Giving Thanks to Those Who Care
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By Assemblymember Mariko Yamada
November is Alzheimer’s Disease and Awareness Month, National Home Care and Hospice Month, and Family Caregiver Month. It also marks the beginning of the traditional season of thanksgiving, taking stock of our blessings, sharing with those less fortunate, and caring for those who are unable to care for themselves. As families come together this holiday season, I urge you to take an opportunity to discuss future long-term health needs with your loved ones. The increase in our senior population, along with the reduction in community-based care programs, requires greater attention to the services needed for those with terminal illnesses and those, both paid and unpaid, who provide care.
Over the past two years, the State has retreated from its support for elder and disabled adults, their families and their caregivers. With assistance decreasing, the need for in-home caregiving is increasing. An estimated one in four California families is currently involved in caring for a loved one with a disability. Caring for a family member who has dementia or who has multiple chronic health conditions can be quite complex, yet most families receive little or no training, assistance or appreciation in their caregiving tasks. Millions of Californians are juggling job and caregiver responsibilities, and those numbers are growing. In 2010, 14.9 million family and friends provided 17 billion hours of unpaid care to those with Alzheimer’s and other dementias. The economic value of the unpaid care provided totaled $202.6 billion.
For those who are able to afford private homecare, lack of proper licensing can be a problem. There are nearly 1,300 home care agencies operating in California, serving about 400,000 clients. Home care serves to prevent or delay the need for a higher level of care, such as a move to a nursing home saving families money and taxpayers untold millions of dollars in Medicare and Medicaid costs. But in California, all that is required to establish a “home care agency” is a business license. While many reputable firms exist, the potential for unscrupulous operators increases with every baby boomer achieving senior status and hiring an in-home care worker. To remedy this, I’m working with the home care industry to pass legislation that would create stronger patient protections by requiring home care agencies be licensed by the state Department of Social Services. With state oversight of homecare agencies, we can help ensure that hired caregivers are qualified and reputable, giving families confidence their loved one will be well taken care of.
Adult Day Health Care (ADHC) is another option for long-term care. ADHC is a recognized national model that provides community-based care to meet the medical and social needs of fragile elders and disabled adults. Through the combination of dedicated professional staff, family caregivers, and the Medi-Cal program, participants have access to supportive and protective medical services during the day while family caregivers are at work. In the new year, Adult Day Health Care will be called Community-Based Adult Services (CBAS), with participants continuing to receive medical care, physical therapy, exercise, counseling and socialization. The cost for ADHC, and next year CBAS, is split between the state and federal governments and saves taxpayers money by helping low-income medically frail elderly and disabled adults stay in their homes and out of much more expensive nursing homes and hospitals.
In the State Legislature, I continue to fight to ensure that strong and vibrant public and private systems for caregiving are supported in California, home to the largest and most diverse older population in the nation. While the funding battle continues, I encourage you, during this annual time of thanksgiving, to take a moment to thank those who are caring for a loved one, often at the expense of his or her own health. Please also give peace of mind to yourself and your family by taking the time to discuss your long-term care plans. In this time of economic uncertainty, it may be the most beneficial conversation you have this holiday season.
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Assemblymember Mariko Yamada represents California's 8th Assembly District.