Lifespan Respite Care Background Paper January 5, 2005

Situation

In 1999 Wisconsin became the third state in the nation to adopt Lifespan Respite legislation. The concept is simple – by creating a coordinated system of accessible, community-based respite options, family caregivers will essentially have “one-stop shopping” to find the programs they so desperately need.

Lifespan respite care – either planned or emergency – provides short-term relief for a family member caring for an individual with special needs within their home. Lifespan respite also recognizes the growing number of caregivers of persons aged 60 years and older, as well as grandparents who are raising grandchildren full-time. Respite is proven to reduce family stress, support family stability and prevent abuse or neglect.

Conflict

Family caregivers are the backbone of Wisconsin’s long-term care system. They provide round the clock, in home care for a family member with special needs, including those with developmental or physical disabilities, those affected by HIV/AIDS, chronic illness or Alzheimer’s disease. Without them many would enter institutions, thereby increasing the governments’ portion of their care. The demographics are staggering:

• Based on national averages, one in four Wisconsin households is involved in care giving to a person aged 50 and older – by 2007 the number of households is expected to increase by 43%
• Studies indicate about half of women and a third of men experience depression as a result of care giving – and use up to three times the amount of prescription drugs for depression, anxiety or insomnia as the balance of the population
• Families who have a loved one with a disabling or chronic condition spend 2.5 times more in out-of-pocket medical expenses than other families
• Wisconsin family caregivers provide almost $4 billion annually in services, ranking 18th in the nation for value of unpaid service.

A startling indication of the need for lifespan respite in Wisconsin is illustrated by two facts based on national averages:

• Without respite the risk for out of home placements for children increases by 35%
• Without respite the risk for out of home placement for the elderly increases by 40%

It is vital that Wisconsin recognize the societal and economic value of family caregivers; and why a key element in long-term care programs must be lifespan respite.

Resolution

Experts agree, respite is a necessary, cost-effective tool for assisting Wisconsin’s family caregivers.

Recent studies in Wisconsin show exciting results for the health of family caregivers when respite care is available and accessed:

• Respite substantially reduced levels of caregiver stress. Participants in the study were asked to rate their level of stress before and after respite. Respondents’ mean self-reported level of stress, on a 7 point scale was 4.79 before respite and 3.08 after respite.
• Respite reduced the likelihood of out-of-home placement. Participants in the study reported the likelihood of out-of-home placement as 2.25 on a 7 point scale before respite. After respite, the rating was 1.27.

Community-based lifespan networks are a proven model for delivering much needed care for caregivers. The Respite Care Association of Wisconsin (as the agency managing Wisconsin’s five pilot projects) reports the cost of institutional placement far exceeds the cost of respite. For example, compare the average hourly cost of respite care against out of home placement:

Cost of Respite Care	Foster Care	Children with Special Needs	Seniors
11 hours per month (x) average hourly rate of $8.28 $91.08	Wisconsin has a flat rate per month $302	Foster care for special needs children is flat rate per month $1,000-$2,000	Reimbursable rate for nursing homes in Wisconsin $4292

Clearly respite care makes good economic sense.

Outcome

The National Conference of State Legislators cited Lifespan Respite Care as a “promising practice” for innovation in consumer directed care. Fewer Wisconsin residents would be institutionalized; abuse and neglect cases would diminish. As care centers close and the responsibility shifts to community-based solutions, respite is a cost-effective tool. Study after study proves what most all know is simple common sense – delivering respite to family caregivers is an essential element in Wisconsin’s long-term care system.

 

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