RALEIGH, NC – North Carolina ranks 38th overall when it comes to services available for our aging population, and AARP warns more must be done, at an accelerated pace, to meet changing demographic demands. Even worse, NC’s support for family caregivers, especially those in families with long-term diseases such as Alzheimer’s or Parkinson’s, ranks just eight slots from the bottom. This, according to a new, comprehensive state-by-state Scorecard from AARP with support of the nation’s leading organizations behind quality long-term care, The Commonwealth Fund and SCAN Foundation.
Picking Up the Pace of Change: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers –the third in a series of reports—ranks each state overall and on 25 specific indicators in 5 key dimensions: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers; and, effective transitions between nursing homes, hospitals and homes.
The Scorecard reveals that in less than 10 years, Boomers will begin to turn 80, placing new expectations and demands on a still imperfect long-term care system. Further, this generation will have far fewer potential family caregivers to provide unpaid help.
Long-term care (also called long-term services and supports) is a diverse set of services designed to help older people and those with disabilities; services can be provided in a person’s home, in a community setting such as an adult day center, or in a group residential facility like a nursing home.
Lawmakers have been trying to catch up, as evidenced by their embrace of recommendations from the state Alzheimer’s task force, yet funding remains the key sticking point. In comparison to most other states, NC has made little progress to improve long-term services and supports for older adults and people with disabilities, as highlighted in this Scorecard. Additionally, proposals in Congress to drastically cut federal funding for elderly programs served by Medicaid would threaten these advancements, likely resulting in our most vulnerable citizens losing the lifesaving supports that they count on,” says AARP North Carolina State Director Doug Dickerson. AARP serves more than 1.1 million members age 50 and older in the state.
“The vast majority of older North Carolinians want to live independently, at home, as they age—most with the help of unpaid family caregivers,” says Dickerson. “If community services aren’t available to them, many will likely become nursing home residents, something they usually don’t want and the state would be hard-pressed to afford. It’s more cost efficient for states to fund Medicaid supports for people to stay at home than to wait for people to move into nursing facilities that cost Medicaid up to nine times more. This Scorecard shows we have more to do, and we need to pick up the pace.”
Today, unpaid family caregivers provide the bulk of care for older North Carolinians, in part because the cost of long-term care remains unaffordable for most middle income families. In North Carolina, more than 1.2 million residents help their aging parents, spouses and other loved ones stay at home by providing assistance with bathing and dressing, transportation, finances, complex medical tasks like wound care and injections, and more. The value of this unpaid care in NC totals about $13.4 billion a year.
“When it comes to helping older residents live in the setting of their choice, family caregivers take on big responsibilities,” explains AARP State President Dr. Catherine Sevier who is also a nurse practitioner. “Many juggle full-time jobs with their caregiving duties; others provide 24/7 care for their loved ones. With every task they undertake, these family caregivers save the state money by keeping their loved ones out of costly nursing homes – most often paid for by Medicaid. They have earned some basic support.”
According to the state Scorecard, North Carolina needs to take action to improve legal and system supports for this group such as allowing nurses to delegate basic health maintenance tasks, like checking blood sugar or temperatures, to home aides. But, more must be done.
That’s why AARP North Carolina is fighting for better supports for aging families and family caregivers such as legislation to improve hospital transitions by including the family caregiver as the frontline of defense against unnecessary and hospital readmissions and to improve patient outcomes. The legislation known as the Caregiver, Advise, Record, Enable (CARE) Act has already passed in 36 states, Washington, D.C., Puerto Rico and the U.S. Virgin Island. This AARP model bill will help family caregivers when their loved ones go into the hospital, and as they transition home. Specifically, the CARE Act will require hospitals to:
- Record the name of the family caregiver when their loved one is admitted.
- Notify the family caregiver when their loved one is to be moved or discharged.
- Give instructions of the tasks the family caregiver will need to perform while caring for their loved one at home.
AARP has also asked the General Assembly to provide increased recurring funds for home and community based services for aging communities, modernize outdated rules to broaden scope of practice, so nurse practitioners will be able to do their jobs better, using all their advanced training and skills to care for patients—when and where care is needed.
“By delegating basic health maintenance tasks to home aides, nurses will have more time and opportunity to focus on treating their patients, and support family caregivers,” Sevier said.
Dr. Sevier concluded, “This Scorecard gives us a snapshot of how well North Carolina serves our older residents, those with disabilities, and family caregivers—and shows us where we must sharpen our focus to better assist hardworking families. Now is the time for policymakers to act. Fully implementing the State Strategic Plan to Address Alzheimer’s and Related dementias should also be a priority of the State Legislature.”
The full state Scorecard, along with an interactive map of state rankings and information, is available at www.longtermscorecard.org.