Research and Resources For a Greying America

Clara T. Kelly is Program Manager of Family Caregiver Support for the Greater Nashville Regional Council on Aging and Disability Services.

NASHVILLE, TN – Meharry Medical College hosted the 33rd Middle Tennessee Geriatric Conference last week. Medical practitioners, researchers, hospital administrators, and representatives from several non-profits attended the conference that was held at the Cal Turner Family Center 
for Student Education

Megan Shepherd-Banigan, Assistant Professor at Duke University School of Medicine presented her research about caregivers of older adults who are veterans.

Her paper, “Optimizing outcomes for older adults through support for family caregivers”, is about how different support models affect caregiver health and the work they do.

Shepherd-Banigan studied elder care programs in various VA hospitals. The system is about one-seventh the size of Medicare and VA hospitals are good laboratories to compare various programs with a fairly large patient population of the elderly frail.

Here are some facts: the number of older adults will double by 2060; there are 18 million unpaid caregivers of adults aged 65+ in the U.S. today and 61% of them report it has impacted their paid jobs; the fastest growing population group in the U.S. is adults over 80.

The Older Americans Act (2016), RAISE Family Caregivers Act (2018), and the Caregivers & Veterans Omnibus Health Services Act (2010) have put federal funds into elder care. Medicaid waivers in 15 states have given seniors allowances to pay for care from family and friends or agencies. That has saved money in fewer hospital stays and less long-term care. Tennessee is not one of those states.

Shepherd-Banigan found 84% of caregivers could use more information to meet their patients’ needs. Trainings in person or over the phone consultations can help. Caregiving is not easy, especially caring for people with dementia or Alzheimer’s disease. It extracts emotional, physical, and financial toll on caregivers.

And support for caregivers is limited. Communication with healthcare providers should be better than it is. Existing services are difficult to access or are too expensive. And despite good research, its conclusions are rarely translated into practice.

Dr. Ed Vasilevskis, a Vanderbilt researcher, spoke about the problems elderly patients encounter when transitioning from a hospital back home, or to a rehabilitation hospital, or a long term care facility. It turns out 20% of elderly patients come back to the hospital within 30 days.

Research shows that at least one quarter of those readmissions are preventable. Poor management of meds and a lack of communication between doctors and caregivers are often to blame.

Vasilevski said the role of a transition advocate is crucial when an elderly patient leaves a primary care hospital. And too often there is none. That’s when a family member can step in to make sure nurses are monitoring symptoms and doctors diagnose medical issues or note therapeutic problems. And most important, a responsible relative should take part in decision-making about the patient.

Dr James Powers organized the conference. He worked many years as a nursing home doctor. Powers spoke about healthy aging and noted that more people are living longer with fewer disabilities. Healthy seniors exercise to preserve function, promote wellness, and independence.

“Looking at the quality of life is probably the most important aspect of longevity,” Powers said.

By 2030 about one quarter of Tennesseans will be 65 or over. Here’s the bad news: more than one quarter of them will have diabetes and 30% will have shingles. But Powers said new vaccines can prevent shingles and two vaccines prevent pneumonia in the elderly.

Not surprisingly, staying active, not using drugs or tobacco promote anyone’s good health and especially seniors.  There is a growing trend to make cities more livable and seniors are driving it. In New York, for example, seniors got the city to keep lights green longer to give slower walkers more time to cross busy intersections.

In Middle Tennessee a number of non-profits and agencies provide information, services, and programs for seniors. Clara T. Kelly runs a family caregiver support program in 13 Middle Tennessee counties.

“You can google us,” she said.  There are differences depending on where you live but regional councils all provide things like respite care and meals for shut-ins.

“If you go to the Tennessee Commission on Aging and Disability you will find all nine of the area agencies and if you click on your particular area you will see what they offer but there will be a family caregiver program there,” Kelly said.

Grace Smith is the Executive Director of the Council on Aging of Middle Tennessee.

“We are developing a home sharing initiative where older homeowners who have extra space can rent out to a grad student or another adult. It becomes an added source of income and more affordable rent for others who are looking for that,” Smith said.

Catholic Charities, AARP, Metro Social Services, and Fifty Forward are also working on the pilot project that will begin next year.

Smith said the Council’s main role is to provide a directory of services and resource guides for seniors and caregivers. But are also organize solutions for unmet needs.

“We were the catalyst behind Senior Ride Nashville being formed and launching,” Smith said. The program began in 2016 and uses volunteers who provide rides for seniors who no longer drive.

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