Sponsor. United Hospital Fund.
Purpose. The purpose of the Family Caregiving Grant Initiative was to support seven hospital-based projects designed to respond more effectively to the needs of family caregivers during and after the hospitalization of the persons for whom they were providing care.
Description. The Grant initiative funded seven projects between 1998 and 2002. Although the specifics of each initiative varied, each project aimed to develop practical approaches to supporting family caregivers' needs, through outreach, education, or a reshaping of the health care culture itself. The projects included interventions that provided frontline support for caregivers, built and sustained institutional support, and involved caregivers as advisors in the care of the treatment of care recipients. Two of the seven projects focused on helping caregivers to take better care of themselves.
The Brooklyn Hospital Center/Wartburg Lutheran Home for the Aging project provided information and training for caregivers of neurologically impaired African-American patients and sensitized caregivers to their own needs.15 The intervention included (1) an assessment of caregivers' stress levels and their need for home care assistance so that appropriate services could be established and (2) upon discharge of their relatives, follow-up assistance and one or two in-home visits for help in making the hospital to home transition. In addition, caregivers were given individualized notebooks with information about resources and supports for their particular caregiver situation.
The Maimonides Medical Center/First to Care Home Care program was designed to offer caregivers a broad range of services and resources--including welcoming sessions, community referrals to health care providers for their own health care needs, and a hotline both during and after their relatives' hospitalizations.15 Two groups of individuals participated in the program, one considered high risk.
To be considered for the high risk group, a caregiver had to be identified by project staff as meeting at least one of the following criteria: advanced age, poor health, or having many other responsibilities such as child care or care for another ill person. The high risk group received information on benefits and entitlements to Medicare, Meals on Wheels, food stamps, and other community resources while their relatives were still in the hospital. In addition, they met with a social worker both while their relatives were in the hospital and within 24 hours of their relative's discharge to learn about how to take care of their own health during the transition home.
The second group included caregivers who identified themselves as candidates for the program and did not meet any of the criteria of the high risk group. These individuals received the same information materials as the high-risk group but did not visit with a social worker during or following hospitalization.
Results. All of the hospital-based projects were completed in 2002. No uniform approach was developed to track results across projects; rather, each project was encouraged to develop its own evaluation process. Caregivers involved with the Brooklyn/Wartburg project (relative to caregivers not involved with the project) reported having less caregiver strain and a greater understanding of the health promotion benefits available to them under the Medicare and Medicaid programs. Similarly, the Maimonides program, which began on two inpatient units in 2000, expanded to 15 units by 2002 because of its positive reception at the hospital. As of August 2002, more than 4,000 caregivers had attended 382 welcoming sessions, about 400 caregivers had attended monthly support groups and entitlement/benefits talks, and its partner, First to Care Home Care, reported more than 1,000 social work referrals.
Next Steps. Even though not all of the projects have been able to maintain their same level of service as under the United Hospital Fund Family Caregiver Initiative, the projects are expected to be continued and to obtain new funding in the future either within the hospital or from outside sources.15
United Hospital Fund
100 Newfield Avenue
Edison, NJ 08837
Phone: (212) 494-0755 (direct line)
Website address: http://www.uhfnyc.org