Editor’s Desk

Caregivers are getting some credit—and maybe some help

Peter Wehrwein

Caregiving—the underappreciated and unpaid glue that holds a great deal of American health care together—may finally be getting its due.

Johns Hopkins researchers and their colleagues reported the results of their caregiving research in this week's JAMA Internal Medicine. Meanwhile, one of the main features in this month's Managed Care is an article on the burden of caregiving and what lawmakers and health plans are doing about it.

This is not just some weird coincidence. Caregiving is a trending topic these days, partly because of demographics. Millions of baby boomers are having to take care of their aging parents while an increasing number of those moms and dads are living into their late 80s and 90s.

Johns Hopkins researchers found that almost half (44%) of caregivers are heavily involved in the cared-for person's health care, which encompasses care coordination (going to medical appointments, for example) and medication management (helping people with adherence). Paid family leave requirements have been proposed as a way to help working caregivers. The Johns Hopkins team found that losses of productivity from caregiving come mainly from productivity dips while working rather than from missing work altogether.

AARP has been pushing states to pass Caregiver Advise, Record and Enable (CARE) Act, which puts some requirement on hospitals to keep caregivers informed and to help prepare them for medical and nursing tasks when they are discharged. AARP told us that 18 states have enacted the legislation and that it's under consideration in 22 others.

A story on caregiving in the February issue of the magazine for the State Conference of State Legislatures reports that the CARE bill was stymied in Hawaii because the association that represents hospitals and other providers had objections. “AARP wants hospitals to train unqualified people to perform complex clinical, medical and nursing tasks,” the association's president is quoted as saying.

We found that Tennessee is a leader in setting caregiving policies. The health plans in the state's CHOICE program make efforts to meet the needs of caregivers, not just the beneficiaries.

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