The Needs of Seniors in Western Illinois And
The WIAAA Service Priorities

Caregiver Needs

In preparation for the FY 2002 - 2004 Area Plan, WIAAA conducted a needs assessment survey of caregivers. This survey assessed the needs of caregivers and how those needs might best be met. This survey was taken into account in planning our programs, and continues to provide baseline guidelines for the implementation of the different services. No needs assessment was conducted prior to the FY 2003 Amendment to the Area Plan. However, a needs assessment of gaps in service for the caregiver program in preparation for the FY 2004 Amendment to the Area Plan was conducted. This indicated the need for more adult day care facilities, nursing homes and assisted living facilities able to provide respite, and for in-home respite evenings, overnight and weekends.

There is a need for support groups in the location in which the caregiver lives.

The WIAAA Family Caregiver Program Coordinator visits the Community Focal Point/Family Resource Centers and Support Groups on a regular basis, enabling her to assess needs on an ongoing basis. The WIAAA Advisory Council established a Caregiver Advisory Committee to provide input from the communities represented by the council members.

Our 2002 Community Input Meetings indicated a need for additional funding in the counseling portion of Training/Counseling/Support Group service. A need for additional videos and VCR equipment for use in support groups was also expressed. Respite services and Supplemental services are being utilized in appropriate ways, and could make good use of additional funding. The books and videos available through the Elderly Learning and Living Facility are being used extensively. Grandparents Raising Grandchildren support groups are, so far, less popular than the support groups for general caregivers, but every attempt is being made to reach those grandparents who might benefit. The program is targeting caregivers with the greatest economic and social need, who are low income and rural, as well as grandparents raising grandchildren.

Service priorities are unchanged since last year. They are: (1) Respite; (2) Information; (3) Assistance; (4) Counseling and Training. Supplemental services will be funded at the allowable annual rate of 20% of the available funding.
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Community Focal Point/Family Resource Center directors say it is becoming more and more difficult to meet the needs of seniors as funding remains static but costs increase.

They are predicting that the Medicaid cuts to health care providers will impact the senior service providers as earlier hospital discharges and longer delays in entering nursing homes result.

All general indications are that the needs for Title III service by the seniors in our ten county area have not changed significantly over the past decade. There is less demand for congregate meals and a greater demand for home delivered meals over the years as the clients originally served age and become homebound.

WIAAA conducted community input meetings on February 26, 27 and 28, 2003. Our agency invited the public to discuss the decisions made by the board regarding the 2002 - 2004 area plan amendment. The meetings are very informal in nature and the participants are welcome to discuss any topic they wish. Providers, seniors and members of the general public have an opportunity to influence the plan's outcome during the early stages of development. Testimony at public hearings, scheduled in late April affords another opportunity for input and possible change at the end of the development process. Total attendance at the community input meetings exceeded fifty persons.

This report summarizes the comments and recommendations from the meetings. They began with a brief introduction by Greta Brooks, WIAAA Executive Director. A handout of the Mission Statement, Area Plan Goals and Service Priorities was distributed. Agency staff presented the following minor proposed changes to the Area Plan Amendment:

• Funding amounts, units and persons
• General updates
• Needs Assessment

There was some discussion of what will be done with an increase in caregiving funds. To spend the increase in half a year is more difficult, and match may be a problem. Several suggestions were made. One-time grants may be issued. Caregivers in the needs assessment had said that physicians and discharge planners do not tell caregivers about available services, or what to expect in the care recipient’s future condition. Alternatives for the Older Adult would be able to use some of the increase for the Galesburg and LaSalle regional offices to give more caregiver/discharge planner support. We might be able to train caregivers on how to talk to medical personnel, question discharge planners, etc. regarding services available. A new grant that WIAAA has received, called "Making the Link" will provide materials that can be customized for distribution to physicians. Another suggestion is a "discharge kit" to be given to caregivers containing information on available services as well as free product samples.

Increased funds could also be used for supplemental services and/or additional medication management. A case manager said both services prevent hospitalization. In the process of administering a memory quiz, she often can detect vision problems or illiteracy which presents difficulties with medication management.

To deal with decreases for the current fiscal year, WIAAA has suspended gap filling as of the end of the second quarter until we know exactly what the funding will be, then it will be reinstated if appropriate. A considerable amount of carryover can be used to cover some of the deficit.

A senior asked if transportation could be provided close-in to Monmouth but in a rural area, and also if evening transportation could be available. She was advised to check with the local provider, Warren Achievement Center that may be able to arrange it.

Two seniors presented a discussion whereby one has long term care insurance and wants to go to a nursing home, and another who does not want to go to a nursing home. Both are valid options. Funding is geared to institutional care but community based services are more cost effective. Adult Day Care is another option although some facilities are closing because the reimbursement rate is too low. Nursing homes and in-home service agencies have staffing problems because workers are underpaid. Staffing is less of a problem in the Quad City area than in outlying areas.

One senior expressed a willingness to pay more state income taxes to prevent further layoffs and potential closing of nursing homes and hospitals because the state is not paying them promptly. It was suggested that she talk to her legislators.

It was asked what could be done for clients who can’t afford the monthly fee for emergency response systems. Gap filling or supplemental funds might pay for installation and/or a couple of months following hospital discharge. One company waived the fee for a person for three years.

In response to the caregivers interviewed in the needs assessment asking for in-home respite evenings, weekends and overnight, one of our in-home respite providers said they have tried to meet all emergency requests and do quite a bit of this type of respite. It is very difficult to staff because the workers have family responsibilities.

A pastor said his church and many others have aging members who need to know about the availability of services. He thought we should find a method to reach congregations. We have tried unsuccessfully to do this is the past.

It was mentioned that the biggest problem is that caregivers often do not consider themselves as caregivers – only spouses or children doing what is expected of them. Also most grandparents raising grandchildren are under the age of 60.

Two Community Focal Point/Family Resource Centers reported that their budgets are very tight, and if they receive any increases in funding it should be to do what they are already doing rather than for it to require additional units of service.

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