DES MOINES, Iowa - The main focus of the Iowa Legislature in its remaining weeks is to craft the state budget. While most of the discussion is about dollars, one issue also gets to the heart of what many Iowa families are going through: caring for an aging loved one.
Anthony Carroll, state director for advocacy at AARP Iowa, said that requires some policy decisions to provide proper support for family caregivers.
"When you look at family caregivers, they are right now the backbone of health care, of long-term care, providing over two-thirds of the long-term care," he said. "How can we improve the quality, the comfort level, to provide the care they are already providing?"
AARP Iowa, the Alzheimer's Association and Older Iowans Legislature were among the groups calling for action at the Statehouse this week. According to AARP Iowa, nearly two-thirds of family caregivers assist their loved ones with complex tasks, but only half have the instruction or training to provide that care.
An effort to enact the CARE Act - Caregiver Advise, Record and Enable - failed this session. It would have helped families when loved ones are discharged from a hospital, and already is the law in more than a dozen states. But Carroll said the CARE Act's intent still could be incorporated into legislation.
"We're asking that our state insist that all adults, when you enter a hospital, have the option to designate and involve a family caregiver," he said. "And those family caregivers can go home with some assurance, some instruction and demonstration of the medical tasks that they need to perform."
Currently, he said, that in-hospital training happens only half the time. However, some hospitals say they already provide training if needed and don't want an additional requirement.
It's estimated that family caregivers provide care worth almost $4 billion in Iowa each year, which Carroll said makes more training and support for them vital.
"We specifically asked for our state leaders to include legislation aimed at improving the lives of Iowa's family caregivers as part of any health policy, any health budget discussions," he said.
Legislative leaders anticipate determining budget numbers within the next 10 days as they aim toward adjournment before April 19.
The CARE Act was House Study Bill 564 in 2016; it's online at legiscan.com. In 2015, it was Senate File 465, online at legis.iowa.gov.
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June was Alzheimer's and Brain Awareness Month, but the Michigan Alzheimer's Association says these should be year-round priorities.
More than 200,000 Michiganders over age 65 are living with Alzheimer's - although only about half receive a doctor's diagnosis. This can delay necessary care and future planning.
Kathryn Ribant Payne - communications director with the Alzheimer's Association in Michigan - said this year, the focus is on educating the public about how to take control of their brain health.
She said when there's a concern, early diagnosis is key.
"We're kind of coming into an era of treatment where we're seeing treatments come down the pipeline that necessitate early diagnosis," said Ribant Payne. "So, if people are experiencing cognitive decline that they've noticed, or their family members have noticed, we really encourage them to speak with their healthcare provider."
Ribant Payne said up to 40% of dementia cases could be caused by risk factors that a person could change by developing healthy habits.
These include challenging yourself by learning new things and staying in school.
Not smoking, getting regular exercise and properly managing other diseases, such as diabetes and high blood pressure, also improve brain health.
She said protecting your head by wearing a helmet for activities like biking, is important - as well as eating a healthy diet and sleeping well.
She added that if you think it's too late to improve your routine - you're wrong.
"These things that we are talking about, as far as the healthy habits, are not something that you have to start when you're in your 20s for them to do something," said Ribant Payne. "Any little thing you can start at any time will affect your health in a way that can cause positive results."
Ribant Payne emphasized that it's critical for caregivers of people with Alzheimer's disease to seek respite and reach out for help themselves.
Michigan leads the nation in the number of caregiver hours - and about two-thirds of caregivers in the state report having a chronic health condition as a result of the stress.
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Washington has received designations highlighting the state's efforts to become more age and dementia-friendly.
Washington is the 12th state to join the AARP Network of Age-Friendly States and Communities.
Susan Engels, Unit on Aging office chief for the Washington State Department of Social and Health Services, said the designation builds on work the state is already doing to support people of all ages.
"Age-friendly communities consider goals that promote high quality of life for each person regardless of their age, allowing older people the opportunity to remain active in their community," Engels pointed out. "The designation begins a book of work that we're very excited to do."
Some cities in the state have already joined the AARP network, such as Puyallup, Renton, Seattle, Tacoma and White Salmon. Some of the goals for age-friendly communities include ensuring people can age in place and building walkable communities to ensure people can maintain both their independence and connection with others.
Washington is also joining U.S. Aging's Dementia-Friendly America network. Engels noted the state is already supporting people with dementia.
"Developing more community opportunities for families living with dementia," Engels explained. "Things like zoo walks and cafes where people can come and not worry about being judged if their loved one behaves differently."
Family caregiving is another important area as the population ages. According to AARP's statistics, the ratio of family caregivers per adult over 80 available in Washington will decline from about 4.5 to 1 in 2030 to less than 3 to 1 in 2050.
Engels added the state has support in caregiving as well, such as through respite and counseling to help people maintain the sometimes difficult roles.
"We have innovative programs, both state funded and federally funded, where we are able to support family caregivers regardless of income levels," Engels stressed. "With services that help those family caregivers be able to maintain their role."
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More people over the age of 64 are being targeted by scams through social media and are more likely to lose money.
According to AARP, around half of American adults report having been a victim or a target of financial fraud.
Judy Dollison, president of the Better Business Bureau of Central Ohio, said the most common and dangerous scams for seniors involve investments, romance, and home improvement.
"Scammers oftentimes go door to door, looking for victims," Dollison pointed out. "Sometimes we see this after a big storm or, you know, hail or tornado comes through the neighborhood, and they tell them that, oh, you know, we got up on your roof, and there's hail damage."
People who suspected they have been scammed or their personal information has been compromised should contact their local police department and their financial institution to get help stopping the payment or disputing the charge. Report scams at BBB.org/ScamTracker or call 614-486-6336.
Dollison explained warning signs include asking for payment immediately and unusual payment types such as debit cards, Zelle, and Venmo, along with claims of a free or unrealistic low-cost product or service.
"Some of the big red flags are, you know, a pressure to act," Dollison emphasized. "So often we see scammers try to really convince you to do something urgently, because they don't want you to ask your friend or family. They don't want to you to research."
A decline in cognitive functioning, such as Alzheimer's disease and dementia, social isolation, and a lack of financial literacy tend to make older adults more susceptible to scams and fraud. Dollison stressed it is important to remind loved ones and neighbors scammers are out there.
"We always encourage just vigilance," Dollison added. "Empower the seniors to be suspicious of things, to question, to pause and seek guidance. Discuss telemarketing and email fraud. Just really highlight how much is out there."
Elder financial abuse costs older Americans at least $36.5 billion each year and more older adults are becoming victims of financial scams, according to the Department of Justice.
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