Housing Report Supports Push to Approve Question 7

Published in Woonsocket Call on October 30, 2016

Earlier this year, Rhode Island Housing (RIH) released a 44 -page report detailing the Ocean State’s current and future housing needs. One thing was clear to those attending this event: over the next decade the state will need more affordable housing for its residents.

Over the last 7 months, RIH’s Executive Director Barbara Fields has crisscrossed the Ocean State calling for increased housing opportunities for working Rhode Islanders. During this period of time she has presented the study’s findings to more than a dozen civic and government groups, including AARP Rhode Island, the Providence City Council and United Way.

During the last legislative session Rhode Island housing advocates were successful in their push for the enactment of a bond initiative that would make a significant state investment in affordable housing. As part of the omnibus statewide budget package, a $50 million Housing Opportunity Bond initiative for housing programs was passed by the House and Senate chambers, ultimately to be signed into law by Governor Gina Raimondo (D) and put to voter approval on the November ballot.

With the November election fast approaching, Fields has not let her report, compiled by HousingWorks RI, a research program at Rogers Williams University, sit on a dusty shelf but is using it to push for passage of the housing bond initiatives.

RIH Releases its Comprehensive Housing Study

On April 6, Fields gathered with state housing advocacy groups at the Rhode Island Commerce Corporation to unveil RIH’s landmark housing study, Projecting Future Housing Needs. Fields warned that the state’s economic comeback must be tied to new and existing housing that stays within the financial reach of Rhode Islanders. “Today in Rhode Island, the demand for housing is high while the supply is much too low. This imbalance simply makes the cost of housing too expensive for what our residents earn. This report provides critical insight into what the future needs of Rhode Islanders will be and that information will allow us to develop a plan to address those needs,” she said.

At this event, Rhode Island Commerce Secretary Stefan Pryor tied adequate housing for working Rhode Islanders as key to bringing businesses to the Ocean State. “Companies looking to expand or relocate consider how well they will be able to retain and attract their workforce, and a key part of doing so is ensuring that employees of all income levels have high quality housing opportunities,” said Pryor. “It’s vital to our state’s economic success and our quality of life that we preserve and produce high quality housing options for our residents,” he added.

The RIH report’s findings indicate that Rhode Island’s population is projected to grow between 3 and 5 percent from 2015 to 2025. Researchers warn that new housing demand will outpace population growth, and anticipate a 12 to 13 percent increase in the number of households, driven by a growing population and simultaneous decline in household size tied to both lower birth rates and an aging population. Researchers also predict housing demand will be driven by a large population growth in two demographic groups that tend to have lower incomes – namely aging baby boomers and seniors and young millennials.

According to the RIH report, cost burden problems of paying rent do not just impact older Rhode Islanders and Millennials, but have become more mainstream issues over the last ten years and now affect all income brackets. The findings found that Rhode Islanders already pay more than 30 percent of their income on housing costs, and that more than half of the increase in cost burden from 2000 to 2012 impacted households earning more than $57,700.

From 2000 to 2014, the researchers found that the state’s total population grew marginally at 0.11 percent, but the number of households grew by 0.28 percent. Rhode Island’s smaller household sizes are due, in part, to a larger proportion of older persons and a smaller proportion of persons of color when compared to national rates. Younger households are likely to have more people than those headed by people aged 65 and older, primarily because they are more likely to be family households with children. As this demographic shift continues, the future population will need more housing units to meet the increased household need caused by smaller household sizes typical of older householders.

Pushing for Passage of Question 7

Like Fields, Chris Hunter, campaign manager for the Yes On 7 Campaign, sees the RIH report’s findings as crucial information that voters need to know about the impending housing crisis. “As Rhode Island Housing’s recent report shows, we’re simply not creating enough new housing to meet projected population growth. At the same time we’re facing an affordability crunch as our young workers just starting their careers, families, veterans, and seniors are having a difficult time paying for housing while also making ends meet,” says Hunter.

“That’s why Question 7 and the $50 million Housing Opportunity bond is such a smart investment in housing and Rhode Island’s economy,” says Hunter, stressing that if approved by the voters the $50 million bond initiative will leverage an additional $160 million in federal and private investments.

According to Hunter, if approved, $40 million of the bond dollars will be allocated to the construction of affordable homes and apartments across Rhode Island, while the remaining $10 million will be used to help cities and towns revitalize blighted and foreclosed properties. The bond will also fund the construction of 800 affordable homes and apartments across Rhode Island and create 1,700 good paying local construction jobs.

Over 60 percent of Rhode Island voters passed housing bond initiatives in put on the ballot in 2006 ($50 million) and 2012 ($25 million), says Hunter. “Funding from these last two affordable housing bonds created 1,943 affordable units in 30 communities around the state, and leveraged more than $300 million in federal and private investment in these projects,” he says.

RIH‘s housing report has sounded the alarm, giving a stark warning to local and state officials that a housing crisis exists and will only get worse with the shifting of the state’s demographics. With the election looming, RIH’s Fields continues to push for passage on Question 7. Hunter works to mobilize his housing advocates and supporters of Question 7 to get the word out to every voter in Rhode Island’s 39 cities and towns that this bond initiative must be passed. Hopefully, their message will get across to Rhode Island voters. We’ll see when the votes are counted.

For more details on Question 7, visit http://www.yeson7ri.com.

Herb Weiss, LRI’12 is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

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Time to Change how Social Security Calculates ‘COLA’

Published in Woonsocket Call on October 23, 2016

On Tuesday, September 18, the U.S. Social Security Administration announced that the nation’s 65 million Social Security beneficiaries will be automatically be paid a minuscule 0.3 percent cost-of-living adjustment (COLA) to their monthly checks in 2017. The average monthly Social Security benefit next year will be $1,360, $5 more than now.

According to AARP, 153,349 Rhode Islanders received Social Security checks as of the end of 2014. Also, 22 percent of Rhode Island retirees depend on their Social Security check for 90 percent or more of their income. That’s chump change, not a lot of money for Rhode Island retirees to buy groceries, gas, or even catch up on their bills.

The federal agency detailed other changes that we can expect, too. Beginning in 2017, the amount of your earnings subject to the Social Security tax increases from $118,500 to $127,200. It’s estimated that this tax change impacts about 12 million of the 173 million people who pay into the retirement system.

Next year’s Social Security COLA increase is the smallest in a decade and comes after no increase in 2016 (zero increases also occurred in 2010 and 2011). Seventy percent of Medicare beneficiaries are protected by a hold-harmless rule, which keeps Social Security benefit payments from decreasing because of increased Medicare Part B premiums. However, 30 percent of Medicare beneficiaries (including high wage earners, those enrolled in Medicare and not yet receiving Social Security, and newly enrolled in Medicare) could see cost increases in their Medicare Part B premiums that cover their visits to doctors and hospitals. The increased premium costs will be deducted directly from their Social Security check.

Chump Change COLA Won’t Pay Bills

Responding to the federal government’s disappointing COLA announcement, AARP CEO Jo Ann Jenkins, whose Washington, DC aging group represents 37 million members, charges in a statement that one major domestic issue ignored by presidential debate moderators and one that demands attention from candidates is the future of Social Security.

“Over the last five years, Social Security COLA’s have remained small or nonexistent at 1,7 percent or lower, even though every cent can matter to beneficiaries and their families. After last year’s zero COLA, this year’s announcement doesn’t offer much help to the millions of families who depend on their Social Security benefits. As prescription prices skyrocket and Medicare premiums and other health costs increase, many older Americans have understandable concerns. Along with many groups, AARP has also asked Congress to ensure that Medicare premiums and deductibles don’t skyrocket next year,” says Jenkins.

Adds Max Richtman, President/CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM), “No one can say with a straight face that providing the average senior with an additional four dollars a month will come even close to covering the true cost of living that retirees face. The average senior spends more than $5,000 a year on healthcare costs alone. A $4 Social Security COLA doesn’t even make a dent in covering rising costs for seniors.”

Richtman asserts that next year’s tiny COLA increase only continues the trend of historically low cost-of-living adjustments for retirees. “Over the past eight years, the current COLA formula has led to average increases of just over 1%, with three of those years seeing no increase at all. For the average senior, the 2017 COLA will mean an extra $4.00 per month which would barely cover the average cost of one Lipitor pill, a prescription drug frequently prescribed to seniors,” he says.

Richtman notes, “I’ve asked seniors at town hall meetings around the country how many of them think the COLA represents their true cost of living — laughter is always the response. We should move to a COLA formula that takes a more accurate measure of seniors’ expenses, which is a CPI for the elderly. The CPI-E has been in the experimental phase since 1982. It’s time to finish the job by fully funding the development of a more accurate COLA formula.”

Congress Must Legislatively Fix COLA Formula

In media releases, Rhode Island lawmakers call for tweaking how Social Security calculates Social Security COLAs.

Democratic U.S. Senator Sheldon Whitehouse, who sits on the U.S. Senate Special Committee on Aging, calls next year’s Social Security COLA increase an “insult.” He says, “For the fifth year in a row, Washington’s outdated formula has resulted in zero or next to zero cost of living adjustment for Social Security benefits. For the fifth year in a row, Rhode Island seniors will have to stretch their budgets to cover the rising cost of the basics, like food, housing, bills, and prescriptions. They didn’t bargain for this when they paid into Social Security over a lifetime of hard work. Congress needs to change the way we calculate Social Security COLAs.”

Adds, Rep. David Cicilline (D-RI), “This is completely unacceptable. The method for calculating cost of living adjustments is completely broken and fails to reflect the costs of gods and services seniors buy in Rhode Island and across the country.”
The Rhode Island Congressman calls for the Republican House Leadership to seriously consider pending legislation that will ensure that cost of living adjustments reflect the goods and services Rhode Island seniors actually buy. “Speaker Ryan should immediately bring the Protecting and Preserving Social Security Act to the floor so we can replace this outdated method for calculating cost of living adjustments with a model that actually meets the needs of Rhode Island seniors,” said Cicilline.

During the last Congress, the Senate and House controlled GOP have consistently kept legislative proposals from being considered that were crafted to bring needed reforms to the nation’s Social Security and Medicare programs. A newly elected Democratic President and a Congress controlled by Democrats might just be the political fix necessary to finally do the job that is ensuring the financial long-term solvency of these two domestic entitlement programs

Rotary Gears Up to Eradicate Polio

Published in the Woonsocket Call on October 16, 2016

Just days ago, Louis A. Marciano came to St. Paul’s Church on a mission to get his fellow Pawtucket Rotarians more involved in Rotary International’s efforts to create a polio-free world. Marciano, a former Mount Pleasant High School football player, a coach, a World War 11 veteran who fought in the Pacific Theater and a Rotarian for over 44 years, came to publicize the upcoming World Polio Day on October 24 and give an update on the international service organization’s efforts to eradicate Polimyelitis (polio).

Polio is a paralyzing and potentially fatal infectious disease that still threatens children in some parts of the world. The poliovirus invades the nervous system and can cause total paralysis in a matter of hours. It can strike at any age but mainly affects children under five. Polio is incurable, but completely vaccine-preventable. The infectious disease is found mostly in lower-income countries where poor sanitation and limited access to clean water facilitate the spread of the virus.

A Call for Action at
the Pawtucket Rotary Club

Marciano’s calls for assistance in raising funds to pay for polio inoculations for children and ratcheting up the awareness for Rotary’s efforts is not new. For over four decades, the former Rotary club president District 7950 Governor, has taken his fund raising campaign to end polio to 66 clubs in Rhode Island and southern Massachusetts. His efforts has received attention from his national headquarters, too. The North Providence Rotarian cherishes the Soccer Ball award “Kick Polio out of Africa” presented to him in 1998 for his efforts to eradicate Poliomyelitis

Some say that it may well “Takes a Village” to marshal the resources needed to make a world-wide impact. Over 1.2 million Rotary members belonging to 34,000 clubs world-wide work together to raise funds, advocate for government support, serve as volunteers to help immunize children, and raise awareness in their communities, said Marciano to his audience of Pawtucket Rotarians.

At the podium, the Cranston resident rattled off specifics as to why this global effort is important and is succeeding. Ending polio will save lives, is a very good investment, and most important is achievable, says Marciano.

Marciano notes, India is a prime example of one of the greatest Rotary International’s achievements in wiping out polio. “There were zero cases of polio in 2010 in India and they have been polio-free for nearly six years,” he says, noting that the World Health Organization has officially certified India polio-free in 2014. [According to Devin Thorpe in his March 15, 2014 article published in Forbes, in the 1980s there were approximately 150,000 cases of polio every year in India]

Marciano also announced the upcoming fourth annual world Polio Day event, co-hosted with the U.S. Centers for Disease Control and Prevention, to be held on Oct. 24. The event streaming live from CDC headquarters in Atlanta, Georgia, is expected to bring together more than 50,000 viewers around the world to learn from celebrities and experts about the progress to eradicate polio. For information about World Polio, go to http://www.endpolio.org.

While winding down his talk, Marciano acknowledges that there is still work to do but Rotary is moving closer to its goal of finally wiping polio from the face of the earth.

Carol Pandak, Director of Rotary’s PolioPlus program, agrees with Marciano’s assessment. “For more than 30 thirty years, Rotary has harnessed the dedication of community leaders around the world in support of polio eradication. When we started this effort, nearly 1,000 children a day were paralyzed by this disease. Today, there have been only 27 cases [Afghanistan (8); Nigeria (4); Pakistan (15)] in the whole world. Rotary remains fully committed to this important effort until every child is protected from this disease.”

From the Beginning

Rotary’s effort to eradicate polio began in 1979, with a multi-year project to immunize six million children in the Philippines. The international service organizations, “PolioPlus program, was established in 1985.

As indicated by the “plus” in PolioPlus, Rotarians also provide support for related health services, such as distributing Vitamin A and zinc tablets, providing bed nets to prevent malaria, assisting with preventative inoculations for other diseases, including measles, rubella, mumps, tuberculous, and other childhood diseases. The “plus” also means a system of advocacy and fundraising, and infrastructure and partnerships that will support the fight against infectious disease long after polio is gone.

Rotary also works closely with partners in the Global Polio Eradication Initiative (GPEI), including the World Health Organization (WHO), the US Centers for Disease Control (CDC), UNICEF, the Bill & Melinda Gates Foundation, and the governments of the world in this public health initiative.

Today, Rotary has given more than $1.6 billion to immunize more than two billion children against polio in 125 countries to wipe the infectious disease from the face of the earth. It is estimated that Rotary’s advocacy efforts have played a role in decisions by countries to contribute more than $7.2 billion to the effort.

Rotary’s polio initiative has also caught the attention of others. As far back as 2008, one of America’s biggest philanthropists came to the table to fight the war against polio. The Bill & Melinda Gates Foundation announced that every dollar Rotary committed to polio eradication would be matched two-to-one by the Foundation up to $35 million a year through 2018. Since this Foundation began its partnership with Rotary more than $2 billion has been contributed to Rotary’s polio eradication effort.

These funds help to provide much-needed operational support, medical personnel, laboratory equipment.

Public figures and celebrities have also joined Bill & Melinda Gates as ambassadors to help educate the public about polio through public service announcements, social media and public appearances. They include: Kristen Bell and Archie Panjabi; WWE superstar John Cena; supermodel Isabeli Fontana; Nobel Peace Prize laureate Archbishop Emeritus Desmond Tutu; action movie star Jackie Chan; boxing great Manny Pacquiao; pop star Psy; golf legend Jack Nicklaus; conservationist Jane Goodall; premier violinist Itzhak Perlman; Grammy Award winners A.R. Rahman; Angelique Kidjo and Ziggy Marley; and peace advocate Queen Noor of Jordan. These ambassadors help educate the public about polio through public service announcements, social media and public appearances.

Until polio is eradicated, all countries remain at risk of outbreaks, says Marciano.

Experts say that $1.5 billion is urgently needed to sustain the polio eradication initiative. Without full funding and political will power, polio could return to previously polio-free countries, putting children at risk contracting this paralyzing disease. From every corner of the globe Rotarians are gearing up on October 24 to garner support to wipe polio out, once and for all.

Winning the Votes of Older Women

Published in Pawtucket Times on October 10, 2016

On Oct. 7, Washington Post reporter David Fahrenthol’s story broke detailing a three minute video of GOP Presidential candidate Donald Trump wearing a hot microphone during a 2005 bus ride with former-host Bill Bush, of “Access Hollywood” to the set of “Days of Our Lives” where the real estate mogul had a walk on cameo on the soap opera. The video captured Trump saying “And when you’re a star they let you do it. You can do anything …Grab them by the p—y. You can do anything” and crudely describing his failed attempts to seduce a woman while being recently married.

Reaction came swiftly to Trump’s locker room banter with Bush. “No woman should never be described in these terms or talked about in this manner. Ever,” said Reince Priebus, the chairman of the Republican National Committee, who was doing damage control to keep woman voters from voting Democrat. The leaked video has also resulted in a number of Republican Senate and House candidates running in November to withdrawal their endorsements of Trump.

This is horrific,” Democratic Presidential Candidate Hillary Clinton said on Twitter, noting a link to the Washington Post article. “We cannot allow this man to become president.”

The embattled Trump initially issued a statement and later a video to try to defuse the controversy and get his flailing campaign back on track 30 days before the November presidential election.

Many political pundits believe that Trump’s off-the-cuff comments that are derogatory to woman, a powerful voting block who decide elections, might just block his chances of becoming the next occupant of the White House.

Women’s Campaign Issues

One day before the politically damaging Washington Post article appeared detailing Trump’s lewd comments in a leaked video, AARP, the nation’s largest aging advocacy group, released survey findings highlighting issues of importance to women voters ages 50 to 69 in key battleground states.

“Older women voters – particularly women of the Boomer generation — could help decide the 2016 presidential election,” said AARP Executive Vice President Nancy LeaMond. “Yet many of their real concerns are being ignored and their questions overlooked in a largely issueless campaign. The candidates still have an opportunity to talk to these women about the issues that matter to them.”

The 27 page report, Women Voters Ages 50 +: Economic Anxieties, Social Security, and the 2016 Election, says that heading into this year’s presidential election, Democratic candidate Hillary Clinton has a whopping 15 point lead (48 percent) over the GOP’s standard bearer Donald Trump (33 percent) among woman over age 50. The findings also indicate that older woman favor Democrats running for Congress by a narrower margin (47 percent are inclined to vote for a Democrat while 36 percent inclined to vote for a Republican).

AARP’s survey results noted that majority of woman age 50 and over believe that Clinton will do a better job than Trump in addressing family caregiving (Clinton, 57 percent; Trump, 27 percent), education (56 percent; 31 percent), environment (55 percent; 29 percent) and health (53 percent; 35 percent). The Democratic presidential candidate is also perceived by older woman as having a slight advantage over Trump in controlling government spending and controlling the budget deficit (44 percent; 43 percent).

“It’s the Economy Stupid”
Plus Retirement Issues

As to the economy, the majority of the older woman respondents across these 15 battle ground states worry about pocketbook issues such as prices rising faster than their income (61 percent) and having to pay too much in taxes (54 percent. Four in ten (41%) worry about having prescription drug expenses they cannot afford. Women with lower household incomes are especially likely to worry about these pocketbook issues.

Also, the AARP survey found that many women also worry about retirement security, including their ability to care for themselves as they age (45 percent), not having financial security in retirement (41 percent), and whether Social Security will be there when they retire (38 percent). These retirement-related issues are of particular concern to women with lower household incomes.

Additionally, most women (53 percent) say that the nearly 25 percent cut in Social Security benefits that would result from not addressing the solvency of Social Security would impact them, including 32 percent who say it would impact them “a lot.”

Fixing Social Security is a key issue to older woman voters. The AARP survey noted that the vast majority of women voters ages 50+ (72 percent) say that the next president and Congress should address Social Security immediately.

Most women (67 percent) also favor giving a caregiver credit in calculating Social Security benefits to people who take time off from work to care for loved ones, says the report.

Social Security is flying under the radar screen of the voter. The survey findings noted that few women say that they have heard about the candidates’ plans for Social Security. About one in three (34 percent) say they have seen or heard anything from Clinton, and even fewer (20 percent) say that they have seen or heard anything from Trump.

The AARP survey found that over 54 percent of the respondents are currently, or have been, a family caregiver providing unpaid care to an adult loved one. More than eight in ten (85 percent) women voter’s ages 50+ think it is important for the presidential candidates to talk about how they would support family caregivers who provide unpaid care to aging parents or spouses or other adult family members.

Finally, four in ten (41 percent) women are not confident that they will be able to cover the cost of care for an aging or elderly parent, spouse, or other family member.

Women: A Powerful Voting Block

According to the Center for American Women in Politics, “In recent elections voter turnout rates for women have equaled or exceeded voter turnout rates for men. Women, who constitute more than half of the population, have cast between four to seven million more votes than men in recent elections.“

Only weeks will tell if embattled Trump can overcome the political backlash generated from his locker room banter degrading woman, political insiders predicting that the gender vote gap might just historically widen.

AARP’s survey findings provide sound advice to Clinton and Trump and congressional candidates who are scrambling for last minute votes, especially from married women, younger millennials and women living in the nation’s suburbs. The women’s voting block might just surely tilt the election to a candidate in many legislative districts.

New Study Looks at Better Ways to Instruct Caregivers

Published in Woonsocket Call on October 2, 2016

A new report released by United Hospital Fund and AARP Public Policy Institute, using feedback directly gathered from caregivers in focus groups, provides valuable insight as to how video instruction and training materials can be improved to help caregivers provide medication and wound care management.

AARP Public Policy Institute contracted with United Hospital Fund (UHF) to organize the discussion groups, which took place in March through December of 2015 and were conducted in English, Spanish, and Chinese. A new report, , released on September 29, 2016, summarizes key themes from the discussions and suggests a list of “do’s and don’ts” for video instruction.

Gathering Advice from Caregivers

In a series of six discussion groups with diverse family caregivers — 20 women and 13 men of varying ages and cultures (Spanish and Chinese) — in New York, participants reported feeling unprepared for the complex medical and nursing tasks they were expected to perform at home for their family member. The participants reported that educational videos lack instructional information and also failed to address their emotional caregiving issues. Stories about poor care coordination came up during the discussions, too.

“These discussion groups gave family caregivers a chance to describe their frustration with the lack of preparation for tasks like wound care and administering medication through a central catheter. But participants also demonstrated how resourceful they were in finding solutions on their own,” said Carol Levine, director of UHF’s Families and Health Care Project and a co-author of the report.

According to Levine, this initiative to study caregiver perspectives on educational videos and materials is an outgrowth of a 2012 report, Home Alone: Family Caregivers Providing Complex Chronic Care, released by UHF and the AARP Public Policy Institute. The findings of this on-line national survey of a representative sample of caregivers noted that 46 percent of family caregivers across the nation were performing complicated medical and nursing tasks such as managing medications, providing wound care, and operating equipment for a family member with multiple chronic conditions. These caregivers felt they were not being adequately prepared by the health care system to perform these tasks and they told researchers that they were often stressed, depressed, and worried about making a mistake. Most of these caregivers had no help at home.

The new caregiving report is an important resource for AARP’s broader national initiative known as the Home Alone AllianceSM which seeks to bring together diverse public and private partners to make sweeping cultural changes in addressing the needs of family caregivers. “The wealth of information we learned from these discussion groups has guided the development of our first series of videos for family caregivers on medication management, and will inform future instructional videos,” said Susan C. Reinhard, RN, PhD, Senior Vice President of AARP Public Policy Institute and co-author of the report. Specific segments of the first series of videos include Guide to Giving Injections; Beyond Pills: Eye Drops, Patches, and Suppositories; and Overcoming Challenges: Medication and Dementia. The videos are on the AARP Public Policy Institute’s website and United Hospital Fund’s Next Step in Care website. Additional video series will focus on topics including wound care, preventing pressure ulcers, and mobility.

In preparation for the discussion group (lasting up to 2 hours and held on different days and locations) ), UHF staff reviewed literature on video instruction and adult learning theory for patients and caregivers and selected several currently available videos on education management and wound care to show to caregivers to stimulate discussion and cull feedback on content and presentation style. Felise Milan, MD, an adult learning theory expert at Albert Einstein College of Medicine, was a consultant to the project.

A New Way of Teaching

For UHF’s Carol Levine, one of the biggest insights of this study was the resourcefulness shown by caregivers in “finding information [about managing medication and wound care] that they had not been provided, creating their own solutions when necessary.” “These are strengths that are seldom recognized,” she says.

“We found that caregivers were eager to learn how to manage medications and do wound care more comfortably for the patient and less stressful for themselves. Providers often use the same techniques they would use to train nursing students or other trainees, and are not aware how the emotional attachment of caregiver to patient affects the tasks, and how adults need learning based on their own experiences, not textbook learning,” says Levine, stressing that providers need more time to work with caregivers to provide follow-up supervision.

Existing teaching videos used for providing information to caregivers were generally found not to incorporate adult learning theory, says Levine, noting that they were intended to teach students, not caregivers. “In watching the videos, the caregivers clearly stated that they wanted to see people like themselves learning to do the tasks, not just a provider demonstrating them. They also didn’t respond well to attempts at humor. For them, these tasks are serious business, and they want information, not entertainment,” she added.

Levine says that she believes that videos and interactive online instruction can be a powerful tool in helping caregivers learn and practice at home. “We encourage other organizations to consider developing videos in the area of their expertise, and we encourage all who communicate with caregivers to look at the list of “Dos and Don’ts” for advice about presenting information in ways that caregivers can best absorb it [detailed in her recently released report].

“However, we strongly believe that good clinical advice and supervision are essential. Videos are not “instead of” they are “along with” clinical care,” adds Levine.

CARE Act Gives More Info to Rhode Island Caregivers

“The report reflects the need to make family caregivers more confident that they have the knowledge and instructions to provide the best possible care of their loved ones,” said AARP State Director Kathleen Connell. “This is why implementation of the CARE (Caregiver Advise, Record, Enable) Act will be so important here in Rhode Island, as it addresses some of the anxiety that accompanies a patient’s hospital discharge.

“In most cases, hospitals do their best to prepare patients for discharge, but instruction has not always been focused on preparing a designated caregiver for medical tasks they may be required to perform. The CARE Act is designed to provide caregivers with the information and support they need. As the report indicates, an instructional video may not always answer all their questions. Like physicians, caregivers feel they should abide by the ‘first do no harm’ approach. And that’s hard sometimes if there is uncertainty that comes from a lack of instruction. Caregivers also are especially tentative about treating wounds and managing medications.

“This can lead to some unfortunate outcomes: Patients can suffer when mistakes are made; caregivers feel increased or debilitating stress; and hospitals readmission rates go up.
“In short, we need to listen to caregivers and all work together to support the work they do.”

For a copy of the caregiver report, go to http://www.uhfnyc.org/publications/881158.