Goal
Educate complementary and alternative practitioners in family caregiving issues through a series of live and recorded caregiving tele-interviews.
Rationale
Family caregivers are a large underserved population that crosses all social and economic strata worldwide. The author proposes that education of compelentary and alternative practitioners on the needs of caregivers can improve the wellbeing of this underserved population.
History
In 1998 and 2001, the Foundation established two innovative centers for integrative medicine – the first at the University of California, San Francisco and the second at the Harvard Medical School in Boston. These two programs have within a few years of their founding become leaders in the field. In the summer of 2005, the Foundation, in partnership with the Barbro Osher Pro Suecia Foundation, provided support for the founding of the Osher Center for Integrative Medicine at the Karolinska Institute (KI) in Sweden.
All three institutions are committed to developing programs that feature research, education, and clinical care in integrative medicine, also known as complementary or alternative medicine.
These programs explore approaches which generally lay outside the mainstream of Western medicine, including chiropractic care, herbal remedies, acupuncture, acupressure, homeopathy, macrobiotics, yoga, massage, guided imagery awareness, and other treatments and remedies. For example, the UCSF Osher Center mission is to transform the way medicine is practiced by conducting rigorous research on integrative approaches to health, educating students, health professionals and the community, and treating patients with compassionate care that addresses all aspects of health and wellness - physical, psychological, social and spiritual..
One of the primary goals of these centers is to conduct basic laboratory research on integrative medicine remedies, to examine their consequences, and to build an empirical case for their application. In the case of the American institutions, third-party reimbursement will likely depend upon persuasive cases being made to insurers that integrative medicine offers effective remedies.
A second goal is to reach out to the larger community with an emphasis on preventive care. The centers seek to educate both medical practitioners as well as the general public. Seminars and conferences help educate people about the benefits of such “non-traditional” approaches to good health and medical care.
A third goal is to establish clinical treatment programs in which the knowledge and resources of integrative medicine can be used directly to help people as well as furnish training opportunities for medical students.
A few additional select grants for integrative medicine have been awarded by the Foundation -- one to Dr. Andrew Weil at the Program in Integrative Medicine of the Health Sciences Center of the University of Arizona at Tucson and another to Dr. Rachel Remen of UCSF for her curriculum development in integrative medicine for medical students. The Foundation also supports a career development award for complementary and alternative medicine practitioners through the National Institutes of Health.
Rationale for Osher Integrative Program To Provide Education on Family Caregiving
Family caregivers are a large underserved population that crosses all social and economic strata worldwide. The author proposes that education of alternative practitioners on the needs of caregivers can improve the wellbeing of this underserved population. Family caregivers are an underserved population that comprises one-fourth of all workers in the United States. Between 25% to 35% of all workers report that they are currently providing, or have recently provided, care to someone 65+ (Family Caregiver Alliance). They are the primary source of care for 75% to 80% of seniors in industrialized countries. It's not just the elderly who are cared for by family caregivers. They are also challenged with caring for a growing number of individuals with chronic diseases or disabilities. The emphasis on short-term hospital admissions, less institutionally based care, and more ambulatory care since the 1970s has resulted in a progressive shift from "care in the community to care by the community" (Yaffe and Jacobs, October, 2008).
A study of elderly spousal caregivers (aged 66-96) found that caregivers who experience caregiving-related stress have a 63% higher mortality rate than noncaregivers of the same age. Over 60% of caregivers are working. Many caregivers are themselves in poor health; studies show that approximately one-third of caregivers provide intensive care although they are themselves in “fair to poor” physical health. Caregivers over 60 die ten years younger than the frail elderly for whom they are caring (Family Caregiver Alliance).
Further studies will determine whether better-trained physicians and nurses can improve "caregiver satisfaction and coping, help to reduce caregiver burnout, and decrease caregiver mortality" (Yaffe and Jacobs). Further studies will also determine whether better informed alternative practitioners will reduce caregiver burnout, and decrease caregiver mortality.
Delivery System Benefits
- The proposed “tele-interview” format simply requires a telephone system (saves transportation, parking, and time).
- The tele-interview format is easier to listen to than having a speaker talk for an hour. It is similar to Franklin Delanor Roosevelt's “fireside chats" or Dr. Rachel Remen's "kitchen table" conversations in the comfort of the listeners’ environment of preference.
- Listeners are invited to ask questions during the interview.
- Listeners have an opportunity to apply the speakers' concepts through exercises prepared by the speakers.
- Tele-interviews are recorded and made available to listeners.
- Classrooms at community colleges can be set up with a speaker phone for those who would prefer to meet in a group to listen to the tele-interview and receive hard copy of the exercises/presentations.
Evaluations
- Listeners can fill out an online form to evaluate each tele-interview.
- Ninety-eight percent of listeners give highly positive ratings for all tele-interviews conducted by author of proposal.
Proposed Content
Studies of the unmet needs of caregivers provide the content of a series of tele-interviews with family caregiver experts, such as the following:
- the family caregiver wellness model (Gelardin)
- issues of caregiving across the lifespan (English)
- caregiving best practices around the world (McCall)
- the influence health belief models and family attitudes toward seeking or accepting help have on problem solving (Colozzi)
- family systems theory, including issues like enmeshment and communication patterns (Chope)
- patient and family experiences with illness (Liebhaber)
- sex and multicultural differences in caregiving (Byers-Winston)
- physical, emotional, financial, legal, family, and vocational consequences of caregiving (Fiedler)
- the presence of somatic symptoms as a possible reflection of caregiver distress (Prashant)
- techniques or inventories to evaluate caregiver burden (Keis)
- roles, interactions, and strengths and weaknesses of health care team members working with caregivers (Christner-Lile or Liebhaber)
- balancing work and caregiving (Marks)
All of the suggested speakers above are either contributors to the Winter 2007-2008 issue of the Career Planning and Adult Development JOURNAL on "Making a Career of Counseling and Advising Caregivers," contributors to the upcoming National Career Development Association monograph, "Career and Caregiving: Empowering the Shadow Workforce of Family Caregivers" (expected publication Summer 2009), and/or career and wellness leaders who have previously been interviewed or who are scheduled for upcoming Careerwell Tele-Interviews. They are helping professionals with backgrounds in a variety of fields, including, but not limited to counseling, nursing, law, higher education, elderly care administration, women's health, psychology of death and dying, and spirituality. All have had personal experience in caregiving. Additional suggestions for interviewees are welcome.
References
Caregiver Alliance. Selected Caregiver Statistics. Retrieved 11/23/08: caregiver.org.
Di Leonardo, M. C. AJCU, Connections. Retrieved 11/23, 2008: office.ajcunet.edu...
Gelardin, S. Careerwell Tele-Interviews with Career and Wellness Leaders (2007-2009). Retrieved 11/23/08: http://careerwell.org.
Gelardin, S. Guest Editor, "Making a Career of Counseling and Advising Caregivers." Career Planning and Adult Development Journal. Volume 23, Number 4. (2008).
Remen, N.(1996). Kitchen Table Wisdom: Stories That Heal. New York: Riverhead Books, 1996. Retrieved 11/23/08: http://www.commonweal.org/ishi/resources/store.html.
Yaffe, M.J. & Jacobs, B.J. Education about family caregiving, Canadian Family Caregiver Physician, Vol. 54, No. 10, October 2008, pp.1359 - 1360. The College of Family Physicians of Canada. Retrieved 11/23/08: http://www.cfp.ca/cgi/content/full/54/10/1359#B13-0541359.