The forgotten worker

In 2010, 5.9 million children were reported as abused or neglected in the United States. The Nurse-Family Partnership, or NFP, arranges for registered nurses to make regular home visits to first-time low-income or vulnerable mothers, starting early in their pregnancies and continuing until their child is 2.

For individuals with developmental disabilities in Washington, D.C., inclusion’s uphill battle, while still happening, has shown results. After the practice of institutionalization ended decades ago, there was a shift to group home living, nonprofit advocacy groups, and job placements. Challenges remain though, like slow-moving bureaucracy, funding, and those still fighting inclusion, but moves toward inclusive jobs and living continue.

*Medical research has done wonders to rid populations of diseases; however, the U.S. health care system has failed to appropriate the right resources to Medicare patients with one or more chronic conditions. Health Quality Partners in Doylstown, PA enrolls Medicare patients with at least one chronic illness and hospitalization and sends a trained nurse to see them on a routine basis, whether they are healthy or sick. As a result, the HQP program has reduced hospitalizations and cut Medicare costs.

New mothers who live in poverty are faced with fewer resources to help them with their physical and mental health as well as the health of their babies. In New York City, the Nurse-Family partnership matches nurses with economically poor first-time mothers. Different studies have shown that women in the program have healthier pregnancies and children.

Emergency room visits cost money and are not the most comfortable places to be. The Massachusetts-based Medicare program called Independence at Home gives doctors incentives to visit frail patients at home and received a cut of the cost. The program also pairs patients with social workers and continues to save Medicare millions of dollars.

Congressional Republicans' push to reduce Medicaid funds is a threatening proposition to the people who use its services. Medicaid funds services at home which allows people to live at home instead of in a nursing home by providing minor house renovations, a visiting nurse or other worker, or other home products.

Apollo Healthcare Services has started an elder caregiver support group in Richland County, OH. The intent of this support group is to give caregivers an outlet to voice their frustrations or experiences that accompany elder caregiving so that they are less likely to take out that frustration on the elders in their care.

Many people, often women, spend large amounts of their lives engaging in unpaid care work, dropping out of the labor market or taking a pay cut to care for their families. Hawaii has launched the Kupuna Caregivers Program to provide financial benefits for citizens who spend large amounts of time caring for others.

As the elderly become more likely to have multiple chronic conditions and experience a gradual decline in health towards the end of their lives, a health care approach that centers hospitalization and intensive care might be ineffective and inefficient. Sutter's Advanced Illness Management program (AIM) is using a new, home-based approach to keep down costs and increase quality of life.

In Alaska, the Community Health Aide Program is helping to connect people in remote, rural parts of the state to medical care. The program, started decades ago in collaboration with the Indian Health Service, local government, and congress, has helped to keep people healthy despite high expectations and turn-over.