How an area agency on aging helped bridge the gap for in-home care

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 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.

The Veterans Health Administration's Caregiver Support Program offers resources to family caregivers looking after veterans, including a monthly stipend, medical services, counseling and mental health care, respite care and coverage for travel expenses. The Program launched in 2011 and by 2014 about 15,600 caregivers had been approved for support — greatly exceeding the Program’s original estimate of 4,000 people.

Family Connects offers free home visits from trained nurses for families with newborns in an effort to increase access to care and reduce infant and new mother mortality rates. The nurses conduct a medical exam and then provide support, guidance and answer any questions the new parents may have. Family Connects found that mothers who participated in the program were 30% less likely to experience postpartum depression or anxiety.

The Boresha afya ya mama na mtoto (improve the health of mother and child) program works to reduce maternal and infant mortality rates by connecting mothers with community health volunteers. These volunteers provide important education on topics like antenatal care and also help to increase access to immunization services. When the group formed in 2018, 531 women died during childbirth or pregnancy, but as of 2023, that number has dropped to 344 thanks to the program’s initiatives.

Agencies like the SHARE Center are beginning to hire peer support specialists, who are individuals who have lived experience of recovery from mental health conditions and substance use disorders. Peer support specialists provide non-clinical, strengths-based support and build trusting relationships with those in need of care. Since the COVID-19 pandemic, demand for peer support specialists has grown exponentially and reports show that working with a peer support specialist can improve health outcomes and quality of life among other benefits.

The Advanced Illness Care Program was founded within local Black churches and offers free, individualized support for people with advanced illnesses and their caregivers, helping them navigate various life and health issues and plan for end-of-life care. Since starting in 2015, the AICP has helped more than 1,600 patients, the majority of which are Black, and 55% of them have gone on to complete advance directives for end-of-life care.

Several groups in the Appalachian region are turning toward harm-reduction strategies to help those struggling with drug abuse. Research shows that those who participate in syringe exchange programs are five times more likely to enter treatment than those who didn’t participate. Groups like Holler Harm Reduction and Choice Health Network host scheduled drop-ins where they deliver supplies, provide naloxone training and education, and administer disease testing wound care to those in need.

As appointments with general practitioners (GP) are often short and hard to get, community link workers have the time and resources necessary to support those in need of care for non-medical issues, like energy management, mood stabilizing and mental health concerns. Appointments with link workers can last up to an hour, versus the average 10 minutes with a GP, and provide comprehensive care that can be followed up on by a GP if any clinical attention is needed.

To prevent burnout and increase employee retention, Ascension Hospitals offers its employees resources like online and in-person therapy, crisis hotlines, incentive pay for holidays and extra hours, mental health check-ins and even tuition reimbursement. These measures help employees feel appreciated and when employees feel taken care of they’re less likely to quit their jobs or leave the caregiving profession altogether.