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Overview

Legislators in Kentucky are well aware of the aging population of America and its implications for their state. They expect that within the next 15 years the total number of Kentuckians aged 65 and older will almost double. Approximately one-fourth of those seniors will be aged 80 and older.

In anticipation of these changes, the 2014 General Assembly enacted a resolution that directed the Legislative Research Commission to collect information about services and supports for family caregivers of elders in Kentucky. The commission staff conducted interviews with family caregivers about their needs, and identified current policies, resources, and programs. Below is a summary of their report, Supports for Family Caregivers of Elders, which was published in 2014.

• Approximately 735,000 Kentuckians are caregivers helping their family members to age in a home setting rather than in an institutional setting.
• Since 2009, the budget for the Department for Aging and Independent Living has decreased by 27 percent. Nonetheless, the Area Agencies on Aging and Independent Living provided 55,834 family caregivers with supports such as respite care and caregiver training in fiscal year 2014 and additional services for seniors that help family caregivers provide care such as homemaker services and home-delivered meals.
• The majority of seniors indicate a preference to age in a home setting rather than in an institutional setting.
• In the future, there will be fewer children to care for more aging parents. The pool of family caregivers is likely to expand to include other family members, close friends, neighbors, and other nonrelated people.
• Aging in a home setting with appropriate supports for seniors and family caregivers may be more cost effective than nursing home care. Kentucky’s Medicaid program pays approximately $48,000 per year for a nursing home bed compared to $15,000 for in-home supports.
• Kentucky spends approximately 81 percent of all long-term care dollars on nursing home care and the remainder on supports to help seniors age at home. The growth of the senior population may outpace available Medicaid funds without a redistribution of spending. The Department for Aging and Independent Living has indicated plans to improve this distribution by increasing services available under the Medicaid waiver for home- and community-based services, which could help family caregivers provide care.
• Some spousal caregivers may feel that they have no other option than to admit their spouse into a Medicaid-funded nursing home to protect financial resources for themselves. If the eligibility for home-care services were given the same consideration of resources as nursing home care, more seniors may be able to care for their spouses in a home setting.
• Caregivers are often not included in transitional care planning when their family members are discharged from a hospital stay. The family members may experience relapses in illness or deterioration of health that leads to nursing home admission or hospital readmission. Transitional care includes coordination and communication between the patient, health care professionals, and caregivers about necessary post-hospital care. Inclusion of family caregivers in transitional care planning could help more seniors recover from hospital stays and remain in their homes.
• Delays in home-care services for seniors sometimes result from an extended time period between an assessed need for services, a determination of eligibility for services, and delivery of service. Delays in services such as assistance with medications, nutrition management, and personal care can result in rapid health declines, hospitalizations, and nursing home admissions. Presumptive eligibility at the time of the assessed need for homecare services could expedite service delivery and help caregivers keep their family members healthy at home.
• There are shortages of personal care and home health professionals, particularly in rural areas. These in-home caregivers provide services essential for some caregivers to help their family members to stay in their homes.
• Family caregivers for seniors are often stressed emotionally, physically, and financially. Improved supports for family caregivers could help more seniors stay in their homes.
• Many family caregivers do not receive any state-funded supports. They are often unaware that services exist or cannot afford services that are available. There are waiting lists for most state-funded services and supports for seniors and family caregivers. More support for the Area Agencies on Aging and Independent Living could help more caregivers provide care for their family members.

Read the full report here