In part one
of the “Caring for the Caregivers” series, the statistics bore this truth: the caregivers of today are entering the Medicare-eligible club themselves and bringing a host of mental, physical, and emotional challenges with them. This not only creates a burden on caregivers, but also on the healthcare deliverers and payers.
In this second part of this series, we take a closer look at four areas of focus as solutions to care for the caregivers today for improved health and well-being.
Providing family caregivers with training on how to support their loved one with activities of daily living, simple medical terminology, and caring for health conditions at home can go a long way in helping reduce anxiety and fear in the caregiver and provide quality care for the member. Creating a formalized training program for family caregivers can provide not only the knowledge required to care for the member, but it also instills confidence in the caregiver.
Payers could partner with educational resources like the American Red Cross (which already has training programs created for external caregiving roles) to provide online programming for the family caregiver. By creating a model of online and in-home training (with a nurse care manager), payers can educate caregivers on needs such as medication management and physical care management.
Care management team support for the caregiver and the patient
The caregiver is a critical player within the care team. They take on the responsibility of communicating with the patient’s healthcare team and advocating for loved ones who are unable to do so for themselves. Regular care management team communications and care conferences are a must to ensure the needs of both the member and the caregiver are being met.
An article by HealthPayerIntelligence
states: “More than financial aid, non-professional caregivers are looking for personal and informative help. When asked to consider several policies, only three in ten caregivers preferred a policy that offered financial aid. Only 28 percent of caregivers in the study had sought out financial assistance, but 84 percent would like more resources about caregiving.”
Payers are key to providing incentives for healthcare providers to develop the necessary programming and time needed to provide access to care teams and other resources. Because many healthcare provider organizations are not currently designed and staffed to support additional caregiver engagement, a shared risk model between payer and healthcare provider organizations—or fee-for-service arrangement—could be part of a viable solution in expanding support for the family caregiver.
Digital support system
In the previously cited article regarding the Aetna partnership with CareLinx, it discusses the incorporation of a digital support system called Care Plan, which connects CareLinx Care Advisors through messaging and providing “updates to the caregiver in real time.” Because smart phones are now a common staple in most homes, having quick and easy access to someone who can provide information and support through a simple text message is quite efficient. It can also be critical in real-time situations where the caregiver needs an immediate answer for a question or situation they are facing.
Virtual medicine is a care model of the future for homebound patients and their caregivers. Utilizing technology allows the medical team to see and evaluate the member’s condition over a smartphone. Being able to communicate directly with the member and caregiver can decrease unnecessary emergency room or urgent care visits and limit the physical and emotional stress of transporting the member outside of the home to a medical facility.
Health and wellness resources for the caregiver
As mentioned previously, the physical and emotional stress of caregiving can give rise to a host of physical and mental health challenges for the caregiver. The Mayo Clinic cites the following health problems as risks from long-term stress response system and exposure to the stress hormone cortisol
- Digestive problems
- Heart disease
- Sleep problems
- Weight gain
- Memory and concentration impairment
We may be extending life and decreasing overall costs of medical care for the elderly who are cared for in the home, but we may also just be transferring the overall cost of care in our society by the increasing comorbidities and healthcare costs for the caregivers.
There is some headway in supporting the family caregivers. Many Medicare Advantage and Medicaid health plans provide respite care benefits for the member, allowing caregivers to take time away from the 24/7 caregiving duties for a limited number of days. This is a great solution for the caregiver to be able to take a “break” from caregiving duties. But as with all solutions, there can be some challenges.
Respite care can require the member to be transferred to a care facility, adding physical and emotional stress for the elderly member as changing the environment can be quite traumatic. Also, if the respite care consists of having a professional caregiver come into the home environment for around-the-clock care, that too can create additional stress due to privacy concerns for the caregiver and their family by having a non-relative in the home.
If the caregiver becomes depleted physically or emotionally, it will have a trickle-down effect on the member. This can potentially lead to added healthcare costs such as agency provided caregiving support, additional medical resource needs, or the worst-case scenario of long-term facility placement.
Payers providing health and wellness support for the caregiver may be a novel idea but one that could reap great benefits for all parties: the member, the caregiver, and the payer. Health plans should consider providing benefits for the caregivers that goes beyond a week or two of respite care a year or online support groups. Additional plan offerings by payers could provide resources and align payers with partners to deliver:
- Access to individualized one-on-one resources with a health coach, life coach, or mental health professional to mitigate long-term physical and behavioral health needs for the caregiver.
- Free or low-cost health club memberships for family caregivers.
- Free or heavily discounted services from massage therapists, acupuncturists, yoga studios, or other holistic and alternative medicine providers for caregivers.
Caring for the caregiver is critical to the overall health of our families, our healthcare systems, and our society.