Posts Tagged ‘adult day-care’

Formal Elder Care Programs Not In Most Business’ Future

AUGUST 7, 1995 VOLUME 3, NUMBER 6

When shoemaker Stride Rite, in 1971, became one of the first corporations to offer a sponsored day care program for employees’ children, it was hailed as a futuristic move. Now such programs are fairly common in many industries.

Almost twenty years later, Stride Rite became a leader once again with a program to provide adult day care for employees’ parents and other family members. The move was once again seen as forward-looking and the wave of the future. Now it looks like the future is not shaping up as expected.

This fall Stride Rite will move its corporate offices from Cambridge to Lexington, Mass. When it moves, it will not be recreating the five year old adult day care program.

The company cites low enrollment in explaining its decision not continue the elder care program. In an article in last weeks Wall Street Journal, Stride Rite executives and other experts are quoted as indicating that the anticipated use of elder care programs simply has not materialized, and that employees have consistently demonstrated a preference for other types of assistance with care of elderly relatives.

No one questions the significance of the problem. The costs to employers when staff members must provide care for family members are well-documented and substantial. It turns out that the solutions are probably not in day care programs but in alternative work structures.

Experts list these consistent elements of successful elder care programs run by employers:

  1. Flexible scheduling for employees who need to be available in emergencies.
  2. Resource (information and referral) services available to employees.
  3. Elder-care seminars and other mechanisms to provide information and planning options for employees about to face increased demands for care.
  4. Long-term care insurance options for employees and family members (including, in some instances, parents).
  5. Strong organizational support for caretaking employees and their need for information.
  6. Involvement with community advocacy and care-giving groups.

One example of these strategies in the local market: Hughes Missile Systems Company has provided informative seminars and information-and-referral services to employees for many years. While it is difficult to quantify the financial reward to Hughes from this program, the company believes it has a significant positive effect and is committed to continued support.

Arizona White House Conference on Aging

FEBRUARY 27, 1995 VOLUME 2, NUMBER 34

The Arizona White House Conference on Aging held in Phoenix last month dealt with issues facing the full White House Conference on Aging when it meets in May. Arizona’s delegation dealt with several issues expected to dominate the national aging agenda.

Long Term Care

Everyone knows that the proportion of elderly citizens is expected to grow dramatically in the next two decades. What many do not appreciate is that the greatest growth is projected for the “old old”; those over age 85. Currently one-quarter of all women (but only one-seventh of men) over age 85 live in nursing homes. Those who turn 65 in any given year have about a 40% chance of spending some portion of the rest of their lives in a nursing home. About 10% of those will spend five or more years there.

Another tremendous segment of the population requires long-term care, but receives care at home. About 70% of all long-term care of the elderly is provided solely by family and friends, without institutionalization.

For those who can be cared for at home, the cost of assistance may be prohibitive. Simply bringing an aide into the home three times a week for meal preparation and light housekeeping can easily cost in the range of about $600 per month. Since about 20% of Arizona’s elderly live at or near the federal poverty level, even such small assistance may be unaffordable.

For those placed in nursing homes in Arizona, the cost of care will typically vary from $30,000 to $40,000 per year. Many seniors expect Medicare to pay some portion of that cost; in fact, Medicare pays only about 3% of the total nursing home bill in this country. Private long-term care insurance (still a relative rarity) and Veteran’s benefits account for another percent or two each; the remaining portion of long-term care costs are paid roughly equally by Medicaid and patient’s private savings and income.

Although nursing homes care for less than one-fifth of those requiring long-term care, they are responsible for more than half of the cost of care. Seniors are reluctant to enter the nursing home, and much prefer to be cared for (and die) in their homes.

Cost effective alternatives to institutionalization exist, especially in urban areas. Adult day care, respite care, hospice and assisted housing programs can keep many nursing home candidates in less expensive settings and more comfortable. Unfortunately, such programs are too rare and are seldom funded by public dollars. Paradoxically, it becomes less expensive for most patients to move into the nursing home and qualify for Medicaid (ALTCS in Arizona) than to secure care at home or in a more home-like setting.

Standards for Adult Day Care Centers

JANUARY 10, 1994 VOLUME 1, NUMBER 8

From The Wall Street Journal, January 6, 1994

“An adult day-care boom propels a move to set up a national accrediting system.”

Adult day-care centers have multiplied tenfold since the mid-1980s to an estimated 3,000 nationwide, and the trend is expected to continue as more parents of employed baby boomers reach ages at which they need daytime care. Many employers have begun providing referrals to adult day care and other services to aid the estimated 20% of workers who care for aging relatives

But only about half the states regulate adult day-care centers, and quality is uneven. Facilities range from high-quality centers offering health care and educational, exercise, cultural and social programs, to warehouses where aged and emotionally ill people are thrown together to spend most of their days watching television.

Now, the National Council on Aging, with partial funding from American Telephone and Telegraph and two of its unions, has begun setting up an accreditation program to encourage centers to upgrade quality and help consumers find high-quality care.

The council is training aides at adult day-care centers in five states and urging state organizations of center directors to embrace uniform quality standards, says Donna L. Wagner, the council’s vice president, programs. By 1996, the National Institute on Adult Day Care, a council unit, plans to endorse centers based on quality of programs and staff.”

Guardianship and Divorce

It occasionally happens that an incapacitated person needs to be divorced from his or her spouse. This may be because the spouse is abusive, because benefits have been reduced or because the spouse refuses to cooperate in applying for benefits, for instance. Until recently, it was not clear what steps could be taken to secure a divorce in such cases.

In the recent case of Ruvalcaba v. Ruvalcaba (174 Arizona 436, 1993), the Arizona Court of Appeals addressed this question. Mrs. Ruvalcaba’s mother became her guardian after she suffered a serious head injury and entered a coma. Mrs. Ruvalcaba ultimately recovered from her coma, but continued to suffer from amnesia and remained unable to make her own medical decisions or living arrangements.

Mrs. Ruvalcaba’s mother, fearing that her daughter’s husband would become abusive, determined that it would be in her ward’s best interest to pursue a divorce. She initiated the proceedings on her daughter’s behalf. Her daughter’s husband objected, alleging that the power to start a divorce is too personal to be delegated to a guardian. The Court of Appeals disagreed, and held that a guardian may pursue a divorce on her ward’s behalf. The Court cited Rasmussen v. Fleming, the Arizona “right-to-die” case, to show that very personal rights may be exercised by a guardian.

The guardian also sought custody of the couple’s minor children for her incapacitated daughter. The Court permitted this, indicating that the best interests of the children might be served by leaving them with their mother (and grandmother)!

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