By John Paul Marosy, President
Bringing Elder Care Home LLC
jpmarosy@charter.net
(508) 854-0431

"Ninety percent of Americans, if faced with a terminal illness, would prefer to be cared for and die in their homes, according to a Gallup Poll. These Americans are interested in using a comprehensive program of care in which physicians, nurses, counselors and other professionals keep them pain-free, comfortable and alert at home, while emotional and other support is given to family members."             -- Jack Gordon, President, Hospice Foundation of America

Despite consumers' stated preference to die at home and to avoid extraordinary measures when death is imminent, 80% of people die in hospitals connected to the very technological devices that they wish to avoid.

In recent years, employers have begun joining consumer, faith-based, and health and social service groups to form coalitions to improve care at the end of life. Bill Densmore, a retired executive from a manufacturing company in Worcester, Massachusetts, helped a leading physician in his community, H. Brownell Wheeler of the University of Massachusetts Medical School, establish one such coalition. Densmore now serves as co-chair of the Central Massachusetts Partnership to Improve Care at the End of Life - a group that is now reaching out to employers and union groups in a community-wide education effort.

Why should business be concerned about care at the end of life?

According to research results compiled by Densmore, there are humanitarian as well as bottom-line reasons to focus on these issues. Important improvements need to be made, for example:

• Too many people spend their last days experiencing unnecessary pain.
• Too often, there is ambiguity about the patient's wishes regarding when to switch from aggressive treatment to palliative care.
• One half or more of patients or their families report that physicians did not keep patients and family members informed and involved in decision-making.
• Only about one-third of the population have done advance care planning and prepared documents defining their wishes and designating a person to make healthcare decisions, and half the time such documents are not available when needed or are not heeded.
  

The business case for getting involved in end-of-life issues links directly to the number of employees who are involved in caring for sick or disabled family members. With the aging of the workforce, it is an issue that employers ignore at their peril. Consider:

• One-in-eight employees - about 15% of the workforce - are actively involved in providing care for an older family member or friend. (National Alliance for Caregiving, 1987 & 1997).
• The number of workers over 55 (those most likely to be dealing with elder care) will increase from 13% of the workforce in 2000 to 20% in 2015. (AARP 2002)
• American businesses lose between $11 billion and $29 billion each year due to employee elder-related work interruptions, absences, turnover, and increased medical costs. (MetLife 1997)
• End-of-life care decisions have a major impact on healthcare costs. When a terminally ill relative has not provided a written, advance directive to renounce unwanted, aggressive treatment, the "default" decision on the part of medical personnel is to employ costly, high tech care in a hospital setting.

Two national groups have developed materials specifically for the use of employers who want to help their employees better cope with end-of-life care:

• Last Acts, a national coalition "to improve care and caring at the end of life" convened a Workplace Task Force that has issued two useful documents:
• A brochure, Model Activities for Employers, highlights a range of education, benefits, services, and the role of management. Free. Contact Sojourn Communications (703) 556-6800
• Helping Employees Deal with End-Of-Life Issues: A Tool Kit - Supportive Workplace Policies and Programs. 3-Ring Binder and CD. A comprehensive guide for human resource professionals in businesses, large or small. $75.00 ($10.00 for CD alone). Call 202-296-8071 or visit www.lastacts.org.
• Aging With Dignity, a non-profit organization, offers an easy-to-complete workbook and accompanying video for planning for care at the end-of-life called Last Wishes ($5.00 for single; $1.00 per copy for 25 or more) and a Last Wishes in the Workplace - a program designed for workplaces that are offering Five Wishes as an employee benefit. These companies receive an Employer Packet that contains all the information needed to promote and distribute the document to their employees and their families. Cost = $1.00 per employee. Call 1-888-5-WISHES or visit www.agingwithdignity.org

Bringing Elder Care Home LLC is a partner organization of the Last Acts Coalition. We urge your organization to support the coalition's work as well.

Hear John Paul in person!

On Saturday, November 8, readers in the New York/New Jersey metro area can meet Bringing Elder Care Home President John Paul Marosy and hear his dynamic Power of Caring keynote speech and seminar at a special National Family Caregiver Month conference sponsored by the Senior Care and Activities Center in Montclair, NJ. Admission is Free. Pre-registration required. Call 973-783-5589 or email scac@monmouth.com.

John Paul Marosy
Editor and President,
Bringing Elder Care Home LLC

John Paul Marosy is the author of Elder Care: A Six Step Guide to Balancing Work and Family, available from Bringing Elder Care Home Publishing on line at www.bringingeldercarehome.com or by calling 508-854-0431

This newsletter may be reprinted in whole or in part so long as the author, John Paul Marosy, is credited and the Web site address, www.bringingeldercarehome.com, is provided.