Providing care to an older adult can be complex. Added to that complexity is the fact that many people never plan or are trained to provide the type of care that is often required when an older adult returns home after a hospital stay. This is where the CARE Act becomes critical for caregivers to be aware of.
Are you aware of the CARE Act and how it can help you as a caregiver?
The CARE Act, short for “Caregiver Advise, Record, Enable”, was initiated by AARP and took effect in Illinois January, 2016.
AARP notes that almost half of all family caregivers provide some type of medical or nursing care to their loved one. So, the question becomes how or who trained them?
There is not always a lot of time or planning that occurs during the discharge planning process when leaving a hospital. Hence, AARP realized, by listening to those doing the care that something needed to change.
The CARE Act requires hospitals to:
- Record the name of the family caregiver on the medical record of your loved one.
- Inform the family caregivers when their loved one is to be discharged.
- Provide the family caregiver with education and instruction of the medical tasks he or she will need to perform for the patient at home.
Who is considered a caregiver?
Keep in mind that many states, including Illinois, define a “family” caregiver to include, but not limited to, a relative, spouse, partner, friend, or neighbor. This is very important for those individuals who may not have family, in the traditional sense, such as many older adults who reside within H.O.M.E.’s Intergenerational Housing program.
Even though residents of H.O.M.E. are expected to be relatively independent, as we do not provide medical care, it is important that they are involved with their discharge planning so H.O.M.E. can be aware of their needs and help residents locate needed assistance.
The CARE Act sounds simple right. The problem is too often that family, and the patient for that matter, are overlooked in the discharge planning process or are an afterthought and handed written instructions to be followed at home.
Achieving patient-centered care
What appears to be consistently mentioned in the literature on case management is the need to involve the patient in the process, what Chewning and Sleath (1996) refer to as a patient-centered collaborative model.
The Agency for Healthcare Research and Quality define patient-centered care as "providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions" and notes that it is one of six pillars of quality care.
The problem is, without an evaluation to discover patient preferences, values or needs, professionals will struggle to meet patient expectations. How does one shift from a case management and discharge planning system that is driven by the provider and the healthcare system at large to one that is patient-centered?
It appears that the CARE Act is one step that can bring us closer to a patient-centered approach. We just have to make sure the patient and caregiver know their rights to be included in the discharge process.
At H.O.M.E., we are proud to partner with programs at Loyola University Chicago and the University of Illinois at Chicago to connect students in nursing, medicine, and other health fields to our housing program. A key part of the learning objectives for these students is to learn more about patient-centered care and how medical orders are implemented in a community setting.
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