A Trickle Down Care System What Makes the Carer Role So Challenging?At this point in the book, you may still have this question. If you have never been a carer or been “directly” impacted by it, this can seem like a lot of “woe is me.” I intentionally, did not place this chapter too early in the book, because my intention is not to draw pity, but rather understanding of how this unpaid workforce within an underdeveloped national and local care delivery system is draining corporate resources at a time when we will need them most.
As a leader, it’s time to get informed. The lack of the health care system’s definition of the real at home care needs, for today have caused tremendous wastes in our system that are very well documented. These wastes extend beyond the time and money waste of the individual and into our society, our business productivity, everything we do and are as a nation.
You may think that this has been the case forever. Haven’t we always taken care those we loved as they aged? At least if we were good sons and daughters? The answer to this is yes, but what has not remained the same is the role and expectations.1. The mantra medical institutions, insurance companies and Medicare is “send it home”, because it is well understood that facility care is much more costly than care in home care setting.This is where a carer comes in, often a family member who has a paid job, but will now be taking on sometimes in excess of 20 hours of active care for an average of 5 years, to meet the needs of their lovedone.2.
We no longer have people who “stay at home” in our society as a whole. Most people are working and many of them do not have an option to do otherwise.3. People are living longer and are more likely to develop chronic, but manageable diseases. However, unable to care for him/herself, the management of this disease falls to a carer.
This means that a carer is increasingly providing skilled care. In case you are unfamiliar with this term, skilled care is defined as care that would normally be provided by a person who has gone to school or otherwise been trained and certified to provide that care (e.g. medical assistant, LPN, crisis counselor,nutritionist).4. The existing healthcare and social services systems are overflowing with bureaucratic red tape, waste, unnecessary duplication of effort, severely outdated technology (have you been in a HHS government building lately?). Does poor funding cause waste or does waste make it impossible to get adequate funding? It’s the chicken or the egg question. But either way, it’s broken and it largely contributes to why the role of a carer today is not what it was even 25 years ago.
Whether you are a business leader, a government representative or a concerned individual, if you have neverbeen in this role, as with anything you have never done, it can be difficult to understand what the role is and why this role is so impactful to business.When some think of elder care, they picture someone sitting in a room reading a book to an individual in their care or trying to cheer the person up, perhaps making an extra sandwich at lunchtime instead of just one and steeping an extra cup of earl grey.This is in many ways how we have been conditioned to see this role. Laid back, low-key, not really “rocket science”, hardly demanding, but, our misperception is derived mostly from what we see on television and in movies. Since we’re talking about movies, I’ll call it the “PG version” of caregiving, and I know you’ll completelyunderstand.The intricacy and pressure of the role is never fully shown on media, because honestly, it is not something we want to see.
Most would find it disturbing or would not understand in the least what they were seeing and they certainly would not think it their new favorite programSo it is established that the true day to day of a carer who quite possibly has a 2ndfull time paid job would not make for a strong prime time TV series. Even a reality show would likely be too much for many viewers. Out of sight and out of mind, carers do their “duty” often because no one else will, unrecognized, underground, unskilled, unpaid.This is not intended to draw pity, but simply to explain the way things are and why this particular role is so demanding because keeping this an underground industry is a preventable drain on our society. Let’s look at additional roles filled by a carer.
COMMON ROLESMedical/Physical/Mental Health rolesWound Care, Pain Management, Hygiene Specialist, Diabetic/Cholesterol/Blood Pressure Care, Physical Therapy, Nutritionist, Medication Management, Mental Health, Disability Management, Disease Management, Geriatric Care, Fitness Instructor, Medical monitoring followed by interpretation and adjustment … I’ll stop there.AdministrationCare Coordination with other professionals (Primary Care, Specialists, Nursing, Therapy, etc.), Managing collections of calls, from receptionists, pharmacists.Social RolesSocial and community engagement interactions, keeping this mind engaged through entertainment, learning, conversation.
Other Professional RolesEmotional and spiritual support, facing the aging process, Legal Representative, Disability and Community Resource Advocate, Accountant, Chauffeur, Case Management, Patient Advocate, Massage, Respite Care.Other (Odds and Ends)Groceries, Laundry, Errands, Banking, Cleaning, Life Management.Is this beginning to look like a job description? It should.This is a new local care delivery model. While I am in no way suggesting that carers are replacing doctorsand other high-level professionals, the services provided are quite often skilled or services, and we are not talking about scraped knees, making, in many cases, their unpaid job more intellectually and physically demanding than their 9 to 5.
The failure of society, policy-makers, healthcare and businesses to recognize this behemoth “underground” caregiving industry for what it is has led to billions in corporate productivity waste and many more billions in lost opportunities for businesses who could be profiting from innovating policy, product and service solutions that address the needs of this customer demographic. The financial, relationship, and health losses have been well documented by National Alliance of Caregivers, other professional associations and academia.