"Family caregiving knows no international boundaries . . . and family caregivers face increasing stress and health burdens," stated Gail Gibson Hunt, executive director of the National Alliance for Caregiving (NAC), in her opening speech at the Third International Family Care Conference, in Washington, D.C., Oct. 12-14. She explained that the aim of the conference, which attracted almost 750 delegates from more than 20 nations, was "to help us all look across borders" by highlighting innovative approaches and programs.
The conference offered almost 300 presentations, from plenary to poster sessions, on the theme. "Empowerment Through Innovation." NAC, which served as the U.S. host for the biannual conference, is a coalition of 38 organizations-including the American Society on Aging, AARP and the U.S. Department of Veterans Affairs-that focuses on issues of family caregiving. NAC is based in Bethesda, Md.
Plenary sessions examined the common needs and experiences of caregivers around the world. Representing the United States, Assistant Secretary for Aging Josefina G. Carbonell, who heads the federal Administration on Aging (AoA), touted the National Family Caregiver Support Program (NFCSP) as "a total success." Although the program, now in its second year, is regarded throughout the aging network as small with its $141.5 million budget for fiscal year 2002, Carbonell called it "a lifeline in many communities." She said it fosters innovation, flexibility, and collaborative efforts and partnerships; encourages consumer input; and "has an aggressive [media] campaign to get the word out that it empowers caregivers." She stressed that she hopes to position the program to grow in both stature and impact and said that although the current budget "was already done when I came in, the next one is mine."
During the conference's opening plenary symposium, AoA's Rick Greene, who oversees NFCSP, said that countries can learn from each other "how to create flexible programs." Greene, who said that he is a long-distance caregiver for his 86-year-old mother-in-law, noted that the program is assisting federal, state and local agencies and organizations. NFCSP aims to support efforts that coordinate or provide a wide range of services, such as caregiver counseling, information and referral programs, "faith-- in-action" collaboratives with assistance programs, and supplemental long-term care services, he said.
Also on the opening panel, Warwick Bruen, assistant secretary for community care in Canberra, Australia, stressed how flexible programming meets caregiver needs. He noted that in Australia flexibility includes "direct payment for carers who cannot work because of their caregiving responsibilities." Paying "family carers"-a common term used internationally for caregivers-has been controversial in the United States. In a conference symposium, experts agreed that the U.S. Cash and Counseling demonstration project has been successful, and no evidence has surfaced to support concern about fraud and abuse.
Ryoji Kobayashi, of Tokyo Metropolitan University in Japan, discussed his country's recently initiated "two-tiered" long-term care insurance program, in which the government pays premiums for low-income elders whereas those who are better off pay most or all of their premiums. He said the program is supplemented by the existing welfare system to ease the burden on caregivers.
In Israel, said University of Haifa's Israel Doron, family care is regarded as a "moral mandate," as it is in Japan. Because of this, Doron said, Israel has forged "no coherent social policy, from a legislative point of view, to support family caregivers." He said there is significant need for research on developing long-- term care insurance for aging Israelis.
A LABOR ISSUE
Lennarth Johansson, research leader at Sweden's National Board of Health and Welfare, said "each caring relationship is …