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New Scorecard Ranks Connecticut on Support for Seniors, Caregivers

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When it comes to support for seniors and caregivers, it matters where you live.  According to a new, comprehensive state-by-state Scorecard from AARP  and the nation's leading organizations behind long-term care, Connecticut ranks 12th in the nation when it comes to meeting the long-term care needs of older residents and people with disabilities.  While that number may seem pretty good, we know that more must be done, at an accelerated pace, to improve specific areas, including more support and training for family caregivers, and easing patient transitions to and from the hospital or a skilled nursing facility. 

“The vast majority of older Connecticut residents want to live independently, at home, as they age – most with the help of unpaid family caregivers,” says Nora Duncan, state director of AARP Connecticut, which serves nearly 600,000 members age 50 and older in Connecticut. “Even facing tight budgets following the Great Recession, Connecticut is making clear progress to help our older residents achieve that goal. However, this Scorecard shows we have more to do – and with a predicted ‘silver tsunami’ sweeping over our state in the next 20 years, the time to act is now.” 

Raising Expectations 2014: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers  – an update of the inaugural 2011 Scorecard – ranks each state overall and within 26 performance indicators along five key dimensions: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers; and, effective transitions.  New indicators this year include length of stay in nursing homes and use of anti-psychotic drugs by nursing homes, raising serious concerns about the quality of institutional care.  The Scorecard was complied by AARP with support from The Commonwealth Fund and SCAN Foundation. 

Today, unpaid family caregivers provide the bulk of care for older Connecticut residents, in part because the cost of long-term care remains unaffordable for most middle income families.  In Connecticut, more than 486,000 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 totals about $5.8 billion.

“When it comes to helping older Connecticut residents live in the setting of their choice, this silent army of family caregivers assumes the lion’s share of responsibility,” explains Duncan. “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, a majority of family caregivers (59.4%) face a degree of stress and worry.   Connecticut needs to take action to improve legal and systems supports for this group.  According to Duncan, “Connecticut has made strides in recent years in rebalancing our long-term care system to provide more access to home and community based care, and to pass laws that will help ease some of the burden on family caregivers, but more must be done, especially to support family caregivers so they can continue to provide care for the ones they love.”

In addition, Connecticut ranks dead last (51) when it comes to the percent of home health patients with a hospital admission.  This signifies a need for more resources and training for family caregivers - especially around complex medical tasks - so that their loved ones don't end up back in the hospital and can continue to live independently at home.      

AARP Connecticut fought successfully in 2014 to expand nursing scope of practice, and in 2013 to allow nurse delegation of specific medical tasks to home health aides - two key indicators measured by the Scorecard.  And it’s why we'll continue to fight for additional supports in the future, including caregiver workplace protections, respite care and changes in hospital practices that can help smooth patient transitions and prevent costly re-hospitalizations.  

The single strongest predictor of a state’s long-term care system is the reach of its Medicaid long-term care safety net.  That’s why AARP also supports continued efforts to expand services provided at home and in the community, by shifting funds away from undesirable and more expensive nursing home care. The Scorecard also highlights concerns about institutional care in Connecticut, such as: use of antipsychotic medication and the high number of nursing home residents with low care needs -- needs that could be served at home or in the community.

According to the Scorecard, Connecticut ranks 29th in the percent of Medicaid long-term care dollars that support care provided at home and in the community – the care setting that most residents prefer.  The Scorecard spotlights specific areas that call for improvement, including:

• Percent of home health patients with a hospital admission;
• Percent of nursing home residents with low care needs;
• Percent of people with 90+ day nursing home stays successfully transitioning back to the community.
• Family caregivers without much worry or stress, enough time, well-rested;

“This Scorecard gives us a snapshot of how well our state serves our older residents, those with disabilities, and family caregivers – and shows us where we must sharpen our focus to better assist hardworking Connecticut residents,” concludes Duncan. “Now is the time for policymakers to act.”

Of the 26 Scorecard indicators, 13 may be improved through state policy changes, pointing to the importance of AARP’s multi-state advocacy campaign, launched this year, to help older Americans live independently, at home, and the family caregivers that support them. 

The Scorecard reveals, “In just 12 years, the leading edge of the Baby Boom Generation will enter its 80s, placing new 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. 

The full state Scorecard, along with an interactive map of state rankings and information, is available at www.longtermscorecard.org.

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