It seems like a little thing, but being able to take a night off from caregiving can make a huge difference.
By Thomas Goldsmith
For the thousands of North Carolinians who look after adults with cognitive or physical problems, there’s real value in being able to take a break from the near constant demands of their duties.
A break of one night or as much as two weeks could be a lifesaver, say people involved with North Carolina’s emerging overnight respite program.
A state pilot of the program allowed caretakers for more than 200 older people to leave their relatives in trained care overnight during the first six months of 2016, lawmakers heard at a recent hearing at the legislature.
When the state program for overnight respite becomes more widely available, likely in April, the service could serve thousands of older North Carolinians and be covered under federal block-grant funding. The approach splits the difference between looking after vulnerable older people at home or placing them in long-term care such as an assisted living center or nursing home.
“Thus far we’ve had a tremendous amount of joy and excitement about overnight respite,” said Joyce Harper, administrative officer at Southeastern Health Care in Raleigh. “The family members look at it as a relief.”
Husband and wife Rhonda and Michael Harabedian, of Wake Forest, look after Rhonda’s uncles, Jerry, 73 and Hugh, 71, who both have dementia and developmental delay, so that they communicate at the level of preschoolers, Rhonda said.
Jerry and Hugh have done well when staying at Southeastern, Rhonda said. Their overnight stays gave the Harabedians a chance to get away together; they were able to spend six days attending their church’s bible study retreat.
“We had six nights to celebrate,” she said. “Normally we take Jerry and Buck [Hugh’s family nickname] with us, but it can be hard.”
Like a guest room
The Raleigh facility takes pains to make the rooms used for overnight respite have a welcoming look, Harper said.
“They look like a guest room in someone’s home,” she said.
Said Rhonda Harabedian: “They have everything set up there so nicely. It was such a homey type of environment and everyone was so friendly.
“I had to go back there to take something and just popping in unexpectedly you could tell that they were very caring.”
During the pilot period, no taxpayer money has been used to pay for overnight respite, which costs $150 per night at Southeastern.
“The pilot project couldn’t use any state or federal money,” Jesse Goodman, the state Department of Health and Human Services division chief for health service regulation, told legislators.
But that will change once the adoption of a licensure process and proposed regulations for the service is completed.
“What we’ve seen on more than one occasion is overnight respite is what kept people from putting a relative in long-term care,” Harper said.
Widespread use of the service could mean a caregiver, or the state, would save money with occasional respite care instead of the $3,000 average monthly cost for assisted living centers and more than twice that for skilled nursing.
“I have every confidence that once it is more widely available it will be a lifesaver,” she said.
Many clients of overnight respite have already been participants in an adult-day care program. That program serves older people or those with disabilities, who can spend daytime hours with access to activities, companionship and exercise in a safe environment.
The respite program has been in the works for several years, going back to a bill passed in 2011 that gave DHHS authority to establish pilot overnight respite in four adult day care facilities, of which two took part. During the first six months of this year, Southeastern Healthcare provided 94 overnights and Care Partners in Asheville supplied 115 overnight stays.
Goodman has shepherded overnight respite through the complicated process for a new social services program. His presentation before the General Assembly’s program oversight committee was well-received.
“This is something we got completed and we are pleased with that,” said Sen. Fletcher Hartsell, a Concord Republican and outgoing co-chair for the committee.[box style=”2″]
Timeline for overnight respite:
- Proposed rules were included in the Sept. 15 edition of the N.C. Register.
- A public hearing on the rules is set for 9 a.m., Nov. 2, in Room 104, Brown Building at 801 Biggs Drive on the Dorothea Dix campus, Raleigh.
- The Medical Care Commission will accept public comments (link to contact info here) on the rules through Nov. 14.
- DHHS will be developing IT systems for the licensing and inspection of overnight respite sites.
- If everything proceeds according to plan, licensing and regulation for adult respite will be final April 1, 2017.