OREGON CAREGIVER TRAINING

OREGON CAREGIVER TRAINING

WORK GROUP REPORT

ACKNOWLEDGEMENTS This report was written by the Oregon Caregiver Training Workgroup, a collaborative project of the Governor's Commission on Senior Services and

the Oregon Disabilities Commission. Thank you to the many stakeholders who provided input, analysis, content

and hard work in creating this report. We specifically thank the Oregon Department of Human Services, Aging and People with Disabilities for

providing staff support. Published June 2014

1

TABLE OF CONTENTS

Executive Summary

3

Key Recommendations

4

Introduction

5

Background and Process

6

Analysis of Existing Caregiver Trainings in Oregon

7

Analysis

15

Recommendations

19

Appendix

22

2

OREGON CAREGIVER TRAINING WORK GROUP REPORT

Executive Summary

Oregon's Health Care Transformation effort is focused on the "Triple Aim" of better care, better health, and lower costs. Caregiving is emerging as a risk factor for poor health and higher costs, and interventions exist to reduce the potential negative health impact on caregivers while improving the quality of care provided to the person or people for whom they are caring.

Many Oregonians require another person to provide daily care and help with activities a majority of us take for granted, such as eating, bathing, and getting dressed. The people receiving care may require it for a few months, a few years, or a lifetime, for many reasons (such as an injury, a physical disability, or a progressive disease). According to research by AARP, each year, over 460,000 unpaid caregivers in Oregon provide about $5.5 billion worth of care.1

The impact of caregiving on a caregiver is tremendous -- physically, mentally, and financially. The most recent data from the Alzheimer's Association shows that each year in Oregon, unpaid caregivers for people with dementia have $100 million in higher health care costs.2 Professional caregivers also face significant job stress in positions that are not well paid, leading to a high rate of job turnover, which is detrimental to the people receiving care.

Training can help improve care, reduce health care costs, improve the health of caregivers, and reduce turnover of professionals. Unfortunately, caregivers face barriers that prevent them from accessing beneficial education and training. The goal of this report is to make recommendations to ensure all caregivers in Oregon who can benefit from training are able to receive it. A valuable byproduct of the work group that wrote this report was the creation of a catalog of trainings that might be useful to many individuals, organizations, and agencies when looking for training -- or when establishing public policy in regard to improving long-term care in Oregon.

1



2



3

Key Recommendations

? Develop trainings to address unmet needs o Businesses and nonprofits that provide trainings for caregivers should consider this list as a jumpingoff point for the development of trainings that meet the unmet need.. o Government granting bodies, such as the Innovations Fund board, might want to use this list as a consideration for their grant process.

? Increase access to Oregon Home Care Commission trainings o The Oregon Home Care Commission should begin a process to determine how to make its trainings more available to the general public while ensuring home-care and personal-support workers have full access to all required trainings.

? More aggressive promotion of existing trainings o The ADRC should be promoted as the central place for Oregonians to find trainings. In addition, every training provider should be listed in the ADRC's resource database. o Hospitals, health systems, and medical professionals should be prepared to provide information about what training would be useful, as well as where to find it.

? Expand access to trainings statewide o Increase the focus on developing Web-based trainings for those with Internet access. o Respite programs need to be developed and expanded, including a revived Lifespan Respite Program. o Investigate the use of public-access television and cable on-demand programming to air training videos.

? Ensure family caregivers are informed about caregiving and how to choose a useful training. o Develop a simple brochure that lists what a caregiver might need help with and what to consider when looking for training. This brochure should be made available in all medical offices, ADRCs, senior and community centers, libraries, and any other relevant locations, and it should be included in any packet of information medical providers give families following a diagnosis that may lead to someone serving as a family caregiver.

These recommendations are intended to be doable actions that will lead to a greater level of training of caregivers in Oregon. Some need to be implemented by nonprofits, some by government agencies, and some by businesses, and others might require legislative action. By following these recommendations, we assert that the quality of caregiving will improve in Oregon, caregivers' lives will improve, and health care costs of caregivers will decline.

4

Introduction

Many Oregonians require another person to provide daily care that a majority of us take for granted. Caregivers help with many "instrumental activities of daily living" (IADLs), such as housework, managing money, and shopping. Additionally, caregivers help with "activities of daily living" (ADLs), such as bathing, eating, dressing, and toileting. The people receiving care may require it for a few months, a few years, or a lifetime, for many reasons (such as an injury, a physical disability, or a progressive disease). According to research by AARP, each year, over 460,000 unpaid caregivers in Oregon provide about $5.5 billion worth of care.3 The Alzheimer's Association estimates that in Oregon unpaid care just for people with Alzheimer's disease is valued at more than $2.4 billion per year.4

To provide the best care for people who require it, caregivers need education and training on best practices. This training might be about how to perform ADLs effectively, but it might also be on communication, legal issues, or maintaining a safe environment. Caregivers have many needs that training can meet, which will ultimately help care recipients live a better life.

Training can also directly benefit the caregiver. The impact of caregiving on a caregiver is tremendous -- physically, mentally, and financially. The most recent data from the Alzheimer's Association shows that each year in Oregon, unpaid caregivers for people with dementia have $100 million in higher health-care costs.5 Thus, training will help family caregivers live healthier and happier lives.

In regard to professional caregivers, training can lead to lower turnover rates and higher quality of care. Since 2011, entry-level home care aides in Washington State must complete 75 hours of basic-level training before they can be hired. Chesterfield Health Services, a home health-care provider in Seattle, invests heavily in training and advancement opportunities for its workforce. Stella Ogiale, Chesterfield's founder and CEO, says it is important to train and empower workers to move up the health-career ladder to improve their professionalism if they choose to remain in home care. This investment has paid off, as demonstrated by high satisfaction rates for clients and home health-care providers, as well as low turnover rates.6

A 2011 study in Washington also pointed to the impact of career advancement and training on turnover among homecare workers. A survey of former home-care workers asked what they felt was most important to recruit new homecare workers. The results mirrored the results of a 20-year-old study that showed interventions to improve salary, benefits, hours, increased training, and support for retention in aggregate reduced turnover between 11 percent and 44 percent.7

The goal of this report is to make recommendations to ensure all caregivers in Oregon who can benefit from training are able to receive it. A valuable byproduct of the work group was the creation of a catalog of trainings that might be useful to many individuals, organizations, and agencies when looking for training -- or when establishing public policy in regard to improving long-term care in Oregon.

3



4



5

Ibid

6



7



5

Background

The Oregon Caregiver Training Work Group started at a retreat for the Governor's Commission on Senior Services (GCSS) in the fall of 2012. The GCSS members recognized the need for caregiver training to improve the quality of care provided in the home and in long-term care settings, and they decided to start addressing this issue by gathering and analyzing data. At the time, the idea dovetailed closely with recommendations in the State Plan for Alzheimer's Disease and Related Dementias in Oregon (SPADO), which was released in July 2012. SPADO was a broad coalition effort to determine how stakeholders in Oregon could help address the needs of individuals impacted by Alzheimer's. The SPADO report identified caregiver training as an area for improvement.

The initial GCSS committee working on this idea recognized that caregiver training was not exclusive to aging or Alzheimer's; the committee reached out to the Oregon Disabilities Commission (ODC) to create a jointly chaired work group on broad caregiver-training issues. The Oregon Caregiver Training Work Group was formed with Sherry Stock, executive director of the Oregon Brain Injury Alliance, representing ODC and Jon Bartholomew, public policy director of the Alzheimer's Association Oregon Chapter, representing GCSS, and multiple stakeholders were invited to participate. The State Unit on Aging provided staff support for the work group. See Appendix A for a full list of individuals who served on the work group.

Oregon legislators passed Senate Bill 21 during the 2013 legislative session, which established a process by which the Oregon Department of Human Services (DHS) will convene stakeholders to discuss improvements to the long-term care system in Oregon. The Caregiver Training Work Group's efforts are in sync with the goals of SB 21, and they will be relevant to the implementation of the law.

Process

During the work group's initial meeting, the members determined the scope of the work needed to be done, as well as the process for doing it. We determined first that we would be focused on family caregivers and professionals who are not licensed. (A separate work group on dementia training for licensed professionals was created via the implementation of SPADO.) We also clarified that we would be looking at all caregiving in Oregon rather than caregiving for a particular condition or age range.

The work group determined our charge would be to:

? Determine what caregiver needs can be met by training

? Determine what trainings exist

? Determine where needs aren't met by existing training

? Recommend solutions to close those gaps

The first step in achieving our goals was to brainstorm and categorize a set of caregivers' needs. From that list, the work group members provided information about known trainings in Oregon to create a catalog. In this process, discussion arose regarding the difference between "training" and "education," as the former can mean something formal and specific with a demonstration of proficiency. We decided to include anything that would be helpful in improving individuals' caregiving skills, regardless of the level of formality.

A spreadsheet of caregiver trainings was created with input from work group members and others whom we reached out to. Erika Sessions from the Institute for Professional Care Education created a pivot table of this spreadsheet, which greatly assisted with the analysis of the data.

In January 2014, a work group subcommittee analyzed the data and brought the findings back to the larger work group to discuss recommendations. The subcommittee consisted of Jean Yamamoto from SEIU, Jan Karlen from DHS, and Suanne Jackson from the State Unit on Aging. The report was compiled by Jon Bartholomew, with editing assistance from his staff and work group members.

6

7

Training Need Activities of Daily Living

Basic Disease Information/ Progression

Behaviors as Communication

Analysis of Existing Caregiver Trainings in Oregon

# of

Family or

Trainings Professional

20

13 for family

20 for professionals

31

21 for family

30 for professionals

Location

Cost

9 online

4 Free

1 webinar on demand

Varies for Alz Assoc and OHCA

5 DVD

Free for OHCC

4 Salem,

HCW/PSW

Corvallis, Albany Yes for OHCC non-

1 Lane Co.

HCW and IPCED

5 statewide

20 online 5 DVD 5 Statewide

Free 9 with Alz Assoc, Alz Network, for OHCC HCW/ PSW

Portland, Bend, Varies 4 for Alz

Medford,

Assoc, OHCA

Eugene, Salem, Corvallis, Albany Yes for OHCC non-

HCW and IPCED

Other Languages Some Spanish and Russian

Some Spanish and Russian

Training topics

Dementia Caregiving Difficult Behaviors Caring for the Caregiver Personal Care Skills IADL Bathing and Grooming Durable Medical Equipment End of Life Care Living with, understanding, caring for, research on Alzheimer's, dementia chronic diseases, heart healthy, diabetes Communicable diseases Developmental disabilities care HIV/AIDS Parkinson's disease symptoms

Aphasia

Blindness and low vision

11

7 for family

6 online

Free for Alz

Some Spanish Dementia Caregiving

9 for professionals

1 DVD 1 Statewide Marion Co., Corvallis SG -provided to

Network, OHCC HCW/PSW

and Russian

Varies for Alz. Assoc

Yes for OHCC nonHCW & IPCED

Handling Difficult Situations, Behaviors

Challenging Behaviors

Savvy Caregiver (SG) ? Basic Communication Techniques / Developing strategies for common behavioral problems

VA families

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download