One morning, my respite caregiver was a no-show. It was supposed to be a morning where a CNA from a home-care agency would come for 4 hours so I could take care of personal business and work on a few career items. Needless to say, I had to delay either the personal business or career items. I chose to delay the career items because the personal business was more urgent.
This brings me to the point that respite care is a vital need with eldercare. With the oncoming glut of Baby Boomers requiring aging-related care services, and a much smaller number of younger adults to provide them, individual households and our larger society need a workable solution to the conflict between caring for our loved ones and providing for ourselves.
Lately, I have been trying to get my father to the local Senior Center for a couple of afternoons per week. Dad reports that they have nice lunches, but the center’s activities are mainly in the morning, and Dad is rarely able to leave the house before 11am. Thus, he frequently misses out on the fun parts of the senior center, and is left to himself to read for a few hours. As an extrovert, this is not a very satisfying way to spend an afternoon away from home.
Additionally, the center has also closed early a few times, requiring me to pick Dad up before I have finished my business. Like many organizations that serve the elderly, Seattle’s Senior Centers rely heavily on charitable donations, membership fees, and government support. This means that programs and staff are limited to what the budgets can afford. Although the Senior Center concept is a good one, it cannot meet respite care needs as reliably as desired.
An idea came to me recently while weeding my now nearly derelict garden- Why don’t we form coops and work together to care for our parents? It is more efficient for one person to look after several people, than have a one-to-one ratio. For example, in grad school we learned that the number of patients a nurse can care for, without increasing costs or decreasing quality of care, was 5 patients for a regular ward, and 3 for an ICU unit. We should be able to improve the ratios of family caregivers, which would allow more young people to work.
In Washington State, a several decades long decline in tax collection has strained the state budget to the point that lawmakers have decided to rely heavily on family caregivers to shoulder the state’s eldercare responsibilities. While it is understandable that the state should wish to place the elderly with family, and this may not be a bad idea short-term, it has a long-term detrimental economic impact. When well-educated professionals leave the workforce to perform eldercare, we cut back our discretionary spending. Since 70% of the US economy is based on consumer spending, one can start to see the potential economic impact of a wave of family caregivers leaving the workforce nationwide. Not only is the economy hurt in the short-term, it is also hurt long-term because unemployed workers are unlikely to contribute to their retirement plans. In some cases, workers may actually raid their savings to pay for necessities while performing family caregiving. This perpetuates a vicious cycle in which the state cannot pay for eldercare, and which can only be resolved by a systematic shift in eldercare thinking.
Once again, I come back to the respite care coop concept. It goes something like this:
A small group of neighbors, or folks from a local community such as a church, club, or employer, get together and take turns providing respite care for one another. The elders are cared for in homes, community centers, or churches. Members undergo background checks and credentialed training programs to promote trust and ensure safety for everyone. The coop charges a small membership fee that is used to cover the cost of activities, background checks, training, and insurance.
I proposed the coop concept to the Senior Services Respite Care Coordinator, and the volunteer respite care coordinator at my father’s church. Both seemed surprised initially by the idea, but were willing to consider the idea since it has the potential to save state money, relieve social isolation, and help young workers rejoin the workforce. Neither of them had any experience with respite care coops.
I felt that I could not be the first person to come up with this idea, and decided to check the Web for other respite care coops. While preschool coops are common in the US, respite care coops for family caregivers are not. I only found a few examples in the US. Perhaps as our population continues to age, respite care coops will become a fact of daily life as well.
Resources:
Washington State Plan on Aging, 2014-2018. Final Draft. Retrieved from:
http://www.altsa.dshs.wa.gov/about/documents/State%20Plan%20on%20Aging%202014-2018.pdf
Respite Provider Training and Credentialing Resources. ARCH. National Respite Network and Resource Center. Retrieved from:
http://archrespite.org/training-ideas
Caregiving Statistics. Caregiver Action Network (CAN). Retrieved from:
http://www.caregiveraction.org/statistics/
Develop a Respite Program. AARP. Retrieved from:
The Caregiving Exchange. Supporting Caregiving Coalitions across the US. September 2008. National Alliance for Caregiving. Retrieved from:
Juggling Career and Elder Care 