Caregiver Crisis Looms
Crush of Boomer Generation Necessitates Change, Experts Say
Last updated Saturday, November 25, 2006 10:41 PM CST in News
By Don Dailey
The Morning News
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Susan Lewis' life has been on hold for 10 years.
Her mother's wants, needs and desires take priority over her own.
Opal Brower, 86, lives in a three-bedroom mobile home next to the house Lewis and her husband share on a few acres east of Fayetteville. Brower needs help with everything -- eating, bathing, dressing -- but she refuses to believe she can't live on her own anymore, the 53-year-old Lewis said.
Brower's health has deteriorated over the years. She has high blood pressure, dementia, pernicious anemia, hearing problems, cataracts, and she's had two strokes.
Brower doesn't want to move into a nursing home. Lewis doesn't want that either.
"It's turned out to be a lot of work for me," Lewis said.
Lewis' arrangement with her mother is a common one. Taking care of aged parents has been a traditional role for children, but will become increasingly harder as the huge baby boomer generation ages and puts a crunch on elder-care resources, according to a report released in September.
The report, "Caregiving in America," was created jointly by the Schmieding Center for Senior Health and Education in Springdale and the International Longevity Center-USA based in New York City, two organizations devoted to better care for the elderly.
The report is the first salvo in an effort dubbed The Caregiving Project for Older Americans, a push to change the landscape of elder care.
More women working, families having fewer children and children who live far from their parents have decreased the number of available family caregivers.
Paid caregivers will have to fill that gap, the study says. But the caregiving work force is small and getting smaller due to poor pay, sometimes unpleasant work conditions and lack of professional advancement. Making matters worse is paid caregivers are often poorly trained, according to the study.
Lawrence Schmieding encountered the problem when he sought a professional caregiver to care for his older brother at home. The experience led Schmieding to establish the Schmieding Center.
A $1 million grant from the Schmieding Foundation kick-started the multiyear Caregiving Project.
"I thought it (the project) would do the whole country a lot of good," he said.
Different World
"We're doing what no society has ever done before and that's age," said Dr. Larry Wright, director of the Schmieding Center.
Wright said continued medical advances will allow people to live with conditions that would have killed them in earlier times. In many cases, they will live for years; and they will need care they can't render themselves.
The common scenario: Someone is treated in a hospital and recovers enough to be discharged but needs outside help. When the family asks where they can get this help, they find out caregivers are in short supply, Wright said.
In most cases a female family member -- a wife, a sister, a daughter or a daughter-in-law -- takes on the role of caregiver, often giving up a job vital to her family.
That's what happened when Alicia Orozco, 74, of Rogers suffered a stroke in March. Bertha Acosta quit her job as a housekeeper so she could take care of her mother during the day. Orozco lives with Acosta's sister, Norma Molina, who assumes caregiving in the afternoon and at night. Another sister, Maria Sanchez, takes over on weekends.
Acosta, 44, said she feels privileged to take care of her mother.
"Right now I feel like I'm giving her a little back of what she gave me," Acosta said.
Much To Learn
The Schmieding Center, seeking to increase the pool of skilled caregivers, established a three-level training program in 1999 and has trained about 700 people. The center maintains a roster of trained caregivers doctors and other health care professionals can refer to when patients need home care, said Marjorie Hart, a clerk in the Schmieding Aging Resource Center and a graduate of all three levels of the program.
Acosta and Lewis have each participated in the training program. Acosta completing all three levels, and Lewis completing the first two levels.
Lewis took the training in January soon after her mother's strokes.
She found out she had a lot to learn when she decided her mother needed a bubble bath to take her mind off her health problems. She was able to get Brower into the tub without a problem, but getting her out was another story.
"She was so slippery."
After regrouping, Lewis took a better grip and got her mother out of the tub. The two laughed at the time, but Lewis realized taking care of her mother would be different.
The training taught Lewis how to help her mother with physical tasks such as walking, talking, eating, dressing. It showed her how to lift her mother in a way comfortable for them both. The program also helped Lewis understand her mother's feelings about growing older, she said.
It would be much easier for Brower to move into Lewis' house, but she refuses.
"She doesn't want to give up her independence," Lewis said. Even though Brower is dependent upon her daughter for everything.
Acosta also plunged into the caregiving role knowing little about how to provide for the emotional and physical needs of her mother, a woman who had always been strong and energetic.
"Everything changed," Acosta said.
Orozco couldn't walk or talk after the stroke. Her daughters helped her with rehabilitation, but she needs specially prepared food and drinks. She's had a hard time with the loss of independence.
"Sometimes she gets depressed and cries because she thinks she can still do what she used to," Acosta said.
The training taught her how to help her mother through those episodes, she said.
Northwest Arkansas is one of the few areas in the United States with such a large pool of trained elder-care workers, Wright said.
"We're a little exceptional because of Mr. Schmieding."
Forcing Change
Their recent experiences mean boomers like Lewis and Acosta think about their elder years and how they are going to spend that time.
"I hope what I'm doing with her my kids are going to do with me," Acosta said. She has three children.
Lewis has a more elaborate plan. She wants to craft a future for herself that won't include her children being obligated to care for her.
Wright believes the political clout wielded by the 70 million baby boomers will change the status quo in elder care.
"In every stage of life the baby boomers have come to, they changed it completely," he said. "The personality of baby boomers is a lot different than that of their parents. The Greatest Generation, they suffer in silence, but boomers won't be silent."
Dr. Robert Butler, president and CEO of the International Longevity Center-USA, said one of the goals of the Caregiving Project is to make training such as that offered at the Schmieding Center available across the country.
A goal of The Caregiving Project is to get a national certification process in place for elder caregivers, which means a universal training curriculum will have to developed. Legislation on the national or state level will have to pass for that to happen.
"I think that's going to be OK," Butler said. "I think it won't be controversial because it's so sensible."
The Longevity Center has invited experts on elder caregiving to a meeting in March to map out a plan for spreading the word.
Future Promise
Lewis used to enjoy much of the time she spent with her mother, calling Brower her best friend. The fun melted away as Brower's health deteriorated.
"It's just this last year when it really got rough on me," Lewis said.
Lewis has had to fight through some health problems of her own. She's recovering from skin cancer. The demands of caring for her mother didn't slacken while she was being treated.
Lewis said she's promised her mother she will take care of her until she is no longer physically able, and then she will put her in a nursing home or some other care facility.
That promise is made all over America every day.
The current "default solution," Wright said, is for those who can't make it at home to go into a nursing home.
"Nothing is more tragic for a family than when someone has to be put in a nursing home because they can't do it anymore," Wright said.
Wright said nursing homes will probably always be needed, but only a fraction of those in nursing homes now really need to be there.
A better national system of elder care could be much more cost-efficient while reducing the need for what is currently normal nursing-home care. Private long-term care insurance and new rules on what Medicare can cover could be part of an improved system, Wright believes.
"It's not that we don't know how to do it," he said. "It's that we haven't organized to do it."
By The Numbers
1.4 million Americans 65 and over live in nursing homes.
5.5 million receive care at home.
About 20 percent of adults needing assistance are unable to find paid or voluntary caregiver.
$139 billion was spent on long-term care in 2002, one-fourth of which was for home-based care.
The economic value of informal caregiving was estimated at $257 billion in 2000.
Education Opportunity
The Schmieding Center for Senior Health and Education at 2422 N. Thompson St. in Springdale offers home caregiver training for families and those wanting to pursue a career in home caregiving. DVDs of the training curriculum are also available. Call the Schmieding Center at 751-3249 or (888) 866-8991.
Web Watch
Schmieding Center for Senior Health and Education:
www.schmiedingcenter.org
International Longevity Center-USA:
www.ilcusa.org
National Association of Area Agencies on Aging
www.n4a.org
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Marianne Beasley wrote on Nov 26, 2006 12:59 PM:
Plan Ahead wrote on Nov 26, 2006 4:33 PM:
U of I student wrote on Nov 26, 2006 9:57 PM:
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