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Area Agencies on Aging operated a delivery system to provide community-based services to older adults and their caregivers (N4A).
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The Generation United is created by groups including the National Council on Aging (ACL, n.d.).
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The Eldercare Locator began by telephone (Eldercare, 2010).
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The Brookdale Foundation Group established Relatives as Parents Program (RAPP) to expand services to grandparents and other relatives who assume the role of surrogate parent (ACL, n.d.).
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The National Alliance for Caregiving is established to focus on family caregiving issues (ACL, n.d.).
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The National Family Caregiver Support Program (NFCSP) was enacted which supports caregiver programs in every state (Feinberg, Wolkwitz, & Goldstein, 2006). States are required to pass funds to non-profit and state agencies providing caregiver support services via 56 state agencies and 629 AAAs. NFCSP grants support counseling, respite services, nutritional services, caregiver training, disease prevention, health promotion, and supplemental services (George Washington Univ., 2012).
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The National Center on Caregiving (NCC) created to advance policies supporting caregivers (ACL, n.d.).
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The Eldercare Locator website began (Eldercare, 2010).
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2002 U.S. Department of Health and Services finds caregivers to be exhausted and burnt out leading to the need for loved one to be institutionalized (Feinberg, Wolkwitz, & Goldstein, 2006).
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There was a survey of programs in all fifty states. The National Center on Caregiving and Family Care highlighted three focus areas:
Assessment of caregiver needs,
Consumer direction in family caregiver support services
Collaboration on caregiving between aging network and health care providers
(Feinberg, Wolkwitz, & Goldstein, 2006) -
2004 The need to support caregivers so that they can remain working is identified (Feinberg, Wolkwitz, & Goldstein, 2006).
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A survey found that over 75% of caregivers had been providing care for at least three years and that 25% of the caregivers were over the age of 75
(Feinberg, Wolkwitz, & Goldstein, 2006). -
AARP contracted with National Center on Caregiving to obtain more information on trends (Feinberg, Wolkwitz, & Goldstein, 2006).
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Amendments required Administration on Aging to implement Aging & Disability Resource Centers (ADRCs). There were 533,000 caregivers that received assistance, which is estimated to be only 7.6% of all caregivers (Feinberg, Wolkwitz, & Goldstein, 2006).
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Funding for Family Caregiver Support Services $153,439,000 (ACL, n.d.).
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It is estimated that more than 600,000 caregivers receive family caregiver assistance through the National Family Caregiver Support Program (NFCSP) developed by the Administration on Aging. Fifty-five percent of caregivers say that the recipient needs someone close by in order to be safe and 68% of caregivers are over the age of 60 and caring for someone older than age 85 (Foster & Kleinman, 2011).
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Funding for Family Caregiver Support Services $154,220,000 (ACL, n.d.).
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It is estimated that 450 billion in care is provided by family caregivers. Sixty-one percent of frail older adults at home receive care from a family caregiver and 72% of frail older adults receive care from family caregivers and paid caregivers (Foster & Kleinman, 2011).
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NFCSP is provided by the federal government based on the state's percentage of those older than age 70. Then states each have their own formulas for providing funds to the Area Agencies on Aging (George Washington Univ., 2012).
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Many family caregivers report that their own health problem or disability affects their ability to provide care. Seventy percent say that they provide at least forty hours of care and 18% of adult children and 15% of other caregivers report providing 24-hour care. Over 75% of caregivers say they help with instrumental activities of daily living (IADLs) and two-thirds report that they help with one of the four ADLs of dressing, bathing, eating, or using the toilet (Foster & Kleinman, 2011).
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Fifth National Survey of Area Agencies on Aging
The survey finds that caregiving leads to physical strain for as many as 44% of spouses, emotional strain for 50% of spouses, and financial strain for 33% of spouses, and also affects adult children caregivers and other caregivers in much the same way but at a slightly lesser percentage (Foster & Kleinman, 2011). -
Eighty percent of the caregivers that received benefits from the NFCSP rated them as excellent or very good. The survey found that 92% those receiving all types of services rated the NFCSP services as excellent or very good, where as only 61% of those receiving one type of service rated them that way. Seventy-six percent of caregivers reported less stress due to the NFCSP services and 77% felt that they received help with caregiving challenges (Foster & Kleinman, 2011).
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Administration on Aging awards Title VI grants to 218 organizations, including Indian tribes and Native Hawaiian organizations (George Washington Univ., 2012).
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58.8% of AAAs serve caregivers of all ages (N4A).
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Over 700,000 caregivers receive support from NFCSP (ACL, n.d.).
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Funding for Family Caregiver Support Services $154,197,000 (ACL, n.d.).
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10th Anniversary of the NFCSP
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Funding for Family Caregiver Support Services $153,911,000 (ACL, n.d.).
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National Alliance for Caregiving presented priorities to the Senate Health, Education, Labor, and Pensions (HELP) subcommittee recommending that caregiver assessment be added as an allowable service and funding increased to 250 million due to need. They also requested that the definition of caregiver include older caregivers with adult disabled children and all variety of families regardless of race, ethnicity and include LGBT communities (NAC, 2012).
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Strengthening Services for Americans Seniors Act (S1819) added caregiver assessments, support for Ombudsman for long-term care resident and family councils, and created an Advisory Council to streamline legal services (NAC, 2012).
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Grants were 71%, almost 1.4 billion, of the Older Americans Act funds. Family caregiver support programs (NFCSP) received 153.6 million, or 8% of all funding for over 600,000 caregivers each year but reach a small percentage of all caregivers (George Washington Univ., 2012).
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OAA Amendments of 2012 (S3562) added older relative caregiver to disabled adult to caregiver definition, created a voluntary caregiver assessment program, supported the development of resident and family councils in long-term care settings, and provided for a grant of 12 million for the period from 2013 to 2017 for National Resource Center on Family caregiving (NAC, 2012).
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The number of AAAs serving caregivers of all ages remained at 58.8% (N4A). Recipients received: 58% Respite care, 47% Assessment for care planning, 41% case management, 28% Assessment for long-term care eligibility, 12% transportation medical, 15% transportation non-medical, 12% personal assessment / personal care, 14% homemaker, 13% adult day service, 10% assistive technologies, and 5% home health (N4A).
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72.4% of Area Agencies on Aging also function as Aging & Disability Resource Center (N4A).
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Strategies to divert individual from institutional placement are implemented with 54% of AAAS providing caregiver education and training. Of the AAAs providing caregiver education, 52.1% are under the 3026 Award and 22% of those are fully reimbursed. (N4A).
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31.9% of AAAs use Veteran Directed Home and Community-Based Services (VD-HCBS) and family caregiver community-based services to avoid nursing homes. (N4A).
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145.6 million was funded to NFCSP as reported by the National Council on Aging (NCOA, 2015).
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Federal funding of 1.88 billion for OAA services that requires states to match 25% for caregiver support services (Fox-Grage & Uvari, 2014).
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145.6 million was funded to NFCSP as reported by the National Council on Aging (NCOA, 2015).
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S.192 - Older Americans Act Reauthorization Act of 2015 was referred to the Committee on Health, Education, Labor, and Pensions. It will reauthorize funding for family caregiver support for 2016-2018 (114th Congress, 2015-2016).
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Administration requested 150.6 million in funding for NFCSP as reported by the National Council on Aging (NCOA, 2015).
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State Long-Term Care Ombudsman Program final rule (Federal Register, 2015).
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S.192 - Older Americans Act Reauthorization Act of 2015 was passed by Senate without amendment by Voice Vote (114th Congress, 2015-2016).
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S.192 - Older Americans Act Reauthorization Act of 2015 was received in the House for Floor Consideration and referred to the House Committee on Education and the Workforce (114th Congress, 2015-2016).
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House and Senate approved 145.6 million for funding to NFCSP as reported by the National Council on Aging (NCOA, 2015).
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Since the enactment of the NFCSP in 2000, the number of programs focused on meeting the needs of caregivers grew due to an increased awareness of the issues. The definition of caregiver has been expanded to include parents caring for adult disabled children, but will likely expand more in the future to recognize other types of families. The programs are working well, but with funding remaining level rather than increasing, this will become more challenging as the number of caregivers grows.
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State Long-Term Care Ombudsman Programs Rule will begin (ACL, n.d.).
