Elder Care

Part
01
of nine
Part
01

Elder Care - Checklist Survey

There are many resources available to family caregivers that range from personal care as a caregiver, to delivering care for elders with specific diseases. Links to specific lists are included on the attached spreadsheet, as well as a brief description of what each list provides. Below you will find a list with attached sources of locations where lists were found, as well as resources for caregivers. Further details are on the spreadsheet.

Family Caregiver Checklists


Family Caregiver Personal Resources


Note that all of the above checklists and resources are specifically for family caregivers, not caregiving agency personnel. The links to the above lists are also provided on the spreadsheet.
Part
02
of nine
Part
02

Elder Care - Comprehensive Checklist

The list of things that need to be taken into consideration when providing care for the elderly is endless. Using several checklists created by different care providers, 66 items have been included in the comprehensive checklist. The items can be condensed into ten major categories:

1. Environmental Safety
2. Personal Care
3. Nutritional Intake
4. Medication
5. Toileting
6. Mobilization
7. Home Management
8. Transportation
9. Administrative
10. Emergency

Another category, Caregiver Self-care is included in the checklist as a caregiver's needs are equally important.

CONCLUSION

The comprehensive checklist tab in the Elder Care Checklists spreadsheet has been updated with a unified list of a caregiver's responsibilities when looking after the elderly. Tasks range from making sure that the home is safe to ensuring that finances are managed properly.
Part
03
of nine
Part
03

Elder Care - Prevalence and Difficulty

While there is no preexisting information to fully answer your question, we've used the available data to pull together key findings: the percentage of informal and family caregivers coordinating care behaviors for elderly Medicare beneficiaries, the impact of cognitive impairment on the difficulty of care tasks and responsibilities, and the difficulties reported by caregivers when researching health issues among other healthcare tasks.

Below you'll find an outline of our research methodology to better understand why the information you've requested is publicly unavailable, as well as a deep dive into our findings.

METHODOLOGY

To answer your question, I searched for academic/medical studies, industry reports and surveys among caregivers for elderly people in the US. While I found several studies that address prevalence and difficulty of several (but not all) care behaviors listed in Column B of the attached spreadsheet, these vary in terms of methodology and intervening factors e.g. cognitive impairment, dementia, etc. such as to affect the parity and consistency of data. Therefore, I opted to present my findings in this response format instead of encoding inconsistent data into the spreadsheet. The bulk of my findings come from the US National Library of Medicine, National Institutes of Health database. Please continue below to see the results of my research.

Families Caring for an Aging America (2016)

The survey results of the 2016 book "Families Caring for an Aging America" published by the National Academy of Sciences gives the most relevant findings I could find for this topic. Figure 3.3 below provides the percentage of informal and family caregivers coordinating care behaviors for elderly Medicare beneficiaries aged 65 and above in the U.S.

•"Help care recipient take shots or injections: 7.8%
• Help manage medical tasks: 10.6%
• Help with skin care wounds: 23.2%
• Help add or change health insurance: 25.2%
• Help with special diet: 27.4%
• Help with other health insurance matters: 33.6%
• Help keep track of meds: 48.6%
• Help speak to medical provider: 54.9%
• Help make medical appointments: 60.5%"

While the book also mentions other tasks such as in Table 3.1 'What Family Caregivers Do for Older Adults', and Table 3.2 'Type and Frequency of Family Caregiver Tasks... by Care Recipient's Dementia Status etc.", these do not indicate prevalence percentage or difficulty. Also, Table 3.2 involves elderly dementia as a factor in care.

Problems experienced by informal caregivers (2016)

The 2016 study ''Problems Experienced by Informal Caregivers with Older Care Recipients With and Without Cognitive Impairment" available in the U.S. National Library of Medicine also gives valuable information regarding difficulty of administering care. Table 2 in particular gives the percentage of prevalence regarding difficulty of caregiver tasks and responsibilities.

However, the reported difficulty of tasks depends on the cognitive impairment of the elderly. The tasks are categorized based on 'demand on informal caregiver', 'safety of care recipient', and 'social-relational problems'. These were then measured for prevalence based on presence of cognitive problem, difficulty and impact. Figure 2 shows that difficulty across all types of problems (care tasks, safety of care recipient, and social-relational) increased when cognitive impairment was present in the elder receiving care.

Seniors and Caregivers Online Survey (2012)

I also found this 2012 survey (the latest available) conducted by the American Academy of Family Physicians (AAFP) about senior citizens and their caregivers. Relevant findings about difficulty in administering care revolved about finding information about health conditions (of the elder receiving care) and medication.

• 92% of interviewed caregivers say they sometimes get confused by physicians' recommendations. (p.9)
• 88% of interviewed caregivers say they sometimes get confused by bill received from physicians or insurance providers. (p.9)
• 94% of interviewed caregivers say they are not experts about prescription drugs and potential interactions. (p.9)
• 58% of interviewed caregivers say they find it difficult to visit multiple resources when researching a certain health issue (p.10)

ADDITIONAL RESOURCES

Here are additional materials for further reading:

Informal Caregivers in the United States: Prevalence, Caregiver Characteristics, and Ability to Provide Care - discusses prevalence of care giving itself, but with no specific care behaviors for the elderly

Caregivers for older adults: Prevalence, characteristics, and health care utilization and expenditures - discusses characteristics and needs of caregivers themselves but with no specific prevalence for care behaviors for the elderly

CONCLUSION

To wrap it up, despite the lack of comprehensive and uniform data about the prevalence and difficulty of caregiver tasks for elder recipients in the US, we've used available data to pull together key findings for your project. These include the percentage of informal and family caregivers coordinating care behaviors for elderly Medicare beneficiaries in 2016. We also found that presence of cognitive impairment in elders increase the difficulty of care tasks and responsibilities. Finally, informal caregivers report difficulties when researching health issues among other healthcare tasks.
Part
04
of nine
Part
04

Elder Care Ecosystem - Legal Zoom-Carely

We have provided an overview of the services provided for elders by the companies Legal Zoom, Life Care, Everplans, Avvo, Assurity, A Place for Mom and Carely in rows 4 to 10 in the attached spreadsheet. A summary of our findings has been provided below.

SUMMARY

Legal Zoom
Category 1: Licensed Professionals
Category 2: Estate Planning
Legal Zoom provides a variety of general legal services but those relevant to elders include power of attorney, disability benefits, living will, living trust, and other estate planning apparatuses. The company offers an Estate Planning Bundle that would be useful for the elderly. This package includes a last will and testament or living trust, power of attorney, living will, a year of advice from an attorney, and unlimited updates for a year.
Life Care
Category 1: Licensed Professionals
Category 2: Senior Care Management
LifeCare provides caretaking and financial services to employees. While the company doesn’t advertise or provide services directly for elders, they do provide programs such as Senior Care Management or Backup Care Connection that help employees who must take care of dependents such as the elderly. LifeCare's target market is employers, who purchase their services for use by their employees.
Everplans
Category 1: General Info
Category 2: General Planning
Everplans provides a digital vault to hold and protect personal information such as passwords, wills and financial details that can be accessed in the case of illness or death. Services specific to elders include Long-Term Care Insurance, Eldercare Living Wishes and Care Providers. Everplans also presents set of resources dedicated to helping the elderly prepare for future choices and life changes such as moving to a retirement home.
Avvo
Category 1: Licensed Professionals
Category 2: Estate Planning
Avvo is a legal practice that provides a range of services such as estate planning, which would be beneficial to elders. They also employ lawyers who work with elder law. Avvo services all fifty states in the U.S. and provides fixed fee lawyer services.
Assurity
Category 1: Licensed Professionals
Category 2: Insurance
Assurity provides a range of insurance options including disability, critical illness and life insurances. Their products are not stated as being explicitly for elders, but products such as life insurance, including whole life, term life and universal life, critical illness and accidental death, are all relevant for elders.
A Place for Mom
Category 1: Long Term Care
A Place for Mom are experts in finding care for seniors, including nursing homes and assisted living facilities, and aim to assist families with the transition as well. The company services the whole of the U.S. and provides consultations with a local adviser, information on care providers, assistance with scheduling site visits and help with transitioning into the senior's new home.
Carely
Category 1: General Info
Category 2: App
The Carely app is designed to foster effective communication between carers, elders and care facilities. While it is not designed specifically for those aged 65+, it is relevant as a majority of people in care would be of this age group. The app allows carers to communicate with elders and their care facilities, as well as the sharing of photos, asking questions, sending messages and scheduling or notifying of upcoming care facility visits.

Conclusion

An overview of the services provided for elders by the companies Legal Zoom, Life Care, Everplans, Avvo, Assurity, A Place for Mom and Carely has been detailed in rows 4 to 10 in the attached spreadsheet.
Part
05
of nine
Part
05

Elder Care Ecosystem - Vital Connect-Living to 100

The eldercare ecosystem provides a wide variety of services for seniors and their families. We've researched 7 companies and three of those were companies that provide a listing or database of providers or care centers that assist the elderly. One was a calculator that helps determine life expectancy based on medical research and health history. Another company is a resource for looking up benefits available to the elderly. Another provides a patch that patients can wear to monitor and report vital statistics. The last provides care services in the home for seniors from basic personal care to hospice care. They provide services for Alzheimer's, dementia, and other conditions. The attached spreadsheet includes service details for each of the service companies.

Vital Connect

Vital Connect provides a patient monitoring solution that monitors vital data. The data is immediately sent to the server and the care provider. It is used in hospital monitoring, post-discharge monitoring, and remote monitoring. According to vital connect the patch costs them $1 to manufacture and they planned to make the complete setup cost the patient $100.

Home Instead

Home Instead offers services in the home that includes everything from personal care to hospice care. They also provide services to care for patients with Alzheimer, dementia, and other acute conditions. This can be short-term or long-term care for seniors. The cost for the services varies by the care provided. Home Instead has franchise locations all over the United States and Internationally.

Seniorly

Seniorly is a resource for locating senior living communities by connecting seniors with communities that will keep them vibrant and alive. They have more than a thousand listings that include assisted living, memory care, independent living, and continuing care retirement communities. Seniorly lists all the cities and locations on the website for easy viewing. They also have a video available with caregiver resources.

Eldercare Locator

Eldercare Locator is a service of the U.S. Administration on Aging to help connect people with services for elderly and their families. They have 17 different categories from which you can search. Eldercare also has a section with tools and resources for locating benefits, long-term, advanced care, and a fact sheet with other federal resources.

Caregivers

Caregivers host a database of providers. They perform the criminal background checks on all providers that sign up for their service. Providers sign up on the site and then get connected with seniors/families needing their services. Caregivers set up the connection between the patient and the provider and they manage the payment between them.

BenefitsCheckUp

BenefitsCheckUp is a service from the National Council on Aging. It allows seniors to find benefits they might be qualified for. The 2020 goal of BenefitsCheckUp is to improve both the health and economic security of 10 million elderly adults. They profess that there are more than 2,500 federal benefits available and they help the elderly by researching and posting information on what is available. This is a free service and upon entering information, it will send them to other sites to check on benefits that may be available to them.

Living to 100

Living to 100 is a life expectancy calculator that determines your life expectancy. It uses medical research and patient history to ask 40 health-related questions to determine an individuals' life expectancy. It's endorsed by the Society of Certified Senior Advisors. This is a free service to take part in the 40 question quiz and obtain results.

Conclusion

In summary, each of the seven companies listed provides various services to seniors that include a life expectancy calculator, a benefits services finder a vital statistics monitor, care providers and centers locator, and an in-home service provider. Each of the companies is entered into the attached spreadsheet with details on services they provide.
Part
06
of nine
Part
06

Elder Care Ecosystem - Doctor on Demand-AARP

We at AskWonder categorized companies that are a part of the Elder Care Ecosystem as companies that specifically provide care for elders and/or information relating to the care of elders (those over 65 years of age). Therefore, companies that do not specifically provide care for elders and/or information relating to the care of elders were not considered to be a part of the Elder Care Ecosystem.

Companies that are a part of the Elder Care ecosystem include Eldercare Advisors, AARP, and Benefits.gov. Companies that are not a part of the Elder Care Ecosystem are: Doctor On Demand, iHealth, DOmedic, and Medic Mobile.

A more in depth breakdown of each of the companies listed above can be found in rows 18-24 on the attached Google docs spreadsheet.
Part
07
of nine
Part
07

Elder Care Ecosystem - National Council on Aging-Hello Wallet

For each of the seven assigned providers in the spreadsheet, I have provided an overview of the services that they provide for elderly people or caretakers, and at least one relevant category that describes the services.

I researched each provider, mostly using information from their own websites. I was able to summarize the services that they offer, and in instances where they are not specifically aimed at the elderly I have clarified what they do offer to this target market. In addition to this I was able to select a relevant category that described the services that were provided, and in most cases I refined this by adding secondary and tertiary categories. All this information has been entered into rows 25-31 of the spreadsheet.

To summarize, this it how I defined the primary categories of each of the providers:

National Council on Aging: Financial planning
Blue Zones: General info
The Conversation Project: General info
Aging Life Care Association: Licensed professionals
Life Planning for You: Financial planning
Mint: Financial planning
Hello Wallet: Financial planning

CONCLUSION
Most of the organizations looked at were either offered financial planning or general information for the elderly. A couple were not specifically focused on the elderly (Mint and Hello Wallet) although they offered services that could be used by the elderly. Aging Life Care Association was different as it is not specifically aimed at the elderly generation, it is aimed at the healthcare professionals who work with them.
Part
08
of nine
Part
08

Elder Care Ecosystem - Fidelity-Merrill Lynch

Fidelity, Financial Planning Association, and Merril Lynch all offer services that can be relevant to people aged 65 or older and their families, such as retirement planning, long-term care, and estate planning. However, none of them have services that are restricted to this age group. FPA and Merril Lynch provide resources dedicated to seniors on their websites, which indicate that they are among their target customers. Clarity Monkey can potentially be helpful for elderly and their families, but its app doesn't offer anything that is particularly relevant to this age group. I filled rows 32-35 of the attached spreadsheet with the information about those four institutions.

Additionally, True Link Financial, Seniors Financial Solutions, Florida Institute of CPAs, and State Trust are four financial services institutions that offer services for seniors. Below, you will find brief overviews of those four companies. I concluded that I shouldn't include them in the spreadsheet, considering that I was only supposed to work in rows 32-35.

TRUE LINK FINANCIAL

True Link is a San Francisco-based financial services company that offers investment services for retirees, customizable cards, and trust investment and management. They have prepaid cards for elderly (to protect them from financial abuse and give them more freedom) and caregivers (to monitor their spending). They also have various potentially useful retirement solutions, such as longevity tool that helps retirees with financial planning.

SENIORS FINANCIAL SOLUTIONS

Seniors Financial Solutions is a financial services company that provides its services to the residents of Texas. It specializes in estate preservation strategies, helping seniors and their families protect their savings while also getting quality nursing care. The company also provides other financial planning services for seniors.

FLORIDA INSTITUTE OF CPAS

Florida Institute of CPAs is a professional association for Florida Certified Public Accountants. The organization created the CPA Elder Planning and Support Services Committee, which provides advice on various aging-related financial issues, helps to establish required care standards and find potentially helpful community resources. It also assists with developing and implementing financial and personal care plans.

STATE TRUST

State Trust is a Miami-based wealth management company. According to them, financial planning is especially important for seniors. They offer their assistance with retirement planning and estate planning. The latter "encompasses wills, trusts, tax planning, life insurance and long-term care insurance."

CONCLUSION

In conclusion, I filled rows 32-35 of the attached spreadsheet with the requested information about Fidelity, Financial Planning Association, Clarity Money, and Merril Lynch. Those companies offer financial services that are relevant to seniors, such as long-term care or estate planning but aren't only for them. Additional financial services institutions that target seniors are State Trust, Florida Institute of CPAs, Senior Financial Solutions, and True Link Financial.

Part
09
of nine
Part
09

Elder Care - Company Policies Overview

OVERVIEW
As the Greatest and Silent generations get older and require more care, their children and other family members try to help as best they can. This leads to heavy levels of stress for these caregivers who are also working a full-time job at the same time. Employers are starting to create policies and procedures to help keep their employees and make the caregivers overall life easier however they can. Roughly 42% (54 million people) of employed Americans have provided elder care within the last five years, and 17% of the workforce is currently providing elder care.
FINDINGS
As the generations before us get older, they start requiring more care which frequently falls to their children to provide. Most of the children in these cases are Baby Boomers who work full-time and are working towards retirement. This creates a high level of stress on the caregivers who try to care for their parents and work full-time leading to decreased productivity at work and depression. There are now studies on policies and legislation that helps caregivers work while taking care of family members.
FMLA
Also known as the Family and Medical Leave Act, FMLA requires companies with more than 50 employees to allow their employees up to 12 weeks of unpaid leave per year. Employees that need to use this option are also protected from losing their job and benefits under FMLA. This doesn't mean you can start working any job and automatically qualify for these benefits, but if you've been working at a company consistently for a year, you likely do qualify. Along with this, the ADA protects you from losing your job or being harassed at work when needing to take time off under FMLA.
EMPLOYER TOOLKIT
AARP and the Northeast Business Group on Health worked together to develop a toolkit for employers to understand caregiving and how they can support their employees. The toolkit is easily downloadable once you enter your email address and company (they firmly state that they do not use the information for marketing purposes) or by going to the source below. Inside the toolkit is a robust document covering almost every aspect of the caregiver's needs such as the employee's needs, what the employer can do and general help for caregivers. The toolkit also walks employers through how to create a program for caregivers working for them. AARP recommends showing the document to employers if there is no policy in place and you need the assistance. The document will not only help employers build the programs but understand what is needed and why, especially for employers that have not been in a family caregiver position themselves.
SILICON VALLEY
In Silicon Valley, the elder care struggle has been noticed, and executives have been looking at ways they can help. There are four new startups in Silicon Valley that have been created to help with different aspects of elder care.
Honor- an app that specializes in non-medical home care where help can be requested for any length of time and in many cases, someone can be at the patient's house in under 2 hours. For children who live in different states then their parents this is nice because they can book visits on the app and know when they arrive and leave the house.
Collective Health- a platform where companies that manage their health care plans can get information on medical claims and keep track of benefits and claims.
Color- a company that provides affordable genetic testing and personalized screening results and options to their patients, rather than just giving them the results and sending them on their way.
Virta Health- this company works with diabetic patients to manage their carbohydrate intake, and they have noticed that 56% of patient's blood sugar level dropped and 87% were able to stop or reduce the medication they were taking.
FAMILY CAREGIVER STUDY
Caregiver.org did a study to determine what policies and programs are in place for family caregivers. They found that there wasn't much consensus on what was best for employees and companies, but there had been a paradigm shift where many places explicitly mention policies regarding care of elders. They also noticed that there wasn't common terminology being used to refer to caregivers and in some cases, this meant that only direct care workers could get benefits. There were ten states in the study and of the ten the most progressive were Pennsylvania and Washington. Both have expanded their state programs with funds from NFCSP to broaden the scope and services that can be offered. California and Maine created standalone programs to use the NFCSP money specifically to provide support to caregivers.
SPECIFIC POLICIES
The State Department has a program called WorkLife4You that offers 24/7 support to employees relating to family care issues, personal issues or professional issues. They can refer employees to services and centers that can help them, and they provide an Eldercare Kit upon request full of resources for a caregiver.
This is another State Department program where employees can call, and a clinical social worker will provide them with resources and services as needed.
As part of the US Department of Health and Human Services, this administration focuses on providing resources for elder care and caregiving.
Pretty much all companies have an EAP that employees can use, and this is a 24/7 helpline where employees can call and get referrals for services. Many companies can expand this program to include other services as well.
Companies utilize a backup care policy so that if care for children or elders falls through the company can help provide care so that the employee can still work.
Some companies will also offer flex scheduling so that employees can care for the family during the day and still work as well. This could mean anything from shortening hours too long breaks to check on family during the day. It can also include time to ensure family gets to doctor’s appointments or other medical care when they need to.
EMPLOYEE RESPONSE
Companies like Google are well-known for their gracious family care policies, and they are finding it helps the company in the long run. Google has dropped their attrition rate for working moms to only 50%. Quicken Loans has 45% of their workforce on flexible scheduling and 22% telecommuting. Some companies have even gone so far as to take the federal recommendations and then expand them to include more time for unpaid leave or family sick days. Many companies that are well-known for their family care plans find that over 95% of employees are not only happy to work there but proud to say they work there as well.
CONCLUSION
As our family members get older, they require more care and need more of our time to help them get the care their need. In Silicon Valley apps and companies have been developed to help caregivers work while still providing care to their family. Companies are expanding EAP and federal recommendations to better assist their employees and retain their employees as well. Not all companies do this but those that do find that employees are happier and more productive when they have the assistance they need.
Sources
Sources