Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Aging safely at home? California's disabled elderly are barely holding on

01.02.2011
The network of public services that supports California's low-income, disabled elderly is fragile, affecting the ability of these vulnerable residents to live independent lives in their own homes, according to a new study from the UCLA Center for Health Policy Research.

This policy note reports the first findings from a yearlong effort to follow the lives and challenges encountered by several dozen representative older Californians in Los Angeles, San Diego, San Francisco and Santa Clara who are enrolled in Medicare and Medi-Cal and who receive in-home and community care.

The documentary project comes as California lawmakers consider additional cuts to a network of services that help seniors remain "safely in their homes" — the stated goal of these public programs and the way in which an overwhelming number of Americans say they want to age.

The policy note, "Holding On: Older Californians with Disabilities Rely on Public Services to Remain Independent," shows seniors struggling to live functional lives in the face of already reduced caregiving hours. For example:

Caring for the caregivers

Sara cares for her disabled son and husband, whose heart disease, diabetes, incontinence and limited mobility require 24-hour care. There's help from In-Home Supportive Services (IHSS) and other family members, but Sara is the primary caregiver. Now, her back is acting up. She's been delaying seeing a doctor to take care of her own needs — who will care for her family if she's hospitalized?

Delicate balance

Paralyzed by polio, Mary breathes with the help of a ventilator and gets around in a wheelchair. She needs help to dress, bathe, use the toilet and eat. She's created an elaborate system to meet her needs, using maximum IHSS hours of support and offering room and board to another caregiver in return for care. Mary's happy with her life and rates her health as "excellent," but she knows that even a small change in the delicate balance of her care system will send her to a nursing home.

His choice

Incapacitated by stroke and diabetes and confined to a wheelchair, Jack spent time in a nursing home a couple of years ago, and he's not in a hurry to go back. In the nursing home, he felt unsafe and more isolated than he does in his own house with support from IHSS. Jack's a realist. He knows a nursing home may be in his future again, but he wants to choose when and where he'll go.

According to the researchers, all participants in the study are aware that the networks of care they've cobbled together could easily unravel, and most say they'd rather "make do" by eating less often, letting their homes become less safe or allowing their medical conditions to worsen than give up their independence and go to a nursing home — the likely scenario if they lose the in-home services they now rely upon.

"These seniors are using every sort of innovation and self-deprivation to make do," said Steven P. Wallace, the study's senior author and associate director of the UCLA Center for Health Policy Research. "They have nowhere to turn if their fragile care systems are further undermined.

"Policymakers need to see the faces of these vulnerable Californians as they crunch the numbers in budget discussions," Wallace added. "Further cuts are an assault on their independence. Slashing in-home and community care will also increase total health care costs as these seniors increasingly use emergency room care, are hospitalized or enter institutions — under conditions that could have been prevented."

Budget cuts looming

California, which is home to the largest number of older adults in the country, has several programs funded by federal, state and local dollars to assist low-income adults with disabilities. Proponents of these programs say that while such care isn't perfect, it is far less expensive and more humane than the alternative — placing seniors in publicly financed nursing homes.

Yet, IHSS program-hours were trimmed by 3.6 percent in January 2011, and they face further across-the-board cuts of 8.4 percent, plus additional targeted reductions in the governor's proposed budget. Adult day health care centers are slated for elimination, and supplemental security income cash benefits are to be reduced for single low-income aged and disabled individuals.

All the older adults in the study receive IHSS support, ranging from 20 hours of in-home help each month to the maximum of 283 hours per month. Most need help with household tasks, such as cleaning and cooking, and personal tasks like getting dressed or taking medications. Many require help getting in and out of bed, bathing and using the toilet. Some who might benefit from adult day health care or other supportive programs are unable to participate because of limited mobility or lack of transportation.

"California's current system to support old and young adults with disabilities at home operates in silos and is not person-centered," said Bruce Chernof, M.D., president and CEO of the SCAN Foundation, which is funding the study. "The Brown administration has an important opportunity to design a more stable, integrated, efficient and person-centered system that can meet the needs of these vulnerable residents throughout the state."

Read the policy note: "Holding On: Older Californians with Disabilities Rely on Public Services to Remain Independent."

The SCAN Foundation is an independent nonprofit foundation dedicated to advancing the development of a sustainable continuum of quality care for seniors that integrates medical treatment and human services in the settings most appropriate to their needs, and with the greatest likelihood of a healthy, independent life. The foundation supports programs that stimulate public engagement, develop realistic public policy and financing options, and disseminate promising care models and technologies.

The UCLA Center for Health Policy Research is one of the nation's leading health policy research centers and the premier source of health-related information on Californians.

For more news, visit the UCLA Newsroom and follow us on Twitter.

Nancy Brands Ward | EurekAlert!
Further information:
http://www.ucla.edu

More articles from Studies and Analyses:

nachricht New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)

nachricht Reusable carbon nanotubes could be the water filter of the future, says RIT study
30.03.2017 | Rochester Institute of Technology

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Can the immune system be boosted against Staphylococcus aureus by delivery of messenger RNA?

Staphylococcus aureus is a feared pathogen (MRSA, multi-resistant S. aureus) due to frequent resistances against many antibiotics, especially in hospital infections. Researchers at the Paul-Ehrlich-Institut have identified immunological processes that prevent a successful immune response directed against the pathogenic agent. The delivery of bacterial proteins with RNA adjuvant or messenger RNA (mRNA) into immune cells allows the re-direction of the immune response towards an active defense against S. aureus. This could be of significant importance for the development of an effective vaccine. PLOS Pathogens has published these research results online on 25 May 2017.

Staphylococcus aureus (S. aureus) is a bacterium that colonizes by far more than half of the skin and the mucosa of adults, usually without causing infections....

Im Focus: A quantum walk of photons

Physicists from the University of Würzburg are capable of generating identical looking single light particles at the push of a button. Two new studies now demonstrate the potential this method holds.

The quantum computer has fuelled the imagination of scientists for decades: It is based on fundamentally different phenomena than a conventional computer....

Im Focus: Turmoil in sluggish electrons’ existence

An international team of physicists has monitored the scattering behaviour of electrons in a non-conducting material in real-time. Their insights could be beneficial for radiotherapy.

We can refer to electrons in non-conducting materials as ‘sluggish’. Typically, they remain fixed in a location, deep inside an atomic composite. It is hence...

Im Focus: Wafer-thin Magnetic Materials Developed for Future Quantum Technologies

Two-dimensional magnetic structures are regarded as a promising material for new types of data storage, since the magnetic properties of individual molecular building blocks can be investigated and modified. For the first time, researchers have now produced a wafer-thin ferrimagnet, in which molecules with different magnetic centers arrange themselves on a gold surface to form a checkerboard pattern. Scientists at the Swiss Nanoscience Institute at the University of Basel and the Paul Scherrer Institute published their findings in the journal Nature Communications.

Ferrimagnets are composed of two centers which are magnetized at different strengths and point in opposing directions. Two-dimensional, quasi-flat ferrimagnets...

Im Focus: World's thinnest hologram paves path to new 3-D world

Nano-hologram paves way for integration of 3-D holography into everyday electronics

An Australian-Chinese research team has created the world's thinnest hologram, paving the way towards the integration of 3D holography into everyday...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Marine Conservation: IASS Contributes to UN Ocean Conference in New York on 5-9 June

24.05.2017 | Event News

AWK Aachen Machine Tool Colloquium 2017: Internet of Production for Agile Enterprises

23.05.2017 | Event News

Dortmund MST Conference presents Individualized Healthcare Solutions with micro and nanotechnology

22.05.2017 | Event News

 
Latest News

How herpesviruses win the footrace against the immune system

26.05.2017 | Life Sciences

Water forms 'spine of hydration' around DNA, group finds

26.05.2017 | Life Sciences

First Juno science results supported by University of Leicester's Jupiter 'forecast'

26.05.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>