The Impact of Family Caregiving

MD Head Shot

By Michelle D. Javid, MSW
Manager of Business Development, Seniors at Home-JFCS
Member, Steering Committee, Aging Action Initiative

In the United States today, there are approximately 44 million family members caring for a person who is aging, disabled, or seriously ill, according to the AARP. At some point in our lives, most of us will care for an elderly parent, spouse, partner, or friend. Initially, we feel rewarded and eager to help our loved one, but as the demands of caregiving increase, so do the stress and exhaustion. With a majority of family caregivers juggling paid employment, childcare, and other responsibilities on top of caregiving duties, it is common for family caregivers to be at higher risk for anxiety, depression, and increased use of alcohol or other substances.
As the aging population in Marin increases, we are seeing more families stepping into the caregiver role. The “sandwich generation” refers to middle age adults who provide physical, financial, and emotional care to both their aging parents and their own children. According to a 2013 Pew research report, nearly half of adults in their 40s and 50s have a parent aged 65 or older and are either raising a young child or financially supporting a child age 18 or older.
The demands of balancing work and caregiving duties can have a significant financial impact on family caregivers, especially on women. According to a 2011 study from MetLife and Family Caregiver Alliance, a woman who leaves the workforce to care for an aging parent stands to lose more than $324,000 in wages and benefits over her lifetime. More significantly, with an increase in college-age children living at home and the unbearable costs of in-home care and assisted living, many report bearing financial responsibility for both their children and their aging parent. This can affect their own financial future and well-being.
Luckily, local resources are available to help ease the burden on family caregivers. Here in Marin County, the Family Caregiver Support Program (FCSP) provides grants to eight nonprofit organizations that provide education, support, and respite to family members caring for an aging loved one. With funds provided by the Marin County Aging and Adult Services from the National Family Caregiver Act, FCSP is administered by the Alzheimer’s Association and has proven to be a successful network of reputable organizations working together to coordinate care and provide much-needed support.
Seniors At Home, a division of Jewish Family and Children’s Services, is one of the organizations providing caregiver support through FCSP. We offer a wide range of support for older adults and their family caregivers including respite in-home care, dementia care consultations, care management, counseling, and more.
For more information on the FCSP collaborative and available services downloadable here or you can call Seniors At Home at 415-449-3777 to learn more about our supportive services.

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Collaboration: It Starts With Application Assistance and Ends With Empowering Older Adults

By Michelle Nochisaki
Program Coordinator, Green and Healthy Homes Initiative
Member, Steering Committee, Aging Action Initiative

Older adults are the foundation of our families, and the safety and integrity of their homes is important to them aging well physically, mentally, and emotionally. Far too often, many of the nation’s older adults struggle to stay in their homes simply because they are unable to afford even the simple modifications necessary to avoid injuries, not to mention major health and safety issues that need to be addressed. Even those who are eligible for government or nonprofit home rehab programs often have difficulty finding and applying for the appropriate assistance.

How can we solve this? Collaboratively!

In Baltimore, the combination of an aging population and aging housing stock prompted government, philanthropy, nonprofits, and healthcare providers to join forces. In 2015, Housing Upgrades to Benefit Seniors (HUBS) was formed through grants by the Leonard & Helen R. Stulman Foundation and Hoffberger Family Philanthropies. The grants allowed social workers from five “HUBS,” each geographically assigned to a different part of the city, to provide application assistance for homeowners above the age of 65 seeking home rehabilitation, weatherization, and home safety modifications. Due to the success of the program, the Harry and Jeanette Weinberg Foundation funded a capital grant with a match from the city of Baltimore, allowing the home repair partners, Green & Healthy Homes Initiative (GHHI), Civic Works, Neighborhood Housing Services of Baltimore, and Rebuilding Together Baltimore to provide more extensive services.

“Sometimes we don’t realize how much the little things matter, like a simple handrail,” said Bryan Koerber, housing intervention and services manager, about the work he does through GHHI’s Aging in Place program in Baltimore. “We’re able to provide handrails, motion lights, non-slip carpet treads, and exterior entrance railings to prevent falls, and also incorporate additional funding to install new furnaces. Now they have a working heat source and are able to live in their homes comfortably. When we’re able to deliver more holistic services, we’re able to change lives.”

As a HUBS partner, GHHI utilizes its holistic home assessment to identify slip, trip, and fall risks as well as health hazards and energy inefficiencies. It then braids together local housing programs to provide the necessary interventions for its clients and delivers education materials that promote good medication practices, healthy eating, and regular exercise routines to ensure that the older adults they help receive a holistic approach to achieving a healthy home.

Locally, GHHI Marin, an initiative of Marin Community Foundation, is a network of providers working together to improve the health, safety, and energy efficiency of Marin County homes. With many of its clients being seniors, Age Friendly Sausalito, Community Action Marin, County of Marin: Health and Human Services and Community Development Agency, MCE Clean Energy, Marin City Community Development Corporation, Marin Housing Authority, Marin Center for Independent Living, Strategic Energy Innovations, and Whistlestop make up the collaborative partnership working towards mimicking Baltimore’s collective success.

GHHI Marin is a housing modification program for income eligible applicants. Interested clients can submit a housing form via the Contact page of its website: www.greenhealthyhomesmarin.org.

GHHI HUBS model

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Climate Change Inspires Collaborative Action

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From AAI Program Director Linda Jackson:

The largest fires ever. The blistering heat. The drought. The rain deluge. The floods.

My cousin writes from Sweden that this summer is the hottest in 200 years. That was not a typo. And the end of summer is still over six weeks away.

This past month, I experienced 100+ degree weather in Portland, Oregon, and drove through the dense smoke of northern California.

While all this is alarming, I am comforted knowing that people from all arenas are addressing the problem. The path of global warming is increasingly documented by scientists of every field. Researchers are exploring carbon sequestration. Most national governments are moving toward the carbon goals set by the Paris Accord. Car companies are developing more efficient vehicles and innovators are creating new batteries. The state of California, the fifth largest economy of the world, is a leader in setting emissions standards. And major world religions, inspired by leaders like Pope Francis, are embracing the imperative to reduce carbon emissions as quickly as possible.

The motto “Think globally, act locally” has never been more meaningful than today. Here in Marin, we have at least a dozen organizations tackling sustainability. We have to save the planet as it is the only ship we have.

In many ways, climate change activism is a model for our work in the Aging Action Initiative. We are building bridges, tunnels and walkways between the silos we work in – between public agencies, nonprofits, and the health sector. We have goals: to share our knowledge and expertise and findings, to advocate for policy changes, to create innovative approaches that change our work for the better.

One of those innovations is an Inform & Connect workshop happening this month. The workshop is the inspiration of the Marin Interfaith Council. It is the first of an Inform & Connect workshop tailored to specific interests, in this case, of Marin faith leaders wanting to answer the call for help from members of their congregations.

Another innovation is highlighted this month’s newsletter: the collaboration behind the Green and Healthy Homes Initiative. Making our homes more energy efficient is vital to reducing our greenhouse gas emissions. GGHI is a collaborative effort that intersects safety and energy retrofits to adapt homes for older adults and to make them more energy efficient. The GHHI network shows how much can be achieved when people come together to do something new in a different way.

These summer months are a chance to slow down, look around and think. As the climate crisis shows us, we must come together to create new and more effective solutions to the challenges we see around us. Our work is essential to helping older people sustain their well-being.

We cannot give up. Our future depends on us doing this work.

~ Linda

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Trees: the Best Medicine?

July newsletter pic

By Lisa Santora, MD, MPH

In 2015, I relocated my family from Los Angeles to Marin County for trees. Yes, trees. There were two moments that crystallized my decision to move: watching my son touch his first earthworm when he was 4 years old, and hearing my 3-year old daughter exclaim, “It’s a farm!” when we landed at Philadelphia International Airport. I realized that I couldn’t stay true to my purpose of nurturing a healthy, joyful family in the concrete jungles of LA. My family and I needed nature in our lives.

Nature is scientifically proven to improve our health and well-being. But when most people are diagnosed with high blood pressure, high cholesterol, or diabetes, their next stop is often the pharmacy. For many of us, the next stop shouldn’t be picking up a new prescription, it should be visiting one of our many parks or open spaces to walk, bike, hike, or shinrin-yoku. Since the 1980s, shinrin-yoku, or “forest bathing”, has become the cornerstone of preventive health care and healing in Japan. Forest bathing has been shown to reduce cortisol (stress hormone) levels, lower blood pressure, and moderate nervous system activity. It measurably, objectively and subjectively, improves your health.

The County of Marin strives to make its parks and open spaces accessible for all in Marin. On the first Saturday of every month, Measure A Day, you can enjoy free entry and free parking at all Marin County Parks. Marin County Parks has an Inclusive Access Plan to ensure visitors can use its 16,000 acres of marshland, forests, creeks, and rolling hills according to their own abilities. Now, “other power-driven mobility devices,” like mobility scooters, can be used on trails by individuals with mobility disabilities. Marin County Parks has also partnered with Marin Health and Human Services and community partners, including Marin City Health and Wellness Center, to promote the Parks Prescription Program.

Next time you see Mt. Tam rise majestically before you, think of it as a reminder that it is time to shinrin-yoku.

More resources to help older adults enjoy the outdoors:

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Downsizing to where?

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From Program Director Linda Jackson: 

We decided to downsize this year. Our family home, long an empty nest since our youngest ones flew away, is simply too large for two people. There were rooms we didn’t go into, parts of the yard that we never saw, and decades of stuff that seems to reproduce when we weren’t watching. Most of all, we had a home that deserved to be full with a new, happy family.

The challenge was: Where would we move to in Marin? We wanted a smaller place in a neighborhood where we can walk about, close to restaurants, shops, and the movies. After months of searching, we found what may be be very last new unit in Marin. With little new housing being proposed in Marin, others will find it even more challenging to downsize to a smaller place.

No doubt about it, the process of downsizing is daunting.

It took months of sorting, a moving crew of millennials, and many boxes to give away and donate the things we don’t need anymore. It’s been a sweet good-bye journey, leaving the house we called home the past 28 years. It’s also been great fun to explore our new neighborhood near downtown San Rafael.

I can’t help but wonder how much harder it would be to do this if we were in our 70s or 80s? What options are there for older people in Marin as their lifestyles change? Will there be enough resources for people who want to grow older in their home and community? For those facing dementia or declining health, will they have what they need for safety and companionship?

The question for Marin is: what percentage of residents are going to choose to stay in San Rafael as they grew older? According to a national survey by AARP in 2012, about 90% of older adults intend to stay in their own homes for the next 5 to 10 years.

Have you heard of NORCs, which are a “naturally-occurring retirement community”? The parameters vary in the field, but I like this simple one: if 50 percent of a community’s residents are over 50, then the town is considered a “NORC.” Marin County hasn’t reached NORC status yet, although in 2010 the median age of Marin residents was 44.5, and there were 5,000 more people aged 75 and older than those five and under. There are some Marin places close to having a majority of residents over 50. In Belvedere, 41 percent of its residents were over 50 in 2010. A few communities in Marin have already reached NORCdom, such as the unincorporated community of Dillon Beach, where 62 percent of residents in 2010 were over 50! (You can look up fun census facts at factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml#)

People working with older adults are aware of the issues facing people as they grow older. Will there be housing for others who want to downsize? Will there be enough housing for the people who work in Marin – those who are caregivers, healthcare managers, and homecare experts? What about low-income people who need affordable housing, or people who need extra care, like assisted living or memory care? The recent report Older Adult Housing in Marin: Planning for 2030 estimated that 7,000 of today’s older residents need affordable housing, and that there is a shortfall of hundreds of assisted living and memory care units to meet the 2030 demand.

One small part of the housing solution in Marin is to support, fund, and streamline the process to create more accessory dwelling units. The new units can be for a caregiver, a family member, the homeowner (who can then rent out the main house), or a close-by neighbor, and can provide extra income for the homeowner. In San Rafael, the number of new accessory dwelling units doubled last year, and the city is on track to double that again. We need to do this across Marin!

This month, A.A.I. is working with our partners to ask local Councils and the Board of Supervisors to budget and prioritize funding, support, and streamlining for accessory dwelling units in 2018-19. Join us by talking this month with your elected leaders and challenging them to support this housing option for older people in Marin.

Working together, we can make a difference, starting with a place to call home.

Now, off to unpack some more boxes!

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