Caregiving
Support for caregivers
Changes in the family structure may lead to fewer caregivers for millions of aging baby boomers. Some boomers' marriages came later than those of their parents, end sooner, and result in fewer births. Greater numbers of women in the workforce have created further changes in the family structure.
An estimated 19 percent of women now in their early 40s have no children. Even those with children face challenges. Families move more than they once did, and adult children often live far from older relatives who need care. Greater numbers of single-parent households and an increase in blended families consisting of stepchildren and stepparents, leave many planners wondering if the divorced and remarried will receive the same support from stepchildren as those who stayed in intact families. Smaller, increasingly fragmented families, and the prospect of record numbers needing assistance create the potential for social and economic crisis in caregiving over the next few decades.
The critical role of caregivers and their need for assistance has been recognized by national leaders. In November 2000, Congress funded initiative to expand caregiver support services under the reauthorization of the Older Americans Act (OAA). The National Family Caregiver Support Program (NFCSP) is the largest program established under the OAA since the nutrition services program was initiated in the 1970s. Under this program, caregivers are defined as anyone caring for a person over age 60, or a grandparent over age 60 caring for a child 18 years of age or younger. Input from caregivers across the country has helped the NFCSP focus caregiver support services in five priority areas:
- Information to caregivers about available services;
- Assistance in accessing services provided through care coordination and benefits counseling;
- Individual counseling, education, support-group organization, and training to help caregivers make informed decisions and solve problems;
- Respite care to allow caregivers to be temporarily relieved of their caregiving responsibilities; and
- Supplemental services to complement those provided by caregivers (e.g., nutrition, transportation, personal assistance and health-maintenance related items).
In Texas, all 28 area agencies on aging (AAA) have developed comprehensive systems of support for caregivers. Most AAAs have designated full-time caregiver specialists responsible for disseminating information about available resources, and coordinating access to the services caregivers need. It is important to note that caregivers are not a new service population for the AAAs. However, the Older Americans Act reauthorization and the associated funding for the NFCSP provided resources needed to significantly expand caregiver support services.
Community support is a particular concern in rural areas where lack of access to services, information, and ongoing support make it harder for people to care for loved ones in their homes. Institutional admission rates for rural elders exceed those of urban communities. Caregivers in rural areas often do not access services because they are unaware of existing programs, do not know they are eligible, do not accept services until there is a crisis, and find services too geographically distant. (see Community Supports). These factors are particularly challenging for rural communities as they develop and promote caregiver support programs.
The Texas Health and Human Services Commission (HHSC) has recognized that caregivers need support and that every area of the state has a unique set of challenges requiring local solutions. The Commission responded by creating an Enterprise Strategy dedicated to Caregiver Support. The strategy, as stated in the 2003-2008 HHS Coordinated Strategic Plan , is to "improve support to families by expanding, developing, and coordinating formal, informal, and innovative supports for caregivers".
Updated: November 2, 2007
