Suchergebnisse

This article originally was prepared as a resource guide to assist the nation's Area Agencies on Aging as they begin developing or expanding services for the caregivers of older adults. A seminal question they face is how to provide case management service for this particular target population. The article reviews the literature on case management service generally, including its goals, functions, models, and outcomes. Its primary purpose, however, is to explicate the specific issues for providers to consider when planning and implementing case management service for caregivers. The article concludes with recommendations based on the results of evaluation research to maximize the benefits of caregiver services.

Objective: Many people with mental disorders are cared for by informed caregivers, but they usually have limited care-related training and lack caregiving capacity and support networks. In order to provide professional training and social support for informed caregivers, we designed the Caregivers-to-Caregivers Training Programme (C2C) and performed a pilot study to assess its effect. Methods: Caregivers of persons with mental disorders who participated in the C2C were asked to participate in a quasi-experimental study to assess their knowledge and skills development, self-care ability, trainer engagement, and training content. A total of 800 participants completed self-designed evaluation questionnaires and two open-ended questions to gather suggestions and feedback. Assessments were carried out at pretest (baseline), post-test, and at 2-month follow-up. Results were analyzed using one-way repeated measures analysis of variance (ANOVA) and pairwise comparison method. Results: At post-test, 667 assessments were considered valid and 515 were deemed valid at 2-month follow-up. One-way repeated-measures ANOVA showed that the main effect of the scores on knowledge and skills development and self-care ability from baseline to 2-month follow-up was significant ( p < .001). Results of pairwise comparison method showed that the scores on each item of knowledge and skills development and self-care ability at post-test and at 2-month follow up were higher than those at baseline ( p < .001). The scores on items of trainer engagement and training content were all above average (4/5). The open-ended questions resulted in 678 comments indicating that participants gained significant support from other caregivers and healthcare professionals in the alliance and wanted more and continuously updated material. Conclusion: This study demonstrated that C2C effectively improved the development of caregivers' knowledge, skills, and their self-care ability. Available social support for caregivers was better than average, including professional support and peer support.

The Great Recession has hit home-based workers like Flora Johnson of Chicago (who cares for her adult son who suffers from cerebral palsy) with a triple whammy. The housing and mortgage crisis threatened their very workplace -- their homes or the homes of those they cared for; the fiscal crisis of the state led to cuts in funds that paid their wages through long-term care programs; and the conservative political backlash and Republican ascent of 2010 opened an assault on their hard-won collective bargaining rights, wage increases, and recognition as "workers." Poor black women like Johnson have long cared for the elderly, ill, and disabled -- whether in their own homes or in the residences of others. Sometimes, they do it out of love; many have referred to care work as "a calling." Often, it is the best job they can find. In Chicago, African Americans dominate this workforce. Elsewhere in the United States, Latinas and other recent immigrants make up a third of those who perform daily tasks -- bathing bodies, brushing teeth, putting on clothes, cooking meals -- that enable people to live decently in their own homes. These workers are America's frontline caregivers. Home care workers earn just a bit more than the minimum wage and historically have had little or no job security, health benefits, or even workers' compensation. Adapted from the source document.

Faced with cuts in programs and stripped of their bargaining rights, home care workers are trying to maintain the activist vigor of their scrappy past, which won union recognition and contracts from reluctant state authorities. FloraJohnson and her sister workers took heart from the Occupy Wall Street protests that swept Chicago this last fall. "We're tired of these big banks and the rich people getting rich and poor people getting poorer. But we're sending a message." Her union members are even willing to go to jail for the cause. After all, their houses are not only homes but also their workplaces; without homes, there can be no home care workers and thus no fight for better work. This merger of home and work turns the foreclosure threat faced by other poor people into a particularly acute crisis.

As a nation, we seem to believe that only through cheap labor can we "afford" to provide long-term care. We think about the needs of recipients but not about those who do the work. The Great Recession and Republican ascendancy are shaking the very programs that made home-based services possible. Can we let these forces make life more precarious for all of us? A majority of Americans will at some point depend on a care worker, often one who has long labored in poverty and struggled to balance her own and others' social needs. The absence of public support and labor standards may hasten the day when no one will be available to care.