Viable Long-Term Care: Sustain The Caregiver


By Nancy Muller, PhD, MBA

Executive Director of the National Association For Continence
The real battleground between the ambitions and goals of President Obama’s Administration and the State Governments, understandably so, appears to be Medicaid.  After the recent Supreme Court decision giving States the option of opting out of the expansion of Medicaid built into The Affordable Care Act, Florida, South Carolina, Texas, Louisiana and other Republican-governed states have gone public stating they will fight against and prevent such an expansion of Medicaid covered recipients.

But even before this latest round of squaring off in opposite corners of the political ring, we have yet to still tackle one of the toughest questions facing us in bridling healthcare costs.  With 70 million Medicaid enrollees, we already have more than one in five Americans enrolled in Medicaid.  Although half of them are children, as approximately half of all children born in the U.S. today are born into poverty, the lion’s share, or two thirds (64%) of Medicaid funds are going to cover the elderly and the disabled.  And although two thirds (62%) pays for acute care in hospitals, a whopping one-third (33%) is spent on long-term care.  Hence, there is keen desire by States to grant nursing home waivers for Medicaid recipients to be cared for at home. Medicaid recipients are not in a position to save for or buy insurance to cover their own future long-term care costs.  Few can meet basic needs, such as food, housing, clothing, and primary healthcare derived from what they earn. That’s why they qualify for Medicaid in the first place.

The party completely overlooked in this discussion about cost containment and individual responsibility is the family caregiver, the impoverished other half of the household on whom daily care of the disabled and the elderly is pushed.

How is it that in the U.S., the wealthiest nation on earth, we have largely turned our backs on family caregivers who are the least equipped to manage a frail, elderly or disabled relative – who otherwise qualifies medically to be cared for by trained professionals in a long term care, residential facility – by denying them education in absorbent product selection and usage and quality absorbent products designed to perform at a minimum threshold?  The National Association For Continence has led for 18 months an effort to change this and facilitate the right intervention to ease that caregiver burden and in the process reduce waste, foolish product purchases, and fraudulent practices, while safeguarding both the skin integrity and dignity of the recipient.  Read the recommendations, share them, and promote their adoption and implementation in YOUR state.


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