Clinical Geriatrics

It didn’t make the front page or lead the nightly news, but there was some very good news for older adults—and their caregivers—in the fiscal year 2011 budget that President Obama proposed last month: In keeping with Mr. Obama’s spending plan, funding for the Department of Health & Human Services’ Administration on Aging (AoA) would increase $108.4 million next year, reaching $1.624 billion.

This is indeed good news because the AoA is responsible for administering the Older Americans Act. Its mission is to provide a comprehensive, coordinated, cost-effective network of home- and community-based services that help older adults stay healthy, independent, and in their homes and communities. As clinicians, we know that coordinating effective community services for older adults can be challenging, and efforts to optimize the delivery of these services are essential.

To that end, the AoA administers a wide range of services, some more familiar than others, provided by state units on aging and area agencies on aging, that are essential to the well-being of our older patients. These include mental health services, transportation, nutritional programs, senior health promotion and disease prevention initiatives, benefits counseling, and elder abuse prevention programs. They also include essential services for older adults’ family caregivers.

There are an estimated 65 million family caregivers nationwide—and many are in great need of supportive services. As geriatricians, we commonly see these individuals accompanying their older adult loved ones to our offices. More than half are employed and juggle caregiving and working (and, often, childrearing as well). Some, however, have had to cut back on work, or stop working—with trying economic consequences—in order to continue to provide necessary daily care and supervision. Caregiving can have a negative impact on employers as well, in terms of lost employee productivity and higher absenteeism, and eldercare needs have been more problematic than child care needs for many employers.

Most of the proposed AoA budget increase would, in fact, go toward implementing the Administration’s new Caregiver Initiative. The initiative would significantly boost funding for three existing AoA caregiver programs. It would allocate $50 million more for the National Family Caregiver Support Program, which provides grants to area agencies on aging so they can offer families eldercare information, training, counseling, referrals, and respite care. The initiative would provide $2.5 million more for the Lifespan Respite Care Program, which affords family caregivers brief breaks from caregiving. And it would allocate an additional $50 million of the Home and Community-Based Supportive Services Program, which helps cover the cost of elder transportation, participation in adult day programs, and home care through local agencies on aging.

“Better support for family caregivers is critical since their availability often determines whether an older person can remain in his or her home,” said Assistant Secretary for Aging Kathy Greenlee, who heads the AoA and will deliver the Public Policy Lecture during the American Geriatrics Society’s Annual Scientific Meeting in Orlando this May.

I hope you’ll share this good news about proposed increases in AoA funding—and additional information about the AoA’s community-based services and how to access them—with your patients and their caregivers.

The AoA’s comprehensive and easily navigable website, www.aoa.gov, can help older adults and their caregivers find essential services right in the communities where they live. Those without Internet access can call the Eldercare Locator at 1-800-677-1116 for this information.