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Care for caregivers: New program offers support for the ‘sandwich generation’

New program offers support for the ‘sandwich generation’
Jessica Rinaldi
The “sandwich generation” are people who are juggling multiple care-giving roles, often at the expense their own physical and mental health.

As a family medicine physician at Fairview Clinics-New Brighton, Kim DeRoche, M.D., often sees a certain sort of patient.

“They’ll come in to see me, and I’ll notice that they haven’t been into the office for three to five years,” she said. “Typically, they’re women. They’re in high-stress, dual care-giving roles, working and taking care of their young children and their aging parents all at the same time.”

DeRoche’s patients come to her with a number of ills: “They have a range of mental and physical health needs, like high blood pressure, insomnia, obesity, anxiety, or depression,” she said. “They have put their own health to the side for a long time because they are focused on caring for the other people in their lives.”

While she can run tests or prescribe medications, DeRoche often feels she can’t accomplish everything that these patients need in just one visit.

“They come in saying, ‘I need to take care of myself. It’s been too long,’ ” she said. “But I only get a small moment of time with them. Once they’re done with me, they are usually off and running. I get to crack open the door at our appointment and try to help, but they need so much more support than I can give them in a brief amount of time.”

DeRoche calls these women members of the “sandwich generation,” people who are juggling multiple care-giving roles, often at the expense their own physical and mental health. 

“They are sandwiched between their parents’ health and logistical needs and the many needs of their children,” she explained. “It’s a high-stress role that can take a toll on a person’s health.” 

Support for the sandwiched

In an effort to provide a different kind of support for sandwiched caregivers, Fairview Health Services has launched a new option called Caregiver Assurance, a membership program that offers telephonic, online and in-person support resources for caregivers. A monthly fee of $50 connects members with a caregiver adviser — a licensed social worker who can provide them with resources, connections, counseling and even an optional in-home evaluation to better understand their needs. It’s suggested that individuals sign up for minimum of six months of Caregiver Assurance, but the service can be canceled any time after that.

Kim DeRoche, M.D.
Kim DeRoche, M.D.

The program, DeRoche said, “is designed to provide solutions to help people who are feeling caught between roles, to alleviate some of the burden.”

Mary Chapa, vice president of strategic development for Fairview Senior Services, said that while other caregiver support programs exist, they tend to focus their attention on the senior rather than on the caregiver. Caregiver Assurance’s focus is different.

“Our primary focus is on the caregiver,” she said. “It turns our that they are the one that often really needs the attention.”

When they developed the program, which launched just last month, Chapa said organizers had a specific audience in mind.

“The target age for our services is between 36 and 60. The average age is 49. Sixty-six percent of our audience will be female, usually the adult daughter, a busy middle-income professional with a family. They need assistance navigating various options for keeping their loved ones at home and safe.”

While providing members with resources for their loved ones is a key function of the service, the most important role of the caregiver adviser may simply be to provide emotional support through the difficult work of keeping a family healthy and happy, Chapa said.

“Sometimes the adviser’s role might be simply reaffirming for the caregiver that they are doing all they can for their loved ones,” she said. And the support can extend beyond the time of most acute need: Sometimes members may want to stay in the program after their elderly parent or grandparent dies.

“They may want to keep talking, to find out about grief groups or other public health or community resources in their area,” Chapa said. 

A range of services

At their medical appointments, DeRoche’s patients often list a range of caregiving tasks that create stress in their lives — things like making medical appointments for family members, checking on elderly parents during the work day and making sure their loved ones are fed and secure.

A Caregiver Assurance adviser can help with all of that, Chapa said.

“A typical client may be in the situation of, ‘Dad died. Mom’s alone. I work. I can’t keep driving over there all the time. How do I keep Mom safe at home? I want to make sure she’s OK.’ ”

Mary Chapa
Mary Chapa

The caregiver adviser can start with simple things, Chapa said, like explaining technological options that can help an elderly person safely live in his or her own home.  Sometimes it’s support for difficult family conversations, like telling an elderly parent it’s time to give up the keys to the car.

To help keep things clear, Caregiver Assurance establishes an online portal for each member, so members can log in to keep track of past conversations and recommendations.

“Say I’m our social worker,” Chapa explained. “I talked with you and I gave you three different referrals. The next time you call, you say,  ‘I can’t remember the name of that provider your recommended.’ The portal will help us keep track of any information I have passed on to you.” 

Potential employer benefit

Caregiver Assurance is available to any individual who signs up and pays the monthly fee. Chapa and her colleagues are also interested in selling the service to large employers as an additional employee benefit. They’ve developed a pilot program for Fairview employees and they hope to soon market it to other large employers.

As the population ages, the number of caregivers in the United States continues to grow. “Caregiving in the U.S.,” a 2015 report sponsored by AARP and the National Alliance for Caregiving, found that 43.5 million adults have provided unpaid care to an adult or child in the last 12 months. In other words: Caregivers are everywhere.

“I know from my work that this is an issue for many of my colleagues,” Chapa said. “I walk down the hall every day and people are making phone calls trying to set up doctors’ appointments or checking in on their loved ones. We know this is an issue in any worksite. In a tight job market, Caregiver Assurance could be an important benefit to offer and attract potential employees.”

Employers that are concerned about improving their employees’ health often offer discounts for gym memberships, Chapa said. Offering support services for caregivers could also serve to reduce stress and improve the health of people who are sandwiched between caring roles.

“I remember back in the ‘70s when it was a new concept to talk about day-care issues in the workplace,” she said. “That’s not an issue anymore. Now, as our population is aging, we have to start thinking about how to provide support for people who are caring for their older loved ones. This could be one way.” 

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Caregiver services have long history

Whenever supportive services are being made available to family caregivers, it’s good news. Kudos to Fairview for joining in.

It’s important to note, however, that Caregiver Coaching and Consultation has been provided by community-based organizations for decades. Much of this work is supported by Title III-E of the Older Americans Act as part of its National Family Caregiver Support Program begun in 2000. Contrary to Ms. Chapa’s assertion, these programs have always focused squarely on the caregiver’s needs and goals. Assessment, goal-setting, counseling, resource finding, family meetings, and ongoing support have long been service hallmarks. Thousands of Minnesota families benefit each year from the guidance and expertise of caregiver consultants throughout the state using evidence-based and evidence-informed methods. Complementary caregiver services such as respite care, support groups, and education programs are often available to further bolster caregivers’ confidence and well-being. FamilyMeans, in Washington County, is one of many wonderful nonprofit agencies across the country that have been providing these services for many years. We will continue to work toward better integration of health care and community services in ways that improve outcomes and lower costs.