With increasing need for programs that aid caregivers, RUSH University Medical Center’s Caring for Caregivers (C4C) program assists families and friends who care for adults 60-years and older in their homes.

C4C is part of a nationwide effort to support the more than 55 million Americans (about 21% of the U.S. population) who provide care for family members with chronic and serious conditions. The home setting saves as much as $470 billion per year for Medicare and Medicaid, but for the caregiver, the price tag can be a considerable burden — as much as $7,200 per year, or up to 26% of their income.

In addition to quantifiable financial pressure, in-home elder care has other costs for caregivers, according to Ellen Carbonell, caregiver programs consultant in the department of Social Work and Community Health at RUSH University Medical Center.

“Caregiving is often a very physically and emotionally demanding task lasting for many years,” Carbonell told Palliative Care News.

Caregiving is associated with a number of health conditions, and mental health can suffer as well: Rates of depression and anxiety are higher among those who care for others, and other effects include negative thought patterns, difficulty concentrating, and issues with substance abuse or misuse, Carbonell said.

Increasing caregiver duties

Family caregivers are also required to perform increasingly more complicated medical tasks, such as administering medications via IV, feeding by a tube and managing pain.

Carbonell states that, under these circumstances, “[Caregivers] typically put their own needs last and have little energy left after providing care. Therefore, caregivers are prone to developing illnesses and conditions of their own, which limits their ability to care for anyone else.”

The C4C program

RUSH realized that it had a unique opportunity to address the issues caregivers face, and established the C4C program in 2019, with the aid of a grant from the RRF Foundation for Aging.

The program was designed to assist caregivers with managing depression, anxiety and other challenges of daily life and provide referrals to community and hospital resources. The C4C program begins with an assessment to measure current levels of anxiety, depression, and caregiver burden and attempts to mitigate these by means of the following:

• Skill-Building Meetings: Professionals in the medical industry help caregivers learn skills that will aid them in their work and prevent injury, including basic medical care and nutritional counseling. Some of these skills include transferring patients from bed to wheelchair, using catheters, and giving injections.
• Planning for What Matters Sessions: Social workers provide one to five sessions, assisting caregivers in developing plans to meet the needs of both themselves and their loved one, while minimizing negative outcomes, ranging from rehospitalizations and depression.
• Care-Team Planning Meetings: Caregivers and care recipients learn how to communicate and work efficiently with the entire care team. In addition the sessions provide both caregiver and recipient with a voice in the care plan. In these meetings, pharmacists may be included to optimize patient medication.

Eligible participants include both caregivers of palliative care patients and those who are caring for someone older than 60.

Data from the RUSH C4C program has demonstrated overwhelmingly positive results, with caregivers reporting significant reductions in emotional and mental distress and reductions in overall burden.

Recipients have also seen fewer trips to hospitals and emergency departments and reduced stay length if they were admitted. Due to these successes, the John A. Hartford Foundation, along with the Institute for Healthcare Improvement, has chosen to fund and disseminate the financially self-sustaining model throughout the United States.

“Research tells us that family caregivers have historically not been asked how they are doing by healthcare providers, and when asked, are seldom offered anything to help,” Carbonell said. “Caring for Caregivers provides a safe space for them to be asked the important questions about their functioning, and to really feel heard and understood, often for the first time, while on this caregiving journey.”