New Scorecard Give South Carolina Middle Ground Marks for Serving Older Residents

South Carolina ranks 34th  in meeting the long-term care needs of older residents, however, AARP feels more must be done to improve support for family caregivers, effective transitions, and home and community based services.  This report is the second 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.

“The vast majority of older South Carolina residents want to live independently, at home, as they age – most with the help of unpaid family caregivers,” says Teresa Arnold, South Carolina state director of AARP South Carolina, which serves more than 580,000 members age 50 and older in South Carolina. “Even facing tight budgets following the Great Recession, South Carolina is making clear progress to help our older residents achieve that goal,” said Arnold.  “Our legislators recognized this need and over the last two years added $6 million for services that help folks remain independent.”

“Another vital support is respite care, which helps family caregivers who are on call 24 hours a day, seven days a week, by giving them a hard-earned, well-deserved break – allowing them to recharge and continue the essential role they serve in safely caring for their loved ones,” said Arnold.  Family caregivers often put aside their own needs – skipping doctors’ appointments, developing poor eating habits, and not getting enough sleep.  This week the General Assembly took action for family caregivers by overriding the Governor’s veto of $2 million for respite vouchers.

“The Scorecard shows significant improvement in the number of home health and personal care aides from  2009 to 2012 and this new state funding will help us to continue this positive trend,” said Arnold.  South Carolina ranked in the top five states for the lowest percentage of nursing home residents with low care needs. “This is a tribute to family caregivers who help their loved ones remain at home.”

Today, unpaid family caregivers provide the bulk of care for older South Carolinians, in part because the cost of long-term care remains unaffordable for most middle income families.  A 2014 AARP South Carolina caregiving report showed more than 55% of registered voters age 45+ are current or former caregivers. About 54% think they will likely be caregivers in the next five years.

In South Carolina, there are more than 770,000 caregivers who help 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 $7.4 billion.

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 reveals that 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.

“When it comes to helping older South Carolinians live in the setting of their choice, this silent army of family caregivers assumes the lion’s share of responsibility,” explains Arnold.  “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.”

To address all these issues, Governor Haley charged a Long Term Care Task Force to assess the long-term care system in South Carolina.  The overall goal is to establish a strategic direction that meets the future needs of the system and those it serves.  The taskforce consists of experts, practitioners and stakeholders from across the state and will identify priority areas that are in need of improvement, particularly in light of the growing older adult population and will research best practices from South Carolina and across the country.  The long-range goal will be to present actionable recommendations to policymakers that promote greater return on investment and to offer a broad vision for affordable, accessible and high-quality services enabling older adults and people with disabilities to live with dignity.

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

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.