Susan Kohler - November 28, 2012
Missoula Aging Services
Good evening. I’m Susan Kohler, CEO of Missoula Aging Services, the Area Agency on Aging for Missoula and Ravalli Counties. I’ll introduce my topic by quoting Rosalyn Carter, who said: “There are only four kinds of people in the world--those who have been caregivers, those who are currently caregivers, those who will be caregivers and those who will need caregivers.”
November is designated National Family Caregivers Month, an opportunity to recognize the more than 65 million family caregivers who provide 80 percent of our nations’ long term care services. I’d like to take this opportunity to speak up about community programs which support family caregivers and to advocate for a stronger public policy which addresses family caregiving issues. Our own state legislature will be looking at these issues and supports as they enter the next legislative session in January.
Although family caregivers provide over $450 billion annually in “free caregiving services” for older adults, their services are far from being free. Financial concerns are topmost among caregivers. A recent survey conducted by Care Improvement Plus and the National Family Caregivers Associations underscores the growing demands placed on those caring for loved ones with complex health care needs, coined Higher-Burden Caregiving. The survey found that 75 percent of people caring for Medicare beneficiaries with complex health care needs have an annual income of less than $25,000, yet a majority still provides financial support to their loved one. Financial worries, diabetes care and care coordination are among the greatest challenges facing “higher-burden” caregivers.
More than half of the 300 caregivers surveyed live at the same residence, with nearly three in four caregivers providing support with Instrumental Activities of Daily Living, or IADLs. These include transportation, nutritional or physical support and coordination of care. It isn’t difficult to figure out why these caregivers have so many financial concerns. If their loved one is placed in a nursing home in Montana it would cost an average of $70,ooo a year. If their loved one is eligible for Assisted Living Care the cost is closer to $37,000 a year. In both cases, the older adult either has to have long term care insurance, which covers three years on average and often does not pay the full amount of care, or he or she must quickly spend down into Medicaid services. Medicaid only pays for Assisted Living when there is a “slot” available.
Most older adults prefer living at home and doing so is usually less expensive than these options. At least that’s the case when family caregivers are available to do most of the work or have the ability to pay for services to manage the care needs, or when the care recipient is low income and eligible for home based Medicaid, with its long waiting list.
This is where our legislature can make a difference. Through Area Agencies on Aging caregivers can access support for transportation, meals, help with coordinating care, homemaking, respite services, personal care and much more. The caregiver can also receive emotional support through support groups and programs like Powerful Tools for Caregivers, which focuses on the well-being of the person providing the care. These services are critical in supporting the work of caregivers and are far less expensive than the options of nursing or assisted living facilities. But many people can’t pay the full cost of these services. Adequate state funding can help.
For six years the Area Agencies on Aging have received $1.5 million statewide for each year as “One Time Only” funding. This funding is not utilized for One Time Only expenses as it is needed for ongoing support of the services I mentioned, but after six years without increases the ability to provide the same level of services is dwindling as the costs climb. It is time for our legislature to get behind caregivers and the people they care for by making the 1.5 million part of the state’s base budget and adding funding to address the increased cost of doing business along with the increase in our older population. With 220,000 adults over 60 in Montana, of which 41,000 are low income according to the 2010 Census, this is a small cost to pay to support families who are trying to take care of their older parents.
I urge you to contact your state House and Senate representatives and tell them how important this funding is. Tell them it’s time to stop the One Time Only approach by designating adequate ongoing funding in the base budget. This just makes good fiscal sense and supports the desire of most older people to stay at home. To learn more about this issue and others which affect older adults, call 1-800-551-3191 to reach the Area Agency in your area.
This is Susan Kohler CEO of Missoula Aging Services and as always, thanks for listening.