How to Meet the Needs of a Diverse Aging Society

As our multicultural nation ages, the population of older adults over age 65 is projected to become increasingly racially and ethnically diverse.

This growing diversity has significant impacts on the way people access health care, how services are delivered, and in the research that seeks to address the complex needs of older adults.

Scientists at the UCSF School of Nursing are leading projects and developing policy recommendations to improve the health of diverse older adults, and to ensure that aging research is both reflective of and responsive to their needs.

Improving Training and Resources for IHSS Caregivers Working With Older Adults

Meanwhile, assistant professor Jarmin Yeh is working to meet the needs of older adults from a different approach: Training their caregivers for success.

The need could not be greater. The number of people living with Alzheimer’s is projected to double by 2040, according to the 2021 Alzheimer’s Disease and Related Dementia Facts and Figures in California report, which Yeh co-authored.

Meanwhile, over 520,000 caregivers currently serve over 600,500 care recipients within California’s Medicaid funded In-Home Supportive Services (IHSS) system.

With a $3 million grant from the California Department of Public Health, Yeh has spent two years implementing a 10-week dementia training program to support IHSS caregivers of older adults living with cognitive impairment or dementia. The pilot project is taking place in Alameda County.

Most of the caregivers are women and people of color. They are typically family members or friends caring for an older adult, or caregivers hired through an agency. Classes are in Cantonese, English and Spanish.

In partnership with the Center for Caregiver Advancement and the Alameda Alliance for Health, the training teaches IHSS caregivers how to identify and manage the signs, symptoms and behavioral changes related to Alzheimer’s disease to maximize the care they provide to their care recipients. In addition, they learn self-care strategies, an important skill to thrive in a role that can be emotionally taxing.

The goal is to train 600 IHSS caregivers by 2024, and the team is halfway to achieving that number. To measure effectiveness, competency checks are conducted with IHSS caregivers during the training, as well as pre, post, and follow-up surveys upon completion.

If successful, the program holds potential for statewide expansion, Yeh said.

“Bolstering the workforce is an upstream intervention,” Yeh said. “Downstream, we hope to show it will save health plans money because their members will be better cared for in their homes. This can lead to decreases in costly types of services, such as emergency room visits and unplanned hospitalizations. By training IHSS caregivers as a point of intervention in the dementia care system, we’re taking a preventive approach.”

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