# Presentation: 263349

## Cliff Burt, MPA
Georgia Division of Aging Services
Two Peachtree Street NW
Ninth Floor
Atlanta, Georgia 30303-3176
Phone (404)-657-5336
Email gcburt@dhr.state.ga.us

- Georgia Division of Aging Services
- Two Peachtree Street NW
- Ninth Floor
- Atlanta, Georgia 30303-3176
- Phone (404)-657-5336
- Email gcburt@dhr.state.ga.us

- Promoting Program Flexibility to Better Meet Caregiver Needs

## Promoting Program Flexibility to Better Meet Caregiver Needs

- How is this to reflect our National Family Caregiver Support  Program Conference theme,  *From Enactment to Action*?

## Caregiver Focus Groups

- Through an AoA Alzheimer’s demo grant, had done  training for Alzheimer’s caregivers, but realized we could do more  for other caregivers.

## Caregiver Focus Groups

- Six focus groups conducted around Georgia by Dr. Cathy Scott, R.N.,C.
- Groups ranged in size from 8-12 participants.
- A total of 64 participants were in the six groups.

## Caregiver Focus Groups

## Caregiver Focus Groups 

**GENDER:**
- 55 females, 9 males
**AGE**
- Caregivers ranged in age from 26 to 80 years old.

## Caregiver Focus Groups

- Participants included family members, nursing assistants, discharge planners, care managers, trustees, home health administrators, neighbors, and volunteers.

## Caregiver Focus Groups

**MAJOR THEMES**
- Lack of Information
- Needs Exceed Availability
- Ageist Providers: (Inadequately, educated, supported, or monitored).

## Caregiver RecommendationsInformation

- Community resources
- Create 1-800 number
- Emergency Services
- Home modifications
- Legal issues (power of attorney, guardianship, donor issues).

- Place information in physician offices.
- Place caregivers on boards of organizations.
- Future planning (financial, funeral, etc).

## Caregiver RecommendationsDirect Services

- Streamline services to decrease fragmentation.
- Expansion of respite (increase hours, weekends, nights).
- Expand transportation.

- Financial assistance with medications.
- More supervision of services.
- Emergency services (back-up for caregivers).
- Counseling & Advance Planners.

## Caregiver RecommendationsTraining

- Ageist issues (respect, communication, dignity).
- Alzheimer’s  and other dementias.
- Normal Aging Issues.
- Complexities of caregiving (finding time).

- More advanced seminars for nursing assistants.
- Course on compassion for nursing assistants.
- Community resources.
- Personal Care.
- Communication skills.

## Caregiver Focus Groups

**What’s next?**
- Plenary Sessions at statewide aging conferences.
- AAA’s prioritized training topics.
- Regional education/training events scheduled.

## Caregiver Focus Groups

- Collaboration with AARP, GGS, & Rosalynn Carter Institute.
- Publish and disseminate data in caregiver report.
- Increased funding for caregiver services.

## What is Mobile Day Care?

- An innovative service delivery model
- Enables rural communities to have their own day care program several days/week
- Staff and materials are mobile, not the facility
- “Shared staff” travel between locations

**Notes:**

Staff load a vehicle early in morning with needed program supplies for the day, then drive to site.  In evening, they return to a central location.

Staff typically provide service to 1-2 days per week at two different sites.

Atlanta Area Chapter Alzheimer's Association developed the concept of mobile day care.  They came up with the idea since most of Georgia's 159 counties are rural, and there were so many areas that did not have any day care or respite  services. 

Program was implemented by the Augusta Area Chapter Alzheimer's Association.

##  Mobile Day Care Programs in Georgia

- Georgia has three mobile day care programs.
- Each program has two sites
- Most sites are open 2 days per week
- Staff drive between 20-45 miles *one way* to sites

## Mobile Day Care Staffing 

- Varies from program to program
- Part-time and Full-time Staff
- Positions Include:
- Day Center Director
- Respite Aide (often a Certified Nursing Assistant)
- Case Manager
- Community Development Coordinator

## Community Development Coordinator

- Should be hired locally
- Preferably someone who is well-known in community
- Develops a coalition of community professionals and caregivers

## Problems That May Be Encountered

- Mistrust of “big city folks”
- “Rural Mentality”--families feel they must take care of their own
- Local Prejudices

## Strengths/Benefits of Mobile Day Care

- Enables unserved areas to have respite services
- Staff costs spread between two sites
- One site’s census may help “support” the other site
- Flexibility with PT & FT positions helps retain qualified staff
- Replicable in urban or rural setting

**Notes:**
State of New York made a site visit to Georgia, believing that they could replicate the model day care model in burroughs of New York City.

## Self-Directed Care Model                               Voucher Project

- Empowers caregivers to choose and make arrangements for services they deem best meets their needs
- Enables caregivers primary authority to make decisions that work for them
- Allows caregivers to determine how and by whom their needs are met

## Georgia’s Self-Directed Care Model Project  

- Called *Legacy Express*
- Designed for older persons and their caregivers living at home.
- Promotes caregiver participation in planning and managing services  that go into their own homes.

## How Does the Model Work?	

- Care Manager provides handbook of service providers
- Explains available services to family
- Caregiver decides which services best meet their needs.

## About the Vouchers

- Are issued in books of $500
- Voucher books in denominations of $10, $20, and $50
-  Each voucher is in triplicate
- Caregivers usually issued two books per year

## Types of Services 

- In-Home Respite
- Home Delivered Meals
- Adult Day Care
- Homemaker
- Home Modifications & Low Technology Devices

## Types of Services 

- Pharmaceutical Supplies
- Medications
- Lawn Services
- Emergency Response System (ERS) monitoring
- Transportation
- Skilled Nursing Care

## Spending Patterns 	

## Professional In-Home Counseling for the Elderly 

- Discussion groups for Georgia caregivers being developed with III-E funds.
- “Open forum” to encourage sharing and questions.
- Stress management tools will be provided.

## Professional In-Home Counseling for the Elderly

- The PICE program has an in-home counseling component.
- Counseling provided in the person’s home, or home of a relative.
- Depression is the primary reason for most referrals.

## Professional In-Home Counseling for the Elderly

- Provided by a Licensed Social Worker (LMSW, CFLE).
- No cost to the client.  Paid for with Title III-B, III E.
- Monthly Support group also available.

## Aging and Long Term Care Information System

- Developed by Atlanta Regional Commission (AAA for metro-Atlanta region).
- Contains numerous components, including *Aging Connection* and *CONNECT.*

## Aging and Long Term Care Information System

- ARC and CyberPath, Inc. developed the *Elder Services Program (ESP*), a comprehensive software program with client and provider/service components.

- The provider/service component (*CONNECT*) has over 10,000 listings statewide of providers serving clients and caregivers, separated into 42 categories of services.

## Assistive Techology & Home Modifications 

- Address the needs of persons with physical or other functional limitations.
-  Services include home modification, Mobile Display Unit, and Lending Closet.

## Assistive Technology & Home Modifications

- Lending Closet-enables caregivers to try assistive technology devices before purchasing.
- Mobile Display Unit- a “hands-on” unit featuring devices on the market.