STATEMENT OF MARY JANE KEGELMAN, PROGRAM DIRECTOR, INDEPENDENCE PLACE OF WHITING Ms. KEGELMAN. Thank you very much. An estimated 7 million to 8 million adult Americans are now providing personal care to their parents, spouse, in-laws, or other elderly relatives, and an estimated 20 to 25 percent of the employees at any typical U.S. company spend 6 to 35 hours a week on responsibilities to the elderly, equivalent to a second full-time job. The burden placed upon women is particularly great. Three out of every four family caregivers who tend to the needs of the elderly are women, according to a recent study that was sponsored by the American Association of Retired Persons. That same study found that more than half of these women provide this care while holding down full- or part-time jobs, and nearly 40 percent are simultaneously raising children of their own. We had testimony right here today to this. Statistics show that while these women spend an average of 17 years caring for their children, they can expect to devote 18 years in caring for an elderly parent. Americans caught between caring for both young and old are called the "sandwich generation," and this group is growing larger by the day as life expectancy increases. Over the next 10 years Americans age 65 and older will increase by 11 percent, while those age 85 and older will increase 42 percent. As more people live into their seventies, eighties, and beyond, more of them will become chronically ill, or possibly infirm, and services must be available to meet their needs. Respite care is one of a number of strategies designed to prolong the continued community residence of the disabled aged. Respite services can be described as a service or group of services that provide caregivers periods of relief and rest away from the patient. The goal of relieving strain on family caregivers is usually linked to the program goal of avoiding or delaying nursing home admissions, thereby reducing the economic costs of care. One of the services available under the Statewide Respite Care Program in New Jersey is adult day care. Adult day health care is a coordinated program of health and social services, provided in a home-like setting to elderly and frail adults with physical or mental impairments. Adult day health care provides working caregivers with a positive, sensible, and cost-effective community-based approach to caring for older adults with health limitations. Of equal importance, the support and respite offered by adult day health care enables working caregivers to be more healthy, productive employees. The overall goal of adult day health care is to promote the independence of the older person to the highest degree possible. Day care is a structured program of coordinated social and health-related services in a protective setting during any part of a day, but less than 24 hours. Providing direct care and supervision, this program addresses individual client needs and is oriented toward prevention, maintenance, or rehabilitation of persons who, due to physical, social, or mental impairment, require community-based supportive services to prevent or delay institutionalization. Individuals who participate in adult day care attend on a planned basis during specified hours. Adult day care assists its participants to remain in the community, enabling families and other caregivers to continue caring for an impaired member at home. As to the typical services of adult day health care, we provide or arrange transportation to enable the clients to attend our centerswe will come directly to your home, pick up our clients, and bring them to the center; we develop a specific client day care plan and goals appropriate to the client's individual functioning status and limitations; nursing services, including but not limited to evaluation of the client's needs, routine health monitoring, and supervision or administration of medication; assistance, as needed, with activities of daily living, such as walking, eating, toileting, and personal care. We will even provide bladder and bowel training programs. A daily meal is provided, and supplementary snacks. Your activity program includes reality orientation. These are activities that are designed to promote the client's awareness of time, space, objects, and persons; resocialization and stimulation; activities to encourage and assist clients to interact with staff and other people; and supportive counseling, which is active listening, attention to the person's needs and suggestions, and guidance to help them interact with others. Social services will be provided to the clients and the families. This will include psychosocial counseling, information, and referral. Adult day health centers offer a special place for daytime care of adults who need professional supervision but do not need 24-hour institutional care. They offer fun, friendship, and acceptance to frail or disabled persons who might otherwise be isolated with their problems. We health professionals have been increasingly concerned that the stresses experienced in caring for a disabled family member may erode the capacity of families to continue providing these much-needed services. Family caregivers may be overburdened and severely distressed. Spouses may be at a greater risk of burden and distress because they possibly are elderly themselves and are likely to have diminished physical capacity for demanding caregiving. Alzheimer's disease and the related dementia disorders are thought to be particularly distressing to caregivers by virtue of the behavior disorders and rapid decrease in functional capacity of the family member. Adult day health centers provide families and others with assistance, support, and relief from the demands of constant caregiving, as well as helping cognitively impaired older adults to maintain their level of functioning and enhance their quality of life. As the director of an adult health center, Independence Place in Whiting, I have found that the Statewide Respite Care Program has increased the caregivers' quality of life, has reduced the economic burden upon the caregivers, and enabled working caregivers to be more healthy and productive employees and, most importantly, assisted cognitively and physically impaired older adults maintain their maximum level of functioning. Without the Statewide Respite Program, many of these families would not be able to obtain the much-needed services that are available under this program. Your elderly caregiver possibly would become physically and emotionally drained, and might possibly become ill themselves. Instead of one frail elderly person, we now would have two, both in need of services. Adult day health care is cost-effective and has proven to prolong community residence. So look at frail elderly and disabled persons that are caregivers, and the Statewide Respite Program. Put them together, and it works. I just have one other thing, Senator Bradley, that I would really like to say to you. I'm not too sure if too many people are aware that Senator Bradley is the sponsor on the Medicare bill for adult day health care. This is an article that was written in a magazine, New Jersey Success, and according to this, what he is cosponsoring is 100 days under Medicare to pay for adult day care. What we are looking at here is more availability of services, more people who would be able to be provided with their great needs. I am going to end my summation on day care and quote you, Senator Bradley. You state here, "Day care programs promote seniors' maximum level of independence by emphasizing their strengths and abilities rather than their impairments and limitations." I couldn't have said it better myself. [Laughter.] [The prepared statement of Ms. Kegelman follows:] FROM: Mary Jane Kegelman, M.S.W. Independence Place of Whiting If you have a parent alive today, sooner or later that parent will need help. It may be financial, medical or emotional. Often it is all three at once. This will have an intense effect, not only on you but your entire nuclear family. An estimated 7 million to 8 million adult Americans now provide personal care to their parents, in-laws or other elderly relatives. And an estimated 20% to 25% of the employees at any typical U.S. company spend six to 35 hours a week on responsibilities to the elderly equivalent to a second full-time job. The burden placed upon women is particularly great. Three out of every four family caregivers who tend to the needs of the elderly are women, according to a recent survey sponsored by the American Association of Retired Persons. The same study found that more than half of these women provide this care while holding down full or part time jobs. Nearly 40% are simultaneously raising children of their own. Statistics show that while these women spend an average of 17 years caring for their children, they can expect to devote 18 years to caring for an elderly parent. Americans caught between caring for both young and old are called "the sandwich generation", and this group is growing larger by the day as life expectancy increases. Over the next 10 years, Americans age 65 and older will increase by 11%, while those age 85 and older will increase 42%. As more of our parents live into their seventies, eighties and beyond, more of them will inevitably become chronically ill or infirm. The following are some facts demonstrating the impact which family caregiving to older adults has had on the workplace. Consider these facts in the context of demographic trends which indicate an aging, shrinking workforce with an increasing number of females: According to the 1989 AARP and Travelers Insurance - A 1989 Fortune Magazine/John Hancock survey found that Public and private surveys indicate that a substantial RESPITE CARE is one of a number of strategies designed to prolong the continued community residence of the disabled aged. RESPITE SERVICES can be described as a service or group of services that provide caregivers temporary periods of relief and rest away from the patient. The goal of relieving strain on family caregivers is usually linked to the program goal of avoiding or delaying nursing home admissions, thereby reducing the economic costs of care. Services available under the Statewide Respite Care Program in New Jersey include: Companion Services Homemaker/Home Health Aides Temporary Out-of-Home Care in a Medical Facility Social Adult Day Care Adult Day Health Care Adult Day Health Care is a coordinated program of health and social services provided in a home-like setting to elderly and frail adults with physical or mental impairments. Adult Day Health Care provides working caregivers with a positive, sensible and cost-effective community-based approach to caring for older adults with health limitations. Of equal importance, the support and respite offered by Adult Day Health Care enables working caregivers to be more healthy, productive employees. Let me tell you about two families that have benefited from the Statewide Respite Program and Adult Day Health Care in particular. Five years ago, Ellen's mother, Alice, was no longer able to take care of her own personal needs, shopping or cooking. Ellen felt that it would be best for her mother, Alice, to move in with her, as Ellen could be sure that she ate well, saw her physician when needed, and had the family to provide her with social stimulation. As the years past and Alice began showing signs of forgetfullness and increasing confusion, the new living arrangements became more difficult and stressful on the family, particularly Ellen. When Alice was admitted to the hospital for pneumonia, a social worker discussed with Ellen the increasing difficulties in caring for Alice at home. Ellen had been losing an increasing amount of time from her job and had even contemplated quitting. This would be a financial burden upon her and her family, but she felt she had no other recourse. Ellen did not want to place her mother in a nursing home but preferred to find some alternative types of care. She was referred to Barbara Wolfson, case manager for the Ocean County Statewide Respite Program. |