Biden caregiving plan: Housing availability, politics hinder transition to more in-home care

The Castle Center provides adults with dementia in need of assistance care during the day. Open five days a week, the center offers participants meals, medication monitoring, personal care assistance with the help of nurses and volunteers, socialization and activities like arts and crafts. The Center also offers time off for caregivers — like family members — who often care for people with dementia 24/7.

Program of All-Inclusive Care for the Elderly (PACE) centers provide government-funded medical care and social services to those aged 55 and above who qualify for nursing home care but can still live independently with some assistance. There are currently more than 160 PACE centers in 32 states. PACE centers are also gaining momentum as a nursing home alternative, as several states have begun passing legislation and making policy changes to allow Medicaid to cover PACE care.

The Ohio District 5 Area Agency on Aging hires state-tested nursing assistants (STNA) to act as community care specialists and provide in-home care to seniors. This care provides respite for unpaid family caregivers and allows seniors to continue living independently in their homes. In 2023 alone, the program served 130 residents, providing 2,371 hours of in-home care.

Program for All-Inclusive Care for the Elderly (PACE) provides care to elders including adult day care, home health care and supplies like bed rails, eyeglasses and access to medications, while simultaneously providing respite to family caregivers. Studies show PACE program participants have lower rates of hospital use and shorter lengths of stay compared to those participating in other programs or opting for general nursing home care. The PACE centers in Metro Detroit serve 1,600 adults across its seven centers. Statewide, there are 14 active PACE programs across 24 centers.

To combat worker shortages, the Presbyterian Homes and Services — a network of over 50 senior living communities — has been partnering with the International Personnel Resource of the Philippines to bring registered nurses from overseas to the states.

South Korea has taken a softer approach to preventing and containing the coronavirus, in large part because they’ve prioritized accessible testing and have an already-existing strong and affordable healthcare system. Beyond that, the government has centered on citizen education – sending daily updates about new cases and provided a hotline for questions and concerns.

Costa Rico consistently places on lists of the happiest countries in the world; the levels of satisfaction, along with longevity of the citizens, has been attributed to its consistently high levels of investment in social programs and citizen well-being. Despite their high wealth inequality, all citizens of Costa Rico are promised access to health care as well as a primary and secondary education.

Hospitals in New York improve healthcare quality and reduce medical costs by staying in frequent contact with patients requiring frequent or long-term care. Montefiore's Accountable Care Organization pulls in care providers from across the medical and social spectrum to improve patient health while curbing expenses.

Worker-owned home-care cooperatives are emerging as an alternative to the for-profit agencies that dominate America's direct-care sector. In these cooperatives, professional caregivers earn an average of $2 more per hour than the industry standard, share in business decision-making, and stay on the job at nearly double the rate of workers at traditional agencies. Patients also stay with co-op agencies twice as long, suggesting higher satisfaction and quality of care.

The Musical Memories Cafe is a social gathering space for people with Alzheimer’s and dementia, as well as their caregivers. Participants gather to enjoy music, seek refuge outside of their homes and get access to peer support and health resources. There are more than 1,000 memory cafes operating around the world, both in-person and virtually.