Age With Care

Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.

As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.

Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform provides an introduction to the principles of palliative care; describes current models of delivering palliative care across care settings, and examines opportunities in the setting of healthcare policy reform for palliative care to improve outcomes for patients, families and healthcare institutions. The United States is currently facing a crisis in health care marked by unsustainable spending and quality that is poor relative to international benchmarks. Yet this is also a critical time of opportunity. Because of its focus on quality of care, the Affordable Care Act is poised to expand access to palliative care services for the sickest, most vulnerable, and therefore most costly, 5% of patients- a small group who nonetheless drive about 50% of all healthcare spending. Palliative care is specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, and stress of a serious illness—whatever the diagnosis or stage of illness. The goal is to improve quality of life for both the patient and the family. Research has demonstrated palliative care’s positive impact on health care value. Patients (and family caregivers) receiving palliative care experience improved quality of life, better symptom management, lower rates of depression and anxiety, and improved survival. Because patient and family needs are met, crises are prevented, thereby directly reducing need for emergency department and hospital use and their associated costs. An epiphenomenon of better quality of care, the lower costs associated with palliative care have been observed in multiple studies. Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform, a roadmap for effective policy and program design, brings together expert clinicians, researchers and policy leaders, who tackle key areas where real-world policy options to improve access to quality palliative care could have a substantial role in improving value.

This book focuses on the emerging global old age care industry developing as a response to tackle the “old age care crisis” in richer countries. In this global industry, multiple actors are involved in recruiting, skilling and placing migrant care workers in different spheres of the receiving country's old age care system. This book delves into the analysis of these actors and the multiple levels influencing their activities. Accordingly, it examines the significance of old age care regimes and policies as well as intermediaries and promoters for initiating, shaping and perpetuating old age care arrangements based on migrant labor and the relationships within them. Particular emphasis is placed on the risks and implications of these arrangements for the well-being and the social protection of the different actors involved. The book analyzes these processes and structures from a global perspective including different countries and regions of the world.

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Does a longer life mean a healthier life? The number of adults over 65 in the United States is growing, but many may not be aware that they are at greater risk from foodborne diseases and their nutritional needs change as they age. The IOM's Food Forum held a workshop October 29-30, 2009, to discuss food safety and nutrition concerns for older adults.

As the Baby Boomers age, concerns over healthcare systems' abilities to accommodate geriatric patients grow increasingly challenging. This is especially true with the population deemed to be “the oldest of the old,” specifically those over the age of 85. Unlike any other time in history, this demographic is the fastest growing segment of most developed countries. In the United States the oldest old is projected to double from 4.3 million to 9.6 million by 2030. The increased life expectancy of the population since the early 1900s has been built on the improvement of living conditions, diet, public health and advancement in medical care. With this we have seen a steady decline in the age-specific prevalence of vascular and heart diseases, stroke and even dementia. Older persons are healthier today than their counterparts decades ago. More importantly than in any other age group, the care of the oldest old must be individualized; management decisions should be made taking into consideration the older persons’ expressed wishes, quality of life, function and mental capacity. The inevitable consequence is that there will be an increase in the prevalence of older persons with chronic diseases, multiple co-existing pathologies and neuro-degenerative diseases. The oldest of the aging population are often excluded from drug trials and their treatments are largely based on findings extrapolated from that of the younger old. Furthermore, among the oldest old, physiologically they are more diverse than other segments of the population. Their demographic characteristics are unparalleled and different compared to that of the younger old. Several studies have drawn attention to the differing attitudes among health professionals towards elderly people and many show prejudice because they are old. As a result, the use of age as a criteria in determining the appropriateness of treatment is of very limited validity, yet there are limited resources that guide physicians through these challenges. This book creates a greater awareness of these challenges and offers practical guidelines for working within the infrastructures vital to this demographic. This book is designed for geriatricians, primary care physicians, junior medical officers, specialty geriatrics nurses, and gerontologists. It is divided into 3 sections: General Considerations, Chronic diseases and Geriatric Syndromes. Each chapter provides a summary of important and essential information under the heading of Key Points. Case studies are included in some of the chapters to highlight the principles of management.

One of Time’s 100 most influential people “shines a new light on the need for a holistic approach to caregiving in America . . . Timely and hopeful” (Maria Shriver). In The Age of Dignity, thought leader and activist Ai-jen Poo offers a wake-up call about the statistical reality that will affect us all: Fourteen percent of our population is now over sixty-five; by 2030 that ratio will be one in five. In fact, our fastest-growing demographic is the eighty-five-plus age group—over five million people now, a number that is expected to more than double in the next twenty years. This change presents us with a new challenge: how we care for and support quality of life for the unprecedented numbers of older Americans who will need it. Despite these daunting numbers, Poo has written a profoundly hopeful book, giving us a glimpse into the stories and often hidden experiences of the people—family caregivers, older people, and home care workers—whose lives will be directly shaped and reshaped in this moment of demographic change. The Age of Dignity outlines a road map for how we can become a more caring nation, providing solutions for fixing our fraying safety net while also increasing opportunities for women, immigrants, and the unemployed in our workforce. As Poo has said, “Care is the strategy and the solution toward a better future for all of us.” “Every American should read this slender book. With luck, it will be the future for all of us.” —Gloria Steinem “Positive and inclusive.” —The New York Times “A big-hearted book [that] seeks to transform our dismal view of aging and caregiving.” —Ms. magazine