Gretchen Barry

BuddyIns partners with several companies to provide value-added services related to long term care. One such partner is TCARE, an evidenced-based high-tech platform plus human-touch way to support caregivers and prevent caregiver burnout. Recently, I had the opportunity to chat with Lindsey Niemeier, head of strategy at TCARE, to get more insight into the current caregiver crisis in the workplace.

As more employees are thrust into the caregiver role, interest in worksite/employer long term care benefits is increasing. My conversation with Lindsey focused on the caregiving crisis but also highlights the impact that employers can have in the long term care planning conversation.

Gretchen: Given that up to 25 percent of the workforce is a family caregiver, what do we need to understand about caregiver burnout?

Lindsey: I think it’s important to recognize based on our experience that a larger portion of the workforce is providing care to someone over the age of 18. This can have a huge impact on employers. On average between 20-25 percent of employees are family caregivers, however it typically is not talked about at work as they don’t want to be perceived as being distracted or disengaged, unable to take on more responsibility or a promotion, or potentially needing more flexibility and time away from work. If a group does not have a caregiver-friendly policy or program in place, there is more pressure for employees to manage these responsibilities on their own.

Gretchen: Your data certainly supports other reports I’ve seen. According to the Rosalynn Carter Institute for Caregiving, family caregivers comprise an estimated 22 percent of the US labor force. So, what are some of the challenges you see with employees who are caregivers for adult family members?

Lindsey: First and foremost, in many instances family caregivers do not necessarily self-identify as a “caregiver,” so they are sometimes balancing a career, family, and everyday responsibilities plus caregiving on their own, without realizing there are programs to help them navigate the complexities of providing care. This can lead to a significant amount of time and resources spent trying to identify how to access appropriate, high quality and cost-efficient services at the right place and the right time.

Caregivers tend to internalize these pressures leading to the higher rates of stress and depression, exhaustion, negative impact to their own physical health, and ultimately making tough decisions such as placing a loved one in a long term care facility. They sometimes feel like they can no longer manage their daily caregiving needs or may even consider leaving their current employer in order to continue to provide care at home.

Gretchen: Why does this have such a tremendous impact on the workplace?

Lindsey: When you are caring for a loved one, and depending on the care needs of the individual, you don’t just walk into work and leave the caregiving at home. When an employer does not have a top-down culture that embraces and supports employees who are managing caregiving responsibilities, then these employees tend to feel isolated. This is when we begin to see the disengagement rates climb, concerns about the ability to remain in a full-time role, reduced productivity, and distraction. Depending on the industry, this can create other pressures within the team, such as needing to fill missed shifts, reassign work, or maintain high standards of safety which can be negatively impacted by exhaustion and distraction.

Gretchen: I would imagine that has other financial impacts as well. What impact can caregiving have on health insurance premiums?

Lindsey: We have found that as caregiving responsibilities increase, the health status of the family caregiver tends to decline. They may miss their own doctor’s appointments, not follow their own medication adherence, or abandon exercise routines due to lack of time and energy. This can lead to increased rates of high blood pressure, higher prevalence of prescriptions for anxiety and depression, and higher rates of obesity and other health concerns.

When family caregivers are supported through a program such as TCARE, we are able to provide them with a care plan and targeted activities to support and mitigate these risk factors, so they can regain focus on their own health as they continue to provide care. We like to say better care starts with self-care. Maintaining the focus on the employee caregiver’s health results in improved health plan claims, risk factors, and ultimately premiums.

Gretchen: Is there advice you can give to an employer who finds out that someone on their staff is experiencing caregiver stress?

Lindsey: When looking at providing caregiver resources, it’s important to communicate that initiative throughout the organization, and foster a culture that supports those with caregiving responsibilities. This includes training for managers to understand what to listen for, which may help them identify someone is caregiving. This becomes the perfect opportunity to refer that employee into the TCARE family caregiver support program and position it as a commitment the organization has to embrace and support their employees who are caregivers at this critical time.

Gretchen: What is the TCARE mission?

Lindsey: Our mission at TCARE is to serve as many caregivers as possible, identifying their needs and providing tailored care plans and advocacy to prevent their burnout. We support individuals as they navigate their caregiving journey and empower them to balance caregiving with their professional and personal responsibilities.

Gretchen: What is TCARE’s process once an employee reaches out?

Lindsey: Employees access TCARE primarily through our digital platform but can also schedule directly with a TCARE specialist for more urgent support. Once an employee is engaged, we encourage them to complete our proprietary, evidence-based screener to help us understand their current caregiving status, identify their leading factors to burnout, and provide a caregiver burnout risk score. Those identified at high risk are connected to a certified TCARE specialist, who becomes their caregiver advocate and establishes an ongoing relationship, developing a personalized care plan for the caregiver to specifically address those leading factors, and reducing their risk for burnout. We also leverage our mobile app to support ongoing engagement with all caregivers, provide self-navigation resources, content, ability to manage
caregiver tasks and responsibilities, and access to local services and resources.

Gretchen: How does a program like TCARE impact the outcome for employers?

Lindsey: We previously identified several ways caregiving impacts employers, and introducing a family caregiver support program such as TCARE works at addressing these factors and helps to reduce those risks to the employee, as well as the employer. From a policy perspective, many groups have implemented programs to support young, growing families, but many do not have policies or programs in place to support families caring for aging family members; caregiving programs support more inclusive benefits. Additionally, providing a robust and effective program that targets individual needs will support overall health improvement of the caregivers, physically, emotionally, and financially. Finally, organizational outcomes such as improved productivity, reduction in time away from work or missed shifts, and improved retention and engagement of those working family caregivers support workforce optimization and financial objectives.

Gretchen: How do you see technology helping caregivers in the future?

Lindsey: Technology really enables tailored care delivery and the ability to meet individuals where they are. Caregiving is personal, and everyone’s experience will look different and could change at any moment. Intelligent technology and robust digital tools support improved engagement, predictive analytics to provide appropriate response to changing needs, and provide desired outcomes by reducing the risk for burnout.

As more Baby Boomers require long term care, and many of them are without the financial resources to afford robust care options, more employees will face the prospect of caregiving. Providing employees with tools to manage these responsibilities, then offering them their own long term care planning benefits will go a long way to helping employers reign in the costs of absenteeism and burnout. For additional information regarding caregiver support, please visit: https://tinyurl.com/4rx74vbm. For information on long term care planning as an employee benefit, read our Long Term Care Insurance Guide for Worksite: https://www.buddyins.com/worksite/.

The long term care insurance (LTCI) claims process and care coordination can be a mystery to policyholders and their financial advisors. It can also be an objection to purchasing LTCI if a client has a negative impression or believes the carrier won’t meet its claims obligation. Even some of the best long term care insurance specialists have questions about the claims and care coordination process. BuddyIns teamed up with our community partner, Amada Senior Care, to answer some of the tough questions around the current claims process and what the future holds as this wave of seniors seeks extended care.

Barry: Let’s start by unpacking the current situation that retirees and seniors are finding themselves in as they enter retirement and age in place. We’ve all heard about the wave of baby boomers entering retirement, and the potential challenges this large aging demographic may impose on our society. As a top national senior care agency, what do you recognize about the situation seniors are facing today?

Thomas: The senior care continuum is incredibly complex. Every administration has been working to address the issue since Roosevelt signed the Social Security act into law and President Johnson signed the Medicare and Medicaid Act. Our aging population presents a public health crisis that affects families, wealth dynamics, economic productivity, hospitals, healthcare systems, and ultimately social and government efficacy.

This large generation of baby boomers aging in place presents several challenges, the largest of which might be the cost to social programs. The government, through Medicare and Medicaid, is the largest payer of healthcare costs, specifically for seniors as they need increased health resources. Senior care and long term care additionally represent exorbitant costs that our government programs aren’t ready to handle. There is increased attention and concern on this issue demonstrated by moves such as Washington’s creation of a public long term care program to shift costs away from their state Medicaid budget, and the dozen other states soon to follow suit. Or the federal government’s attempt to include long term care benefits in the ACA (Affordable Care Act) and multiple proposed fed initiatives being evaluated currently. There is a substantial need for our society to get its arms around what to do with our senior population.

In addition to societal pressure, families are experiencing tremendous challenges to care for their loved ones physically and financially. The reality is that most seniors want to stay at home for as long as possible, and family members end up becoming primary caregivers. It’s estimated that there is a loss in income of nearly $522 billion annually by the nearly 53 million people in the U.S. who care for someone close to them. As a long-time provider of home care services, Amada Senior Care understands how important it is for families to preserve their loved ones’ health, independence, and dignity. Senior care advisors from Amada offices around the country frequently meet with families who have become weighed down by both the physical and emotional exhaustion that occurs when caring for a loved one. At Amada, we provide support not just for the senior loved one but also the entire family.

Barry: This immense societal pressure has certainly been growing for some time. Has COVID made a significant impact on the situation, and in what ways?

Thomas: COVID has absolutely made an impact. It was a collective gut check globally that forced us all to take inventory of what is important. Families lost loved ones, people learned to work from home, many senior care facilities lost 20-40 percent of their residents either to COVID or as they transitioned to care at home. COVID changed how healthcare is being delivered, with far more healthcare services being delivered at home. Ultimately, families were forced to consider other options and many families have chosen to keep their aging loved ones home or make plans for care at home as their loved ones age. A long-lasting impact of COVID will be that there will be more and more care services delivered at home and because there is now a sea change in thinking about what kinds of health care can be accomplished in the home.

Barry: I understand that Amada takes an active role in assisting families during their time of need. Can you explain your process?

Thomas: We take a holistic approach to care as a care advocate for our seniors and their families. We start by conducting a comprehensive assessment of our client’s needs, evaluating the medical, financial, and social needs present for our family. This assessment by our team of senior care advisors identifies support needs with activities of daily living (ADLs) and other needs identified in the client’s plan of care with their health professional, such as cognitive issues, ambulatory issues, etc. This comprehensive needs assessment is necessary to then create a personal care plan for our senior clients that is suitable based on their needs and preferences.

The plan of care for many families includes some level of home care. It might be part-time home care in partnership with the family or full-time, round-the-clock care by our trained caregivers. Most seniors desire to stay in their homes for as long as possible. If care at home isn’t possible because of the level of medical needs present, we have partnerships with thousands of senior housing and elder care communities across the country. An Amada senior care advisor has the knowledge and experience to help the family find the right assisted living or continuous care community or nursing community for their loved one.
Of equal importance in this process is helping our clients afford the type of care that they desire. We are experts in helping our clients financially plan to cover the costs of in-home care. This might include identifying VA benefits, retirement benefits or LTCI benefits that will completely or partially pay for care.

Amada Senior Care began franchising in 2012, thus we have locations across the country with a large network of caregivers providing care to thousands of seniors.

Barry: Wow, care advocacy sounds like so much more than just care coordination or care advice. For those of us looking for help, what should we look for when choosing the right care advocate?

Thomas: A senior care advisor should certainly address all physical, health, and emotional needs as well as financial needs. Additionally, does the advisor ask the right questions about the senior’s unique situation? Does the home care agency employ its own workforce of trained caregivers? What is their process for vetting caregivers or the assisted living communities they recommend? What is their experience working with LTCI claims management and advocating with brokers on behalf of senior clients and their families? Can the senior care advisor show a proven process for filing LTCI claims or successfully working with the VA to acquire funding to pay for in-home care services?

These are a few of the many questions that should be asked when choosing the right care advocate and partner to provide care services for your loved one. Amada has earned critical acclaim for our home care services, primarily because we employ our caregivers and have established a culture of compassion and gratitude for the work of our caregiving team that extends to the value and dignity of the seniors they care for. Home care agencies that contract independent caregivers don’t have the same influence or control over the quality of care provided by their network. We have also worked with clients who have LTCI for over a decade and have become leading experts in working with insurance carriers to file, process, and get approvals from every long term care carrier in the market. We have found this to be pivotal in ensuring that senior policyholders receive all the long term care benefits they are due.

Barry: This comprehensive approach to care is certainly valuable to the families you serve. Tell us more about how you provide support for families with LTCI.

Amada: The process begins with re-educating clients on the benefits available in their LTCI policy. We’ll contact the insurance company on the family’s behalf, collect information, complete and file the claim forms, and even continue to manage the payments if the client wants us to. A critical component of the claim process is providing an RN or medical professional to meet the client in their home and complete a medical assessment as well as a plan of care that is submitted upon filing the claim. Once the claim is approved, our team will automatically collect and file all paperwork as well as maintain the client’s eligibility status by managing recertifications.

As client advocates, Amada senior care advisors have worked with most insurance carriers and have filed tens of thousands of LTCI claims on behalf of clients. That gives us a unique perspective that is based on real-world cases. We work hard to share our experience with others, like BuddyIns, to help educate financial advisors and consumers about the long term care claims process.

Barry: How do you foresee the LTCI claim’s process changing as more and more seniors age and become benefit eligible?

Thomas: There was a little more than $12 billion in LTCI benefits paid in 2022, and that number is expected to grow considerably over the next decade. Additionally, there are an estimated 73 million baby boomers that will all be over age 65 by 2030. This block of aging baby boomers has represented a majority of LTCI policyholders over the last several decades. As many carriers are transitioning from not just collecting insurance premiums to now paying significant claims benefits, it’s foreseeable that there will be additional scrutiny on the claims process.

Applying even more pressure to the situation is the predicted shortage of geriatric specialists, care managers and caregivers. Seniors will desperately need advocates to not only help them navigate their LTCI claims but also to navigate the complexities of the senior care environment. It’s expected that home care services, quality caregiving, and senior advocacy all will be in short supply and incredibly valuable. This demand is already being felt by non-medical, in-home care providers as they struggle to hire enough caregivers to meet the growing need.

Barry: Is home care right for everyone?

Thomas: Home care isn’t right for everyone, but it is ideal for many. Data from AARP’s Home and Community Preferences Survey* shows that 77 percent of adults 50 and older want to remain in their homes for the long term—a number that has been consistent for more than a decade. Most seniors intend to stay home and age in place. The challenge for many is that without a plan to make staying at home possible, their desire isn’t possible. For seniors who can’t afford to stay home or have complicated medical needs that make aging at home untenable, there are a range of options for them to consider.

Barry: You’ve highlighted how complex our healthcare system is and the challenges that seniors face. Whose job is it ultimately to make sure our seniors are cared for?

Amada: It’s our job to serve seniors, it’s the job of family members, and it’s the job of our communities. The complex needs of many seniors and families require an all-hands-on-deck approach. That being said, we have recognized how valuable and critical the impact of LTCI is for families that have prepared ahead. We are huge proponents of LTCI and the higher quality of life and superior care that it delivers to many seniors who, without it, wouldn’t be able to afford the personalized care they need to stay healthy and happy at home.

Organizations that advocate for and educate consumers about the need for long term care planning are an invaluable resource. The movement to ensure consumers are educated and have all the information they need to make the best senior care decisions for their families will continue to grow and serve more people. And that’s a positive development no matter how you look at it.

*https://www.aarp.org/home-family/your-home/info-2021/home-and-community-preferences-survey.html.