BLOGGER: MICHAEL FRIEDMAN, L.M.S.W
Are you one of the 2.9 million grandparents in America who are raising their grandchildren? Although there are many good reasons to do this, it brings increased responsibility, stress and sacrifices that you probably didn’t anticipate for your “golden” years. Kin caregiving becomes necessary in families of all backgrounds and socioeconomic statuses and for many reasons, from military service to parental illness or death to child abuse or neglect. Census data reveal a significant increase in kin caregiving recently, probably due to the recession. When called to provide care, you may be relieved that the children can be safe with you, but now you have a lot to do. You’ll need to take care of getting the children enrolled in school, apply for financial and medical benefits, make sure they are seen by a pediatrician, perhaps arrange for counseling, consider pursuing custody or guardianship. The list goes on and on. So how do you do this and still find time for yourself? Many grandparents respond to the children’s needs first and try to take time for themselves later. Many never get to it — an understandable choice, but ultimately you need to take care of yourself to be able to do the best you can for your grandchildren. How Can You Cope? Becoming a kin caregiver evokes many emotions, from the joy of having your grandchildren with you to feeling angry and resentful about your adult child being absent or about your losing so much — your time, possibly your job, your independence, sleep, your financial security.
How can you cope?
• Staying healthy is important. Don’t miss your annual physical or ignore symptoms that are new for you. Fit in some exercise. Walking is a lot better than nothing.
• Have some fun. Stay in touch with friends. Do things you enjoy.
• Find reliable people to talk with — a trusted friend or family member, clergy or a counselor. Alternatively, join a support group where you can talk with others in similar situations and learn about services and resources for you and your family.
• When you feel overwhelmed and that you can’t possibly get everything done, make a list of things to do, decide what has to get done now and what can wait, and schedule when you will do them. Literally, put them on your calendar.
• Talk with your grandchildren about what you’re finding difficult. They may be having a tough time emotionally, but they also may be able to help more than you think.
All of this is easier said than done, and you can certainly expect that there will be times when you feel that you just can’t take it anymore. That’s par for the course when raising children. Sometimes it’s wonderful to be with the kids; sometimes it’s enough to make you furious or bring you to tears. But sometimes caregiving can overwhelm anyone. You may not be able to do the things that really have to get done or lose patience more than you used to. You may feel hopeless or helpless or lose pleasure in everyday life. You may have trouble sleeping, more than the usual physical aches and pains, or be drinking too much. You may be withdrawing from the friends and support you need. These are all signs that your coping is running short and when you need to recognize that you need to take care of yourself in order to care for your grandchildren. Raising grandchildren can be very satisfying, and it is always a challenge. Take care of your kids and take care of yourself. That’s the best caregiving of all.
This post was co-written with Deborah Langosch, Ph.D., L.C.S.W., the Project Director of the Kinship Care Program at the Center for Trauma Program Innovation at Jewish Board of Family and Children’s Services in New York City.
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Posted 6 months ago at 12:08. Add a comment
Meeting the Mental Health Challenges of the Elder Boom
BLOGGER: MICHAEL FRIEDMAN, LMSW
The elder boom has begun, and our nation is not prepared. Between 2011 and 2030, the number of adults 65 or older will increase from 40 million to 72 million and from 13 percent of the population to 20 percent. This drives growing concerns about the viability of Social Security, the sustainability of Medicare, and the availability of a workforce to provide health and social services.
Despite widespread concern about the physical health of older adults, mental health needs are mostly not on the national radar screen, a serious oversight for five reasons.
First, contrary to the ageist assumptions of our culture, people can live well in old age, but not without mental health.
Second, mental illness has a terrible impact on physical health. People with mental disorders are more likely to have physical disorders, and people with co-occurring physical and mental and/or substance use disorders are at higher risk for disability and premature death and have far higher medical costs than those with physical disorders alone.
Third, approximately 20 percent of older adults have diagnosable mental and/or substance use disorders, including dementia. This increases to over 50 percent of older adults by age 85, mostly dementia, the prevalence of which doubles every five years beginning at age 60. The range of mental health problems also includes:
- Anxiety and depression, which often co-occur with dementia
- Psychotic conditions, such as schizophrenia, bipolar disorder and severe depression
- Substance use disorders
Fourth, untreated mental disorders contribute to avoidable placement in institutions, such as nursing homes, driving up the costs of long-term care in the U.S. They also contribute to social isolation and high rates of suicide.
Fifth, all older adults face emotional challenges related to social and occupational role changes, diminished — but not lost — physical and mental abilities, losses of family and friends, and the inevitability of death.
Both the public and the private sectors need to take steps to meet the mental health challenges of the elder boom. These include:
- Making mental health promotion a key element of the health and aging services systems.
- Providing home and community-based services to enable people developing disabilities to live where they choose.
- Supporting family caregivers who provide 80 percent of the care for people with disabilities.
- Improving access to mental health and substance abuse services in the community.
- Improving the quality of mental health and substance abuse services in the community and in residential and institutional settings such as formal and “naturally occurring” senior housing, assisted living and nursing homes.
- Fostering integration of physical health, mental health, substance abuse and aging services.
- Enhancing the adequacy of services for minority populations, which will grow from 20 percent to 30 percent of the older population by 2030.
- Increasing research regarding effective mental health promotion and treatment of mental and substance use disorders and improving translation for research findings into practice.
- Providing outreach and public education to older adults and their families regarding mental health, effective treatment and where to find resources.
- Addressing the shortage of a clinically and culturally competent workforce, in part by recruiting and training more geriatric professionals and paraprofessionals and in large part by including older adults themselves in the helping workforce in both paid and volunteer roles.
- Restructuring methods of financing needed services so as to make them affordable, to enhance integrated care and treatment, and to support services in the home and in natural community settings.
- Making the mental health challenges of the elder boom more than a rhetorical priority in both private and public service systems.
In these times of cutback in government spending, addressing the mental health needs of older adults may appear to be an unnecessary frill. But the truth is that failing to address mental health needs will drive costs up in the long run. Ignoring this is very poor policy.
(This article is coauthored by Kimberly Williams, co-founder and Director of the Geriatric Mental Health Alliance of New York.)
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Posted 6 months, 2 weeks ago at 12:08. 1 comment
Now that I am almost 64, who will meet my needs when I am 84?
BLOGGER: DEBBIE HEISER
AUTHORS:
Deborah Heiser, Judith L. Howe, Robert Maiden, Beverly Horowitz, Pat Brownell
When you think of growing older, what comes to mind? Fun, family, golf, workforce issues…? Workforce issues? Yes, workforce issues. Believe it or not, we need to pay very close attention to them. Each day 8,000 baby boomers turn 60. In 2011, 78 million baby boomers will begin to turn 65. The Bureau of Labor Statistics (2005) estimates the demand for employment in aging will increase 26% over the next few years – particularly in health related jobs. All the while, those 85 years and older are the fastest growing segment in the U.S. population. This age group is expected to double in 2030 to 9.6 million and to double again by 2050.
Unfortunately, there is a down side to all of this longevity. There is a HUGE need for a trained workforce to serve the aging. According to Boxer and Collins (20007), 8 out of 10 older adults have at least one chronic illness and, of those, about 2/3 have multiple chronic conditions that require complex treatment and coordinated care. Maiden, Chireac, and Maiden (2002) found that 50% of people requiring in-home care are 85 but older-family members find it difficult to secure, manage, maintain, and pay for adequate in-home assistance. To met the demand, we need 36,000 certified geriatricians; we only have 7,128 in the U.S. Despite the demand, and the increase in demand, the supply of in-home workers remains very low and is expected to remain low. Even those who are available receive very little training and are then asked to perform functions they are not adequately trained for (Maiden & Maiden, 2004). Only 5% of social workers are trained in aging issues and only 3% of advance practice nurses specialize in aging. “Besides being inadequately prepared in geriatrics, the current workforce is not large enough to meet older patents’ needs. and the scarcity of workers specializing in the care of older adults is even more pronounced” (Institute of Medicine, 2007, p. 5).
To determine what was going on in education, Dr. John Krout, a professor in New York State and a Past President of the State Society on Aging of New York, recommended taking a look at the New York State Institutions of Higher Learning. Based on this recommendation, an inventory of all schools within the state was conducted. The findings were astonishing!
Of 242 schools in higher learning:
Note ***Only one school, now defunct, offered a PhD.
The State Society on Aging of New York (SSA) and The State Office on Aging of New York (NYSOFA) teamed up in 2007to create the Workforce Project charged with understanding training needs in the State of New York. The SSA and NYSOFA conducted a series of 8 Listening Sessions across the State. The notes taken during each of the Listening Sessions were compiled and a content analysis was conducted to systematically identify key words and phrases used at each Session to determine important structures and themes. The results are based on ratings provided by three independent coders who identified and tallied themes discussed at each of the Listening Sessions.
A total frequency and percent of discussion associated with each key topic was determined for each of the seven major discussion questions that framed the Listening Sessions.
The 7 Questions asked at each of the 8 Listening Sessions were:
Question 1:
Do you see a need for more education about aging staff in your organization?
Question 2:
On what topic would you like to see more education?
Question 3:
How should training / educational opportunities be presented?
Question 4:
What credentialing and certification should be considered?
Question 5:
Should gerontology be infused into college curricula? Across disciplines?
Question 6:
What is the ability of organizations to support education/training for employees
Question 7:
Other comments
The Top 10 Key Findings were:
The findings from the Listening Sessions, as described in the Content Analysis show that a variety of issues were brought up. Some were brought up only once, and some several times.
The organizations collaborated again at the SSA’s Annual Conference in 2008 to discuss the findings and “next steps” with 120 conference participants. The participants completed questionnaires. Notes were taken and were reviewed for key themes with regard to the four workforce training and education questions posed to the group. The results are broken down by question:
Question 1:
What do you think are good next steps we can take?
The overarching theme for this question was education. Forty seven percent (47%) of the responses and notes highlighted the need for education from k-12 and. Additionally, they recommended educating college students earlier in their undergraduate education, and employing online education. Other responses with suggested sensitivity training for gay/lesbian issues in training aides, elder abuse training, expanding nursing programs, fully funding GECs, emphasizing Geriatrics as a career, exposing teachers to SSA and Teach for America, and grassroots efforts.
Question 2:
Of the top 10 key issues identified, what do you see as the most important to focus on?
There were three distinct themes for this question. Thirty nine percent (39%) of the responses advocated education, 39% training, and 22% financial aide and incentives. With regard to education, the responses were: education for k-12 and all curriculum, college students receiving education earlier in their undergrad education, and online education. Training responses were: aide training, caregiver training, and work-site training and mentoring. Financial aide and incentives were not broken down further.
Question 3:
How can we – area agencies, academics, practitioners, and government – work together to move workforce education and training issues forward?
There were two distinct themes for this question with 42% of the responses advocating financial solutions (financial aide and incentives, support the Boxer Bill, and fully fund GECs) and 31% supporting increased education (education – k-12 and all curriculum, online education, and pilot curriculum programs for secondary education
Question 4:
Can you think of any other incentives for promoting education and training in aging?
Nearly 67% responded that there was a need for community service for high school students; approximately 33% responded that there is a need for increased payments and reimbursement for medical and social services.
Recommendations coming out of the Next Steps, SSA conference, mirrored the listening sessions. They focused on education (k-12 in particular, and online training). Responses for education were addressed in questions 1-3, and for two of the three questions, was a top response.
NowWhat?
We must now move toward addressing the issues brought up by New Yorkers as key workforce issues.
Let us know what you think! Leave a comment below!
To read the full report published in 2008 by NYSOFA, please go to the State Office of Aging of New York Website: http://www.aging.ny.gov/ReportsAndData/WorkforceEducation/Introduction.cfm
To read this article on the SSA website, please go to: www.ssany.org
To become a member of the State Society on Aging of New York, please go to: www.ssany.org
To find out more about Dr. Heiser, click the photo below:
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Posted 2 years, 6 months ago at 12:08. 1 comment
