Family Members Caring for People With Cognitive and Behavioral Health Conditions: Nationwide Survey Results


October 23rd, 2014

In 2012, 9.6 million adults in the United States had lived with a serious mental illness in the past year. Also, 20 percent of adults over age fifty have depression, and about 11 percent suffer from anxiety disorders. And what about the people who care for an aging population? What challenges do family caregivers face when supporting and providing for adults with chronic physical and mental illness?

The report, “Family Caregivers Providing Complex Chronic Care to People with Cognitive and Behavioral Health Conditions,” published in August by the AARP Public Policy Institute and the United Hospital Fund (UHF), with support from the John A. Hartford Foundation and the AARP Foundation, sheds some light on the stresses and challenges that family caregivers of people with these conditions face.

The report is the third in the “Insight on the Issues” series, based on analyses from a December 2011 national survey of 1,677 family caregivers. Earlier findings were published in the AARP/UHF report Home Alone: Family Caregivers Providing Complex Chronic Care and earlier publications in the series.

The Stresses of Family Caregiving

According to the survey results, nearly half of family caregivers performed medical/nursing tasks (such as medication management and wound care) in addition to assisting with both activities of daily living (such as bathing and dressing) and instrumental activities of daily living (such as transportation and shopping). And about half of this group provided care for a family member with at least one behavioral or cognitive health condition.

Authors Susan C. Reinhard of AARP and Sarah Samis and Carol Levine of UHF define cognitive impairments as memory problems, dementia, or Alzheimer’s disease, and behavioral conditions as depression, anxiety, or other mental illness.

In addition, care recipients with behavioral and/or cognitive conditions were more likely to have chronic physical diagnoses such as stroke/hypertension, musculoskeletal problems, cardiac disease, and diabetes than care recipients who did not have behavioral or cognitive conditions. Care recipients with both behavioral health and cognitive conditions were most likely to have undergone ambulatory surgery or to have gone to a hospital emergency department. Read the rest of this entry »

The RWJF Seeks Proposals for a New National Program: Policy-Relevant Insurance Studies


October 22nd, 2014

In its coverage work, in recent years, the Robert Wood Johnson Foundation has prioritized grant making related to the implementation of health reform. Research we have funded in this area has focused largely on monitoring the impact of health reform on important outcomes such as coverage, access, and utilization.

Many of these activities can be seen on our landing page Reform By the Numbers, where we feature results from unique data sources such as the Urban Institute’s Health Reform Monitoring Survey, Breakaway Policy’s Health Insurance Exchange (HIX) Compare (comprehensive data on silver plans, under the Affordable Care Act), athenahealth’s ACAView, and the University of Pennsylvania’s Health Insurance Exchanges Research Group’s Health Insurance Exchanges (HIX) 2.0.

We are also funding a number of analytical briefs that provide more detailed looks at particular issues and places, such as the Leonard Davis Institute of Health Economics at the University of Pennsylvania’s Deciphering the Data series and the Urban Institute’s Monitoring and Tracking series.

In keeping with our focus on health reform, we have a strong interest in funding investigator-initiated research that is highly policy relevant. On October 15, we announced the awarding of nine grants for State Health Access Reform Evaluation (SHARE), an investigator-initiated research effort focused on state health reform issues. Newly funded SHARE projects focus on topics ranging from Medicaid expansion to a study of health care provider networks.

That same day we also announced a call for proposals (CFPs) for a new funding opportunity, Policy-Relevant Insurance Studies (PRIS). While funding research that informs policy is not new, the PRIS announcement differs somewhat from prior CFPs in both focus and approach. One way in which PRIS is unique is in its exclusive emphasis on highly policy-relevant questions related to health insurance markets. Additionally, we would prefer to fund projects that use modeling and have relatively short timeframes. Read the rest of this entry »

Supporting Returning Veterans: the Military Medic to Paramedic Program


October 14th, 2014

Among the current challenges facing our nation are the high unemployment rate of veterans returning from active duty in the Middle East and the current shortage of health care professionals.

There is a significant unemployment problem for the more than two million “Gulf War-era II veterans”—servicemen and -women who have returned from deployment to Iraq and Afghanistan since deployment began in 2001. According to the US Department of Labor’s Bureau of Labor Statistics, the national unemployment rate for this particular group of veterans averages 9 percent, compared with an unemployment rate of less than 7 percent for all veterans. In Michigan, the state where I live, more than 10 percent of all veterans are unemployed, the second-highest rate in the country.

Veterans returning home are confronted with multiple challenges to assimilation: the absence of military structure and order; the need to re-adapt to family, a spouse, children, and community; and the task of finding work rather than being ordered to specific work duties. While the training and skills gained in the military make veterans excellent employees, they need help equating military training to civilian jobs.

A concurrent problem is our country’s shortage of health care professionals. In Michigan, employment of emergency medical technicians and paramedics is expected to grow, statewide, by 23 percent from 2010 to 2020, resulting in a demand for 1,700 additional such professionals by 2020.

According to the 2013 Michigan Health Care Cluster Workforce Analysis, there were more than 1,700 online job advertisements for registered nurses (RNs) in April 2012, “the highest demand of any [health-related] occupation.” Compared with other occupations, RNs had many of the long-running job advertisements, and Michigan employers were struggling to find enough trained nurses. Statewide, RNs were at the top of the list of most annual job openings—roughly 2,900 openings for RNs were expected per year through 2018, the report says.

Among the servicemen and -women who were deployed to the Middle East since September 11, 2001, more than 7,500 have been trained as medics each year by the US Army Medical Department Center and School. “We have a rapidly growing shortage of paramedics and registered nurses in Michigan. At the same time, we have returning military medic veterans who have training and experience that can be quickly translated into employment as a paramedic or nurse,” Jeanette Klemczak, then at Michigan’s Workforce Development Agency, told Blue Cross Blue Shield of Michigan in 2013.

In response to these two issues, Lansing Community College partnered with the state’s Workforce Development Agency and the Blue Cross Blue Shield of Michigan (BCBSM) Foundation to implement the Military Medic to Paramedic Program. This program supports a goal of Michigan Gov. Rick Snyder (R) to build a path for rapid training and employment of returning military veterans. The foundation provided a two-year, $50,000 grant for the program, and the state’s Workforce Development Agency and Lansing Community College’s Community Health and Nursing Department provided matching funds. Read the rest of this entry »

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