How New Tech Can Support Caregivers as They Support Seniors

Up to 42% of Americans over the age of 65 take five or more medications, and in 2018, at least one in every five seniors experienced an adverse drug reaction. Such reactions are more common when seniors can’t properly adhere to the instructions that accompany their prescriptions.

In fact, according to U.S. Pharmacist, nonadherence accounts for about half of treatment failures and a quarter of hospitalizations every year. This, combined with the fact that healthcare providers are largely overwhelmed and overburdened, means caregivers have a unique opportunity to improve senior health outcomes. Caregivers can act as an extension of the medical industry to help seniors overcome the hurdles they face when it comes to medicating themselves properly.

Why Medication Adherence Is Challenging for Seniors

Experts agreed that the therapeutic efficacy of any medication requires an adherence rate of 80% or higher. To medicate properly, seniors must closely follow the instructions on each drug’s label and keep a consistent routine around consuming the right doses to avoid complications.

Unfortunately, the current average for medication adherence for chronic health conditions is only about 50%. For most patients, this isn’t enough to improve or stabilize their conditions — much less boost their life expectancy. But nonadherence is often a combination of hurdles that can be difficult for seniors to overcome on their own.

For example, the instructions on drug packaging may be confusing, and age-related memory loss can lessen the chances of proper adherence. The side effects of certain medications may also be uncomfortable, making patients hesitant to stick with them. Overall, keeping track of when and how to take various medications can be overwhelming for anyone.

The Important Role of Caregivers

Daily routines and medical schedules can be much easier for senior patients to adhere to with the assistance of a caregiver. As caregivers, a patient’s family members, friends, loved ones and volunteers can help ensure seniors take their prescriptions as directed and eat regular meals. What’s more, they can better monitor changing behaviors or symptoms that could indicate a poor reaction to medications.

Because the healthcare system is becoming increasingly overburdened, healthcare providers don’t always have the time or means necessary to devote to helping patients adhere to medications. Instead, the healthcare system should focus on providing caregivers with tools they can use to make senior care more manageable, especially when it comes to drug adherence. This will become even more necessary as the senior population grows.

The following tools can help caregivers address the medication adherence problem plaguing American seniors:

  • Automated medication dispensers: Medication dispensers have come a long way — from manually organized pillboxes to modern, automated dispensers that ensure people get the prescriptions they need. One of the most valuable aspects of automated medication dispensers is that they can sync with a mobile application to alert caregivers of missed doses and low prescriptions.
  • Personalized medication reminders: Medical alert systems and healthcare apps — or even simple reminders on a smartphone calendar — are vital to helping seniors prevent missed doses. Some apps are more detailed than others, so consider whether simple reminders will suffice or whether caregivers should receive confirmations as well.
  • Home delivery of presorted medications: In terms of convenience, having presorted medications delivered directly offers a critical advantage for both seniors and caregivers. Automated delivery systems can be synced with medication reminders to create a convenient, holistic routine that makes adherence more accessible than ever.

When Medication Adherence Is Easier

There are very clear, immediate benefits to practicing better medication adherence — the most obvious being the success of the medication. Data suggests that for every 10% improvement in medication adherence, healthcare costs can be reduced by 29%.

Adherence also has a halo effect on other aspects of a patient’s life, improving chances of eating healthy, exercising regularly and taking one’s own personal wellness journey more seriously. Better adherence is key to improving seniors’ quality of life and reducing the burden on the healthcare system, and caregivers are in a great position to help make it happen when armed with the right tools.

Ninety-Two Percent of Caregivers Are Financial Caregivers

A Merrill Lynch study, conducted in partnership with Age Wave, finds that the 40 million family caregivers in the U.S. spend $190 billion per year on their adult care recipients. Despite the financial, emotional and functional challenges in this life stage, preserving the dignity of their loved one is their primary goal. The vast majority of caregivers (91 percent) are grateful they could be there to provide care, and 77 percent say they “would gladly do so again.”

“As tens of millions of people take on caregiving responsibilities each year, supporting those caring for our aging population has become one of the most pressing financial issues of our lifetime”

Family caregivers are America’s other social security, providing the bulk of long-term care today. The aging of the baby boomers will result in unprecedented numbers of people in America needing care. As a caregiving crunch is upon us, “The Journey of Caregiving: Honor, Responsibility and Financial Complexity” offers an in-depth look at Americans’ financial and emotional journeys during this life stage. This study marks the beginning of a new, multiyear research series from Merrill Lynch and Age Wave that will examine five distinct life stages: early adulthood, parenting, caregiving, widowhood, and end of life.

As the first of the series, this study examines the responsibilities, sacrifices, and rewards of caregiving – a life stage that nearly all Americans will participate in, as a caregiver, care recipient or both. This study comprehensively explores the topic of financial caregivers – a role largely unexamined, yet held by 92 percent of caregivers. Financial caregiving involves contributing to the costs of care and/or coordinating or managing finances for a care recipient.

The study is based on a nationwide sample of more than 2,200 respondents, including 2,010 caregivers. Key findings about their caregiving journey include: Paying bills from their recipient’s account (65 percent), Monitoring bank accounts (53 percent), Handling insurance claims (47 percent), Filing taxes (41 percent), Managing invested assets (21 percent).

  • Much more than hands-on care. Providing emotional support (98 percent), financial caregiving (92 percent), household support (92 percent) and care coordination (79 percent) far outweigh physical care (64 percent).
  • Financial costs – with little discussion of their ramifications. Seventy-five percent of financial contributors and their care recipients have not discussed the financial impacts of these contributions.
  • Caregiving for a spouse vs. for a parent. A spouse is 3.5 times more likely to be the sole caregiver looking after a care recipient and is more likely to spend more out of pocket on care-related costs. Their caregiving journey is also different in terms of the obligations and financial interdependencies they hold with their loved one.
  • Caregiving gender gap. Both for cultural and biological reasons, women are more commonly caregivers for spouses and parents, averaging six years of caregiving in their lifetime versus four years for men. As a result, women are disproportionately impacted by the challenges of caregiving, including struggling to balance responsibilities and making career sacrifices. And then, more find themselves alone and without someone to care for them when needed.
  • Responsibilities extend beyond the care recipient’s life. Sixty-one percent of the time, caregivers expect their role will end with the death of their loved one. However, the complexities of financial, legal, and other aspects of caregiving often continue for months or even years.

“As tens of millions of people take on caregiving responsibilities each year, supporting those caring for our aging population has become one of the most pressing financial issues of our lifetime,” said Lorna Sabbia, head of Retirement and Personal Wealth Solutions for Bank of America Merrill Lynch. “Greater longevity is going to have a profound impact on the caregiving landscape and calls for earlier, more comprehensive planning and innovative solutions to address the health and long-term care needs of our loved ones.”

Financial caregiving: Navigating complexity and responsibility
The study finds that 92 percent of caregivers are also financial caregivers, and are contributing to and/or coordinating finances for their loved one. In fact, after two years of receiving care, 88 percent of care recipients are no longer managing their finances independently.

Financial caregiving is often far more complex than simply contributing to the recipient’s care. Financial caregivers are responsible for a wide variety of tasks, including:

  • Health care rises as top challenge. Respondents find that navigating health insurance expenses is the top challenge of financial caregiving (57 percent).
  • Uncharted territory. An estimated 49 percent of financial caregivers don’t have the legal authorization to perform their role.
  • Guidance and resources lacking. Sixty-six percent of caregivers feel they could benefit from financial advice.

Costs and compensations of caregiving
While some aspects of caregiving may feel like a burden, those surveyed also tell us it is a blessing. Contrary to all we hear about the stress and sacrifices of caregiving, for many caregivers, the role is also often associated with a range of positive experiences and rewards. Caregivers describe a complex, demanding yet often nourishing journey – defined by honor, gratitude, fulfillment, purpose, and strong family bonds.

Costs:

  • Nearly three quarters of respondents say they’ve made numerous sacrifices as a caregiver – whether familial or professional.
  • Fifty-three percent have made financial sacrifices to compensate for caregiving expenses. Thirty percent of caregivers say that they have had to cut back on expenses, and 21 percent have had to dip into personal savings.
  • Two in five caregivers under the age of 64 have made sacrifices at work due to caregiving responsibilities, including reducing their hours (17 percent) and leaving the workforce (16 percent).

Compensations:

  • Caregivers feel rewarded knowing they are doing something good for someone they love – 61 percent say the greatest benefit of providing care is the sense that they have “done the right thing.”
  • Seventy-seven percent say they would gladly take on being a caregiver for a loved one again.
  • Forty percent report a strengthened bond between themselves and the care recipient, and 24 percent say caregiving brought their family closer together.
  • Eighty-six percent say watching their loved one’s health struggle was a motivator that caused them to place more value on taking care of their own health.

“Caregiving is one of today’s most complex life stages, throughout which hard work, high stress and heavy obligations intertwine with honor, meaning and resilience,” said Ken Dychtwald, Ph.D., CEO and founder of Age Wave. “This experience becomes even more emotionally complex and financially challenging when caring for loved ones suffering from dementia or Alzheimer’s. Even with that added burden, this study reveals that 65 percent say that being a caregiver brought purpose and meaning to their life.”

The crucial role of employers
Employers can play an integral role in supporting caregiving employees during this demanding life stage. While 84 percent of employers say caregiving will become an increasingly important issue in the next five years, only 18 percent strongly agree that their workplace is currently “caregiving-friendly”– underscoring the need for new approaches and solutions across the workforce.

“Meaningful, well-designed employer benefits can make a crucial difference in helping caregivers navigate the high stress of caring for a loved one and help them balance these responsibilities with the rest of their working and financial lives. Just as child care has been an issue in the past that led to revolutionizing HR benefits, the aging of the population means we need to consider how caregiving is becoming an increasingly important issue for employers and employees,” said Kevin Crain, head of Workplace Solutions for Bank of America Merrill Lynch. “These should include resources and programs focused on addressing caregiving complexities and employee networks that facilitate support from experts and peers.”

According to Crain, “Bank of America Corporation is committed to meeting the needs of caregivers in today’s transforming world. Companywide initiatives dedicated to addressing the needs of our country’s aging population and those of their caregivers include combatting elder financial fraud, increased awareness of cognitive decline and Alzheimer’s disease, and implementing caregiving best practices through training and resources for its financial advisors and corporate clients. The company supports our employees who are caregivers through a variety of resources including access to emergency back-up care for adults and children, professional elder care assessments, elder care law services, and an internal Parents and Caregivers employee network.”

Stressed Out Caregivers Are Using ER Visits for Respite, Study Finds

Emergency room staff call it a “pop drop” – when a disabled older person comes in for medical attention, but it seems like the person who takes care of them at home is also seeking a break from the demands of caregiving.

It’s been hard to actually study the phenomenon. A new University of Michigan study suggests that tired family caregivers are associated with greater ER visits and higher overall health care costs for the person they care for.

In a paper in the new issue of the Journal of the American Geriatrics Society, the team reports their findings from a study of 3,101 couples over the age of 65, each with one spouse acting as caregiver for their disabled partner.

The researchers looked at the Medicare payments and emergency department visits for the disabled spouses in the six months after the caregiver spouses took standard tests to measure their fatigue, mood, sleep habits, health and happiness.

Even after they took into account many factors, the researchers found that in just those six months, emergency department visits were 23 percent higher among patients whose caregivers had scored high for fatigue or low on their own health status.

Patients with fatigued or sad caregivers also had higher Medicare costs in that same time period: $1,900 more if the caregiver scored high for fatigue, and $1,300 more if the caregiver scored high for sadness, even after all other factors were taken into account.

The cost of unpaid help

“Many of us who work in clinical settings feel that patients with high home caregiving needs, such as dementia, often rely on the medical system as a source of respite for their spouses or other caregivers, because other respite isn’t paid for,” says lead author Claire Ankuda, M.D., M.P.H. “But there hasn’t been a lot of data about it, and only recently has our society been talking about caregivers and potential ways to incentivize and support them as a way of keeping patients living at home.”

Ankuda, who led the study during her time at in the Robert Wood Johnson Clinical Scholars program at U-M’s Institute for Healthcare Policy and Innovation, is now training in palliative care at the Icahn School of Medicine at Mount Sinai.

“Informal caregivers, including spouses, enable older adults with functional disability to stay out of the nursing home and live at home where they’d prefer to be,” says senior author Deborah Levine, M.D., M.P.H., an assistant professor of internal medicine and neurology at U-M.

We need to do a better job of identifying and supporting caregivers experiencing distress, in order to help caregivers feel better and hopefully improve outcomes in older adults with disability.” Deborah Levine, M.D., M.P.H.

Long-term data gives key insights

The couples in the study were all taking part in the long-term Health and Retirement Study, conducted by the U-M Institute for Social Research on behalf of the National Institutes of Health. Ankuda, Levine and their colleagues probed HRS data because it allowed them to correct for factors that other, short-term studies can’t – such as the baseline level of Medicare costs, demographic differences including income and education, and even whether the couples have adult children living nearby.

The findings add hard new data about the link between caregivers’ own experiences and the amount the Medicare system pays to take care of those the caregivers take care of at home.

Nearly 15 million older adults get help with everyday activities from spouses and other family or friend caregivers. In the new study, the researchers included couples where one spouse got help from the other with activities such as bathing, dressing, walking, getting into or out of bed, shopping, cooking, and taking medications.

Helping with these tasks on a daily basis, without pay or respite, can take a toll on the caregiver’s own health, wellness and mental state – which can lead to burnout. Medicare does not offer payment or formal respite coverage for family or friends who take regular care of older adults – and only covers home care by certified agencies under certain circumstances.

More research & services needed

Ankuda notes that studies on the impact of supporting family caregivers more formally are just beginning to produce results.

Meanwhile, health policy researchers are beginning to suggest that it may make fiscal sense to incentivize home caregiving, to keep seniors from needing more expensive nursing home care.

“I definitely think there are specific services that could help caregivers, if we can identify those people who are highest risk and provide a basic level of support such as an around-the-clock geriatric care call line that could help caregivers feel less isolated and talk to a nurse about whether, for example, to go to the emergency department,” Ankuda says. “This is a high-cost, vulnerable population.”

Formal respite care, peer support groups and other options could also help stave off fatigue and sadness – and the hospital staff who notice “pop drop” practices could help steer caregivers to such options. So could the primary care clinicians who take care of both the disabled spouse and the caregiver.

Because the new study takes into account the level of Medicare spending for the disabled spouse in the six months before their caregiver was interviewed, it may actually underestimate the impact of caregiver fatigue, she notes.

Indeed, before the authors corrected for the full range of factors, they documented that Medicare costs were lower for patients whose spouse-caregivers who reported being happy or rested. They also saw higher costs among patients whose caregivers had higher depression scores on a standard mood questionnaire.

One factor that wasn’t associated with higher costs in the new study was the caregiver’s score on a standard measure of sleep habits. Sleep disruption is harder to quantify in older people, Ankuda notes. But the measurement of fatigue, which can result from both the strain of caregiving and poor sleep, was clearly associated with both higher rates of emergency department visits and higher overall costs.

Caring for the Caregiver

During cancer treatment, the main focus is on the patient. However, a cancer diagnosis affects the entire family, including caregivers. A caregiver is any person who supports a patient during treatment; this can be a spouse, partner, sibling, son, daughter, or friend. Taking on the role of a caregiver can change the dynamic in a relationship.

Partners who were once equals can now have an imbalance and a child can often need to take on a parental role. Often the caregiver’s needs can be overlooked. It is important for the caregiver to keep their body and mind healthy in order to provide the best care to the patient. While this seems easier to say than do, working in some self-care does not have to take a lot of time or money.

Ways to put yourself first:

Let go of guilt. It is natural to feel guilty for taking time for yourself when your loved one needs so much. Try to remember why all airlines instruct passengers to put their own oxygen mask on first before helping others. The reason behind this is simple: You cannot care for someone else when you are depleted. It is important to acknowledge guilty feelings and find a safe place to share them, but do not allow them to stop you from caring for yourself.

Build in fun. Create a list of activities that make you happy. Playing your favorite song, taking a bubble bath, or going for a walk are just some of the possibilities.

Relax. Simple breathing exercises, guided imagery, meditation, and proper sleep habits. There’s even an app for that! You can download apps like Headspace and Calm to help guide you in relaxation practice.

Self-compassion. Cut yourself some slack! When you care for yourself and a loved one, it is normal to experience stress. Recognizing this stress in a non-judgmental way and taking small steps to combat it is the first step in self-care.

Your oncology social worker is there to help patients and caregivers, and we can help you make a personalized plan to cope with the challenges of being a caregiver.

Here’s How Technology Is Providing Support For Dementia Patients

Dementia is one of our time’s leading epidemics currently affecting over 24 million people globally. This has forced governments to catapult healthcare costs to unsettling proportions. These strikingly huge and rapidly increasing numbers have caused researchers across the globe to find a cure for the ailment and unveil ways of improving the quality of life of patients.

Even though a cure for dementia is yet to be found, these escalated research efforts along with groundbreaking developments in electronic/ mobile healthcare have given rise to an array of self-help technologies for patients.

These tools are aimed at facilitating dementia patients at every stage of their condition and include cognitive screening tests, assistive technology and self-care apps all aimed at allowing patients to reclaim control of their health. Here we take a deeper look into how these technological advancements are providing support for dementia patients and their caretakers worldwide.

Benefits of healthcare technology for dementia patients

Healthcare devices go a long way in supporting dementia patients and caregivers by developing a safer environment for them, engaging them, managing their behaviors non-pharmacologically and reliably monitoring them from a distance. The most noteworthy advantages of such healthcare technologies include:

i. Early diagnosis and intervention:

Dementia is irreversible. However, early intervention and healthy lifestyle choices can be monumental in improving the quality of life of patients. This is because an early intervention enables physicians to identify the cause of the ailment well in time to curtail its progression. However, despite this, we see that most dementia patients hesitate to open up to a healthcare professional about the difficulties that they are facing and often wait as long as seven years before finally seeking medical help.

Also, many times the patient him/herself remains unaware of their symptoms and therefore tries to avoid medical consultation about the matter. To overcome this pattern of delayed diagnosis, many healthcare platforms have conjured up cognitive screening tests that can be used by patients and their caregivers to detect the presence of cognitive ailments early on. The results from these tests can then be used as grounds for gaining a thorough clinical diagnosis.

ii. Functioning and Independence:

By hindering routine activities, dementia considerably raises healthcare costs for patients and places a great deal of burden on their caregivers. However, supportive technologies go a long way in remedying this by enabling patients to independently carry out routine activities and reducing their neuropsychiatric symptoms.

iii. Support for caregivers:

Telehealth devices possess great applicability both at home as well as care facilities and work to significantly reduce stress for both patients and their caregivers.

These devices include video monitoring technologies that allow patients and caregivers to conveniently and instantly reach healthcare professionals for counseling. Moreover, they also include sensors, flood detectors, extreme temperature detectors, CO detectors, medication reminders and bed occupancy detectors.

iv. Safety:

Safety devices allow for detailed patient security and include surveillance equipment, exit-sensors, injury prevention tools, door security bars, location sensors, touchpad key locks and window sensors among others.

v. Behavioral management:

Studies have found that the use of non-pharmacological treatments such as music, vibrating tubes, fiber optic string lights, aroma diffusers, solar effects projectors and plasma balls are instrumental in the behavioral management of dementia patients.

This is because multi-sensory intervention leads to an improved attention span, impulsiveness and consequently lead to reduced levels of agitation and anxiety in patients.

Technologies that support dementia patients

Here are some technologies that are improving the lives of dementia patients and caregivers the world over:

1. Cognitive screening apps for patients and caretakers:

Cognitive screening tests are brief self-assessment instruments that can be used by patients as well as their caregivers to detect the presence of cognitive ailments. These tests are available in electronic format online and can also be downloaded in the form of an app to help you monitor your own or your loved one’s cognitive performance.

Moreover, apps such as Brain Test go one step further by allowing patients and their caregivers to identify the presence of cognitive dissonance and monitor patient progress over time.

2. Assistive technology:

Dementia causes a decline in the cognitive abilities of patients, eventually inhibiting them from carrying out simple day to day activities. Therefore, it is tremendously encouraging to note that there are several devices and systems available nowadays that allow dementia patients to perform these crucial tasks independently.

These devices include low-tech items such as walking sticks and frames, calendar clocks and bath aids, etc. In addition to high-tech items like telecare and automatic lighting among others.

The term ‘telecare‘ here refers to detectors and sensors such as movement, smoke, flood, gas or fall detectors that generate a signal via a base unit which is connected to a telephone line in use by the caregiver or monitoring service. These devices can also be used to quickly call for medical assistance as and when needed. Primarily categorized based on the need their core purpose; these devices include:

  • Supportive technologies that assist individuals in completing tasks.
  • Preventive technologies that protect patients from harm and trigger alarms.
  • Responsive technologies that allow for thorough risk management.

3. Apps connecting patients to fitness resources:

As people age, they tend to avoid complicated gadgets such as PCs and this hesitation increases yet further in dementia patients who may not find the strength to use such complex devices.

This avoidance of technology increases the risk of isolation among dementia patients and also refrains them from acquiring knowledge that is necessary to manage and improve their condition. However, in such cases, mobile devices like as tablets prove extremely useful as they are more intuitive to use and avoid the complexity of a mouse, keyboard and operating system.

It is for this reason that we see healthcare applications proving extremely effective in connecting dementia patients with the world around them.  This allows dementia patients to access online fitness resources across multiple mobile devices. These resources help dementia patients in staying fit but also allow them to record and evaluate their progress over time.

Advancements in the field of dementia research are ongoing at an exponential pace, and therefore we can expect to see more groundbreaking technologies surface in the years to come.

Are We Afraid of Developing Technology for the Elderly

I work for a hospice program providing palliative care which means we attend to the emotional and spiritual needs of terminally ill patients at an inpatient facility or at the patient’s home, and I see lots of people near the end of their life. Some of them are too lethargic to use an iPad, but many are not.

birdbeard-300x300Though all of my clients are dying, they are otherwise able to function normally for a person their age. Those who are not lethargic or in their last days often tell me how bored they are!

They speak about their inability to find anything that entertains them. So, I did a little research on the subject thinking “Well maybe a computer for older folks might help.” Turns out there are some, the options are not great, and I have yet to see one in an assisted living facility.

So why has Apple not attempted to make iPad adaptable to Seniors’ needs?

Personally, I want to be able to browse the internet when I am seventy, and I want to be able to keep up with the news when I have arthritis and can’t swipe properly. Below are some reasons why we don’t have it and why we are going to need it.

Generational Gap

The affordable personal computer came out in the 80’s which means those who grew up with computers are now just entering their early to mid 40’s. To everyone else, computers were new and confusing.  However, this doesn’t excuse the lack of technology for those who are older, but it does help to explain the lack of attention to this market.

Infantilization

In-fant-til-ize-a-tion: To treat or condescend as if still a young child

Would you let a baby play with your expensive iPhone? If the answer is yes, you have more money than I do. Most people are afraid their child will break their expensive toy. They are not wrong either most children will. We assume the same of older adults, that they will either break it out of frustration or will not be able to comprehend its use. Neither is true. There are many older adults who know how and enjoy using computers to entertain themselves

Denial

Likely the worst offender, we refuse to make these adaptations to technology because doing so would be admitting our own mortality. It would require acknowledgment that we will grow old and may eventually need these devices ourselves. Once we can admit we are growing older as a society more and more of these devices will be present.

That’s it for now, but I can’t wait for the Angry Bird’s senior edition to come out. In the comments below tell me about what you want on your computer when you are older!

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