (HCBS) – Medicare services (home health)

16. Strategies for Caregivers - 2 Psychosocial support - reduces isolation & permits ventilation of feelings with other caregivers Psychosocial support - reduces anxiety, guilt, depression & psychosomatic complaints

17. Strategies for Caregivers - 3 Psycho-education about caregiving – The aging process – Coping with caregiving – Communication strategies – Problem-solving – Information regarding community services

18. Strategies for Caregivers - 4 Immunizations - influenza, pneumococcal, tetanus Health screenings - cervical cancer, mammogram, blood sugar and blood pressure Mental health screening - stress, depression and anxiety

19. Strategies for Caregivers - 5 Encourage planning for future needs (caregiving can last for > 4 years) Living Will Advance Directive Durable Power of Attorney

20. Strategies for Caregivers - 6 Family member keeps copies of person’s important records. Direct deposit of person’s check(s) Automatic bill-pay Joint access to a bank account

21. Strategies for Caregivers - 7 Utility party notification Decide what to do about checkbook, credit cards Develop a system for handling mail Consider Volunteer Rep Payee Program

22. Interaction with Caregivers Give information in small doses Tackle one issue at a time Limit the length of your visits Verify that families understand Give manageable “homework” assignments and write them down!

23. Resources Family Caregiver Alliance http://www.caregiver.org/caregiver/jsp/content_node.jsp?n odeid=1717 Nevada ADRC http://www.nevadaadrc.com/ Aging and Disability Resource Center (National) http://www.adrc-tae.acl.gov/tiki- index.php?page=ADRCLocator Eldercare Locator http://www.eldercare.gov/Eldercare.NET/Public/Index.aspx AARP http://www.aarp.org/home-family/caregiving/

24. Sanford Center Geriatric Specialty Clinic Kelley R. Macmillan, Ph.D., LSW kmacmillan@unr.edu (775) 327-2281