By Scott Tanaka
I am grateful to be able write again for this first issue of the new year! I wanted to share news on laws that recently went into effect for caregivers. In October 2012, AARP’s Public Policy Institute and the United Hospital Fund released results of a national study of family caregivers to determine what types of medical/nursing tasks they perform and how frequently they perform them.
The study, “Home Alone: Family Caregivers Providing Complex Chronic Care,” was funded by the John A. Hartford Foundation, and it found that almost half (46 percent) of those surveyed were expected to perform complex tasks that are normally done by a medical/nursing professional. These tasks include managing multiple medications, administering injections, performing wound care and managing special medical equipment, among many others. The study shed light on the large gap between what caregivers are expected to perform and the instructions and guidance provided to them.
This study led AARP’s State Advocacy and Strategy Integration team to take the findings of this study to the state legislation level to form the Caregiver Advise, Record and Enable (CARE) Act. Oklahoma became the first state to pass the CARE Act, and as of July 2017, 39 states and territories have also passed it.
What Does the CARE Act Require?
- Record the identified caregiver on patient’s hospital medical record
- Inform caregiver when patient is to be discharged from the hospital to another facility or back home
- Provide training needed for the patient once discharged. This can be done in person or through video and will demonstrate the medical tasks the caregiver will need to perform at home such as medication management, injections and wound care
Providing this kind of training greatly benefits both the patient and the family caregiver. The caregiver is better prepared to care for a family’s loved one, and the loved one will receive better care. Hospitals are also already seeing a decrease in readmission rates since the CARE Act has gone into effect.
During my first year of grad school, I was placed at Providence TrinityCare Hospice, where I worked as a medical social work intern. I was part of a greater team that included a medical doctor, nurse, massage therapist, art therapist and, when needed, a physical therapist and occupational therapist. Though the CARE Act was not in effect during that time, my team was already in line with this new law.
If a patient was scheduled for a medical procedure, both the nurse and I would attend medical appointments. This allowed us to hear firsthand what was going to happen during the procedure and help us plan for when the patient would be discharged back home. We would then be able to meet with the caregiver and empower him or her with the tools he or she would need to provide the best care possible for a family’s loved one.
The nurse would tend to the physical/biological needs of the patient by training the caregiver on wound care, medication management, etc. As the social worker, I would be there to provide support for the patient and the caregiver.
This can be an overwhelming time for both the patient and the caregiver, and social workers can provide that much-needed safe space for people to process what is going on and what is to come.
Following the procedure, we would visit the family at least once a month to assess the needs of the patient and caregiver and provide any necessary support.
During my second year, I worked as a psychiatric social work intern at the USC Memory Aging Center at the USC Keck School of Medicine. I became part of a greater team there and worked with a neurologist, physician’s assistant, nurse, psychologist and other health care professionals. One of the organizations that I would often refer my patients to was the Alzheimer’s Association of Greater Los Angeles.
Through the Alzheimer’s Association, caregivers can call a 24/7 helpline, attend support groups and even go through a caregiver training designed specifically for caregivers who are caring for a loved one with Alzheimer’s or another dementia. The association also has social workers on staff that can provide support, education and resources based on specific needs.
I have talked a lot about social workers, but it is important for our community to know who they are and what they do. I am proud to be a social worker and am proud of what social workers bring to the health care team!
To learn more about the CARE Act, visit AARP’s Public Policy Institute at www.aarp.org/ppi. There you can find the full article, “From Home Alone to the CARE Act: Collaboration for Family Caregivers,” written by Susan C. Reinhard, AARP Public Policy Institute, and Elaine Ryan, AARP State Advocacy and Strategy Integration.
Scott Tanaka is a board member for the Washington, D.C., JACL Chapter, and Project Coordinator for AARP Multicultural Leadership.