National Center for Creative Aging

(1) What prompted the development of the NCCA?

The National Center for Creative Aging was founded in 2001 as program within Elders Share the Arts in New York City with the mission to foster an understanding of the vital relationship between creative arts and healthy aging and to promote the development of programs that build on that understanding at a national level. In 2007 NCCA incorporated as an independent 501 (c) 3 organization and moved to Washington, DC under the leadership of Dr. Gay Hanna, Ph.D., MFA and affiliated with George Washington University.

(2) What are the key issues that the Center is currently addressing?

In 2011, the National Endowment for the Arts and the U.S. Department of Health and Human Services partnered with the National Center for Creative Aging to develop a white paper, "The Arts and Human Development: Framing a National Research Agenda for the Arts, Lifelong Learning and Individual Well-Being." NCCA is currently working to address a number of concerns that came to light through that process, including a lack of research and strategizing to place a greater policy emphasis on creative aging, a lack of quality programs serving older adults, a lack of professional development programs serving artists and healthcare professions, and a lack of opportunity for caregivers to learn more about how to use the arts to improve communication and strengthen the bonds between the caregiver and the client.

(3) How might a family caregiver or helping professional use NCCA's programs?

NCCA provides numerous educational programs targeting both family and professional caregivers. Professional development is offered through symposia, distance learning programs and onsite trainings. NCCA's website connects the caregiver to a wealth of events, news, programs, guides, toolkits, best practices, research, trends, opportunities and technical assistance. NCCA has also partnered with the Washington, DC Geriatric Education Center Consortium to better serve professional caregivers through online and onsite trainings.

(4) Are there any future plans for the NCCA?

NCCA is currently working to expand and enrich the creative aging field through the MetLife Foundation Creativity and Aging in America Leadership Awards,Technical Assistance Site Grants, Speakers Bureau and community resources for caregivers.

(5) If readers have other questions, how can they obtain more information?

They can contact Alecia Torres de Valdez at atorres@creativeaging.org or call (202) 895-9456. NCCA is located at 4125 Albermarle Street, N.W., Washington, DC 20016 and the website is: http://www.creativeaging.org

$1.3 Billion Awarded to Help Improve Health and Independence of Older Adults in U.S.

• Nutrition: Studies have found that 50 percent of all persons age 85 and over are in need of assistance with certain activities of daily living (ADL), including obtaining and preparing food. Administration on Aging (AoA) projects its network of partners and organizations will deliver approximately 219 million meals in FY 2012. These meals help older adults improve their nutritional intake, provide an essential service for many of their caregivers, and also provide seniors an opportunity for social interaction.


• Supportive Services for Helping Frail Seniors Remain at Home: Home and community-based long-term services and supports assist seniors living at home who are unable to perform critical activities of daily living, such as bathing, eating, or dressing unaided. Among the services these funds are projected to support include nearly 7.5 million hours of adult day care and 21 million rides to critical places like the doctor, pharmacy, or grocery stores.
  
  
• Preventive Health Services: AoA is committing more than $20 million in FY 2012 to evidence-based programs focused on fitness, wellness, falls prevention, chronic-disease self management, and medication management.

These grant awards are annually awarded by formula for the states and territories based on their share of the population age 60 and older. Each state develops a comprehensive service plan before receiving federal funds. States and territories recognize the value of these programs, typically leveraging as much as $3 additional dollars for every federal dollar, contributing to the outcomes expected from these awards. Of the 57.8 million seniors 60 and older living in the United States, 5.5 million are living in poverty and more than 27 percent have difficulty in performing at least one activity of daily living. These services contribute significantly to helping those seniors with frailties, many of who are economically vulnerable, to remain in their own homes and avoid or delay entry into nursing homes.

Mental Health First Aid Training

Mental Health First Aid is a public education program that helps the public identify, understand, and respond to signs of mental illnesses and substance use disorders. The program is managed, operated, and disseminated by three national authorities ? the National Council for Community Behavioral Healthcare, the Maryland Department of Health and Mental Hygiene, and the Missouri Department of Mental Health. Mental Health First Aid is offered in the form of an interactive 12-hour course that presents an overview of mental illness and substance use disorders in the U.S. and introduces participants to . . . risk factors and warning signs of mental health problems, builds understanding of their impact, and overviews common treatments. Those who take the 12-hour course learn a five-step action plan encompassing the skills, resources and knowledge to help an individual in crisis connect with appropriate professional, peer, social, and self-help care.

The course has benefited a variety of audiences, including: primary care professionals, employers and business leaders, faith communities, school personnel and educators, state police and corrections officers, nursing home staff, mental health authorities, state policymakers, volunteers, young people, families and the general public. To find a 12-hour Mental Health First Aid or learn how to become a certified instructor to teach the 12-hour course in a community, visit: http://www.mentalhealthfirstaid.org/cs/program_overview/

Effects of Parenting Adults with Disability

Any caregiver is likely to be vulnerable to stress. However, parents who care for a child with a serious mental illness (SMI) are at increased risk for adverse physical symptoms resulting from stress. Those who care for an adult child with a SMI are even more likely to suffer the negative effects of stress because of the length of time that they have had to cope with the difficult task of caring for a loved one with SMI. Erin T. Barker, Ph.D. of the Waisman Center at the University of Wisconsin-Madison addressed this specific dynamic in a recent study by examining the cortisol levels in individuals charged with the care of adult children with SMI. The goal of the study was to examine whether parenting an adult child with a serious mental illness (SMI) has a physiological impact on parents. On days after elevated stress, a hypoactivation pattern of diurnal cortisol suggestive of chronic stress was evident for parents of individuals with a SMI. After more stressful days, cortisol levels increased less from waking to 30 minutes after waking and declined less from 30 minutes after waking to bedtime for parents of individuals with a SMI. The results of the current study add to a growing body of evidence that the long-term effects of parenting an adult with a disability has a biological impact on aging parents and support the need for family interventions across adulthood and into old age for parents of individuals with SMI. For more information about the study, go to: http://www.goodtherapy.org/blog/stress-parents-children-mental-illness-0213123/

Yoga Meditation May Lower Depression and Improve Brain Functioning In Caregivers of Individuals with Dementia

Research studies suggest that yoga not only can help people with a multitude of health problems, it can also help the person taking care of the person with the ailment. Researchers from the University of California, Los Angeles found that meditation from yoga can help lower depression in caregivers, and may also improve their cognitive functioning. The researchers also found that meditation was associated with a decrease in cellular aging from stress. "To a varying degree, many psychosocial interventions like this have been shown to enhance mental health for caregivers," study researcher, Dr. Helen Lavretsky, a professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, said. "Yet given the magnitude of the caregiver burden, it is surprising that very few interventions translate into clinical practice. The cost of instruction and offering classes may be one factor. Our study suggests a simple, low-cost yoga program can enhance coping and quality of life for the caregivers." For more information about the study, go to: http://onlinelibrary.wiley.com/doi/10.1002/gps.3790/abstract

Gender Differences in Caregiver Stress Syndrome

Women still outnumber men when it comes to family caregivers. However, the number of men caring for an older adult has doubled in the past 15 years, from 19 percent of caregivers in 1996 to 40 percent by 2009, according to a study from the Alzheimer's Association and the National Alliance for Caregiving (NAC). More men than women provided long-distance care in that same time period. Several factors have contributed to the increases. Smaller family sizes (which makes the role fall more often to men), the challenging economy (making men less able to outsource the role), and more diagnoses of Alzheimer's disease (which affects women more than men, making many men spousal caregivers). There is also a growing proportion of men ages 60 to 74 in the population. In an article by Paula S. Scott of Caring.com, she discusses the protective and risk factors of men's approaches to caregiving, and provides suggestions for more effective outreach efforts. For more information, visit: http://newamericamedia.org/2012/03/eldercare-stress-whats-different-for-malesespecially-black-men.php

Policies to Better Support Family Caregivers

In December 2011, the AARP Public Policy Institute hosted a forum in which ten authors came together and discussed the current state of caregiving in the US. A recent policy brief from the Public Policy Institute captures ten themes from the written work of the authors and also includes a section focused on public policy options to better support family caregivers. The policy proposals are grouped into several sections, including better communication, collaboration and coordination with healthcare professionals and also creating greater public awareness and education. One proposal includes: "Create a national council of family caregivers and advocates, including celebrities, to heighten attention to family caregiving issues, to protect the well-being and vital interests of families, and to identify potential solutions to meet the growing needs." Another PPI publication, released in February, found that 30% of older adults (Aged 50-64) were in families that spent 10% or more of after-tax family income on health care in 2007, compared to only 18% of adults aged 18-49.

For more information visit:

New NAC Study Looks at MS Caregivers

Multiple Sclerosis (MS) is a chronic, often disabling disease that attacks the central nervous system, often times beginning in young adulthood. It presents in many different symptoms, at differing time frequencies and duration, requiring substantial caregiver assistance. One of the biggest challenges of living with multiple sclerosis is coping with the constantly changing state of the disease. It's not unusual to encounter periods of severe symptoms followed by remissions. As a result, the physical, mental and financial burdens on family caregivers of people with MS are significantly greater than the general family caregiving population. This is the reality reported in National Alliance for Caregiving's most recent study: Multiple Sclerosis Caregivers 2012. For more information, go to: http://www.caregiving.org/pdf/research/MS_Study_Press_Release.pdf

Focus on Emergency Respite

With enhanced recognition of this possibility among the most vulnerable families, and the limited options for all family caregivers when emergencies arise, emergency respite models are slowly being developed for the adult and older populations as well. Area Agencies on Aging in some states, such as Arizona and Georgia, do make provisions for emergency respite for family caregivers who are eligible for the National Family Care Program. Additional examples of emergency respite:

• In Minnesota, a crisis respite program exists for adults with developmental disabilities who are eligible for the state's Medicaid developmental disabilities waiver and live at home. Agencies licensed by the state Department of Human Services provide short-term care and crisis intervention in the home of a person with developmental disabilities receiving care or services. Out of home services may also be provided in an adult or child foster home. Crisis Respite services include: assessment of what led to the crisis; creation of a plan to help end the crisis and to keep the person safe; services for both medical and behavioral needs; and caregiver consultation and training as needed.
• The Illinois Lifespan Respite program has established an emergency respite program. The goal of the program is to offer funding of up to $500 per year ($1000 with special approval) and resources to support caregivers of children or adults with special needs who have an urgent need for respite care in the absence of any other funding source. The program supports the caregiver's decision to request emergency respite care and determine where the care will be delivered and by whom.
• The Statewide Respite Program of New Jersey provides some emergency respite for state residents ages 18 and older with a chronic physical or mental disability who require supervision or assistance. Income criteria must be met as well.

The issue of emergency respite is currently trending in the ARCH Respite Discussion Forum. ARCH will be preparing a fact sheet and additional guidance on this topic. If you have information about emergency respite programs in your state, especially for the adult and aging populations, or the state Lifespan Respite program is developing emergency respite services or support, please consider sending information about these efforts to ARCH so that we can share it with the respite network. Please send the information to Maggie Edgar, Senior ARCH Consultant.

For more information on crisis nurseries, see ARCH Fact Sheet #1 Crisis Nursery Care: Respite for Children at Risk of Abuse and/or Neglect and ARCH Fact Sheet #3 Crisis Nursery Care for Infants and Children Who Are Medically Fragile

For summary research on the benefits of respite and crisis care in child abuse prevention, see the FRIENDS National Resource Center Fact Sheet #14: Respite and Crisis Care.

New ARCH Resources

Enhanced and Updated ARCH National Respite Locator

The ARCH National Respite Locator now allows family caregivers, care recipients, and those assisting them, to search for respite services in their state by zip code and to designate the radius from an address as their search area. Providers are then mapped for ease of location. Users can search by age, condition or type of respite preferred. This is an interactive site where service providers may enter their own information and keep it updated. Searchers are directed to the consumer information page, the ABCs of Respite, for background on respite and the types of respite that may be available.

New state-by-state information now displays at the bottom of each page of provider search results. Information includes contacts for the State's Lifespan Respite grant and the State Respite Coalition if the state has them. Also included are links to:

• Family Caregiver Alliance's Family Care Navigator for links to state family caregiver resources and other public and private supports, statewide online aging or disability information and referral services,
• other state or local online provider data bases,
• local and state Aging and Disability Resource Center (ADRCs),
• national data bases, such as Benefits.gov, Eldercare Locator for links to Area Agencies on Aging and Family Caregiver Support Services,
• National Dissemination Center for Children state agency and disability organization contacts, Easter Seals, and a National Resource Center for Participant Directed Services map for state contact information on consumer-directed services.

The Respite Locator's state pages also display respite funding possibilities, eligibility criteria, and contact information, including each home and community-based Medicaid waiver that funds respite and other possible state funding sources.

State Lifespan Respite News You Can Use

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• Texas: The Texas Lifespan Respite website, www.taketimetexas.org (or .net, .com, .info) is now active. While still under refinement, the site includes resources for family caregivers, including consumer information on how to search for and pay for respite, caregiver self-assessment tools, and a searchable inventory of respite providers statewide. For respite providers, the site includes training resources, and downloadable versions of the printed materials developed for the program's Take Time Texas awareness campaign.
• Tennessee: The Tennessee Respite Coalition, which administers a Family Directed Respite Program utilizing several federal and state funding streams, including some funds from the Lifespan Respite grant, has developed a very useful Caregiver Survey, which is completed by family caregivers who participate in their program. The survey asks about respite time use and also assesses the effects of respite on caregiver stress, health and employment status. Each family caregiver also completes a Family Respite Plan with goals and objectives for respite, and dates of completion.

If you have a program tool you would like to share, please send it to ARCH.