Highlights
- •This article provides a comprehensive research and health care policy agenda for family caregiving in the U.S.
- •A confluence of structural and process barriers impedes effective partnerships between family caregivers and providers of patient care.
- •Optimizing the role of family caregivers will minimally require systematic identification, assessment, and support of family caregivers throughout the care delivery process.
- •Research is needed to develop assessment tools, decision algorithms and procedures for integrating caregivers into existing clinical practices.
- •Payment reforms are needed to motivate health care providers to engage, assess, and support caregivers.
The authors of this review both served on the National Academy of Science, Engineering,
and Medicine Committee that produced the report, “Caring for an Aging America”. In
this commentary we summarize key findings and recommendations most relevant to clinicians
and researchers in geriatric psychiatry and related disciplines. The report notes
the growing prevalence of family caregiving in the United States, especially those
caring for high-need patients with multiple chronic conditions, disability, and/or
cognitive impairment. To support the capacity of family caregivers to perform critical
caregiving tasks, the report recommends a major shift in healthcare policy toward
collaborative partnerships among patients, their defined family, and providers of
care. Optimizing the role of family caregivers will minimally require systematic attention
to the identification, assessment, and support of family caregivers throughout the
care delivery process. Research is needed to develop the tools and protocols to efficiently
assess caregivers, and identify ways in which they can be integrated into existing
clinical practices. We also need research to identify how to best implement, maintain,
and evaluate caregiver support programs within clinical and community settings. The
Centers for Medicare and Medicaid Services should be charged with developing, testing,
and implementing provider payment reforms that motivate providers to engage and support
family caregivers. Payment reforms should include clearly articulated performance
standards that hold providers accountable for caregiver engagement, training, and
support by explicitly including caregiver outcomes in quality measures.
Key Words
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References
- Schulz R. Eden J. Families Caring for an Aging America. National Academies of Sciences, Engineering and Medicine, The National Academies Press, Washington, DC2016
- Informal caregivers in the United States: prevalence, caregiver characteristics, and ability to provide care.in: National Research Council, The Role of Human Factors in Home Health Care: Workshop Summary. The National Academies Press, Washington, DC2010: 117-143
National Health and Aging Trends Study: Produced and distributed by www.nhats.org with funding from the National Institute on Aging (grant number NIA U01AG32947).
National Study of Caregiving: Produced and distributed by www.nhats.org with funding from the U.S. Department of Health and Human Services' Office of the Assistant Secretary for Planning and Evaluation in cooperation with the National Institute on Aging (grant number NIA U01AG32947).
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- National Family Caregiver Support Program (NFCSP).(Available at:)https://www.acl.gov/programs/support-caregivers/national-family-caregiver-support-programDate accessed: June 20, 2017
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Article info
Publication history
Published online: July 04, 2017
Accepted:
June 29,
2017
Received:
June 29,
2017
Identification
Copyright
© 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
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- PreviewMany societies are facing the challenge of caring for the increasing number of people with dementia. As well as providing symptomatic treatment to patients, healthcare practitioners have to deal with the needs of family caregivers who are at elevated risk for depression and health problems. Programs to support caregivers to exercise their role in the long term and to reduce the likelihood of adverse health outcomes are urgently needed.1
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