Caregivers program. Final rule

The Department of Veterans Affairs (VA) adopts, with changes, the interim final rule concerning VA's Program of Comprehensive Assistance for Family Caregivers. VA administers this program to provide certain medical, travel, training, and financial benefits to caregivers of certain veterans and servicemembers who were seriously injured during service on or after September 11, 2001. Also addressed in this rulemaking is the Program of General Caregiver Support Services that provides support services to caregivers of veterans from all eras who are enrolled in the VA health care system. Specifically, changes in this final rule include a requirement that Veterans be notified in writing should a Family Caregiver request revocation (to no longer be a Family Caregiver), an extension of the application timeframe from 30 days to 45 days for a Family Caregiver, and a change in the stipend calculation to ensure that Primary Family Caregivers do not experience unexpected decreases in stipend amounts from year to year.

Impact of Mental Health Care Bill on caregivers of mentally ill: Boon or bane

BACKGROUND

To improvise the shortcomings of existing of mental health legislation (The Mental Health Act, 1987) of India, amendments have been made which ultimately conceptualized, to form the Mental Health Care Bill. Mental Health Care Bill has brought a revolutionary change in the existing mental health legislation which is in its final phase of approval.

METHOD

Many of the changes brought by the Mental Health Care Bill has been appreciated at different level, at the same time it has received robust criticism for over-legalizing and complicating the delivery of mental health care.

RESULT

Caregivers play a pivotal role in the management of psychiatric illness in developing countries like India and they face a lot of challenges for providing support to the mentally ill patients.

DISCUSSION

The social, economical, physical as well as the psychological wellbeing of the caregivers are significantly affected while providing care to the mentally ill. The forthcoming Mental Health Care Bill is likely to have a noteworthy impact on the caregivers. It's high time to analyze, its projected impact on the caregivers of patients suffering from mental illness.

The time-associated impact of the Newborn Influenza Protection Act on infant influenza rates in New York State

BACKGROUND

Influenza presents with increased morbidity and mortality in children ≤5 months of age. Vaccination of caregivers is indicated, but immunization rates are estimated at only 30%. The 2009 New York State Neonatal Influenza Protection Act (NIPA) mandated offering of influenza vaccine to caregivers during the post-partum hospitalization. The purpose of this study was to determine the impact of NIPA on infant influenza rates.

METHOD

Data on laboratory-confirmed influenza cases between 2006 and 2012 were extracted from the New York State Electronic Clinical Laboratory Reporting System (ECLRS). Data on infant cases were categorized by age (0-5 months) and location [New York City (NYC), outside NYC] based on reporting laboratory site. The total number of influenza cases and the percentage of total cases in the infant age group were normalized to the number of reporting laboratory sites. The χ2-test was used to compare the proportions of cases pre- and post-implementation. Year-to-year trends were assessed by linear regression. All tests of significance were two-sided and evaluated at the P<0.05 level.

RESULTS

During the 6-year study period, 3154 cases of infant influenza were detected. In bivariate analysis, 1707 (54.1%) of cases occurred prior to NIPA implementation and 1447 (45.9%) of cases occurred after (P<0.001). Of the 1422 total infant cases detected in NYC, the percentages of influenza cases pre- and post-NIPA were 54.6% (777) and 45.4% (645), respectively (P<0.006). Outside NYC, the percentage of infant cases was reduced from 53.7% (930/1732) to 46.3% (802/1732, P<0.02). Prior to implementation, there was a year-to-year increase in the number of infant influenza cases statewide (P<0.04 for trend). The ratio of infant influenza cases normalized per ECLRS site in NYC increased each year after NIPA passage (P<0.01 for trend). The ratio of infant cases outside NYC decreased annually (P<0.05 for trend). No year-to-year trends were seen in the percentage of total influenza cases in the infant age group compared to total cases across all age groups either within or outside NYC.

CONCLUSIONS

Comparison of three influenza seasons before and after NIPA suggests a total statewide reduction in infant influenza. However, the greatest driver of this reduction occurs from reduced disease in infants outside NYC. We speculate that, with increased crowding within NYC, parental immunization as encouraged by NIPA may not create cocoon immunity.

The Family and Medical Leave Act. Final rule

This Final Rule amends certain regulations of the Family and Medical Leave Act of 1993 (the FMLA or the Act) to implement amendments to the military leave provisions of the Act made by the National Defense Authorization Act for Fiscal Year 2010, which extends the availability of FMLA leave to family members of members of the Regular Armed Forces for qualifying exigencies arising out of the servicemember's deployment; defines those deployments covered under these provisions; extends FMLA military caregiver leave for family members of current servicemembers to include an injury or illness that existed prior to service and was aggravated in the line of duty on active duty; and extends FMLA military caregiver leave to family members of certain veterans with serious injuries or illnesses. This Final Rule also amends the regulations to implement the Airline Flight Crew Technical Corrections Act, which establishes eligibility requirements specifically for airline flight crewmembers and flight attendants for FMLA leave and authorizes the Department to issue regulations regarding the calculation of leave for such employees as well as special recordkeeping requirements for their employers. In addition, the Final Rule includes clarifying changes concerning the calculation of intermittent or reduced schedule FMLA leave; reorganization of certain sections to enhance clarity; the removal of the forms from the regulations; and technical corrections to the current regulations.

The importance of place and time in translating knowledge about Canada's Compassionate Care Benefit to informal caregivers

Canada's Compassionate Care Benefit (CCB), an employment insurance program designed to allow Canadian workers time off to care for a dying relative or friend, has had low uptake since its inception. Due to their role in working with family caregivers, social workers are one group of primary health care professionals who have been identified as benefiting from a knowledge translation campaign. Knowledge tools about the CCB have been developed through social worker input in a prior study. This article presents the findings of a qualitative exploratory intervention. Social workers (n = 8) utilized the tools for 6 months and discussed their experiences with them. Data analysis revealed references to time and space constraints in using to the tools, and demonstrated the impact of time geography on knowledge translation about the CCB. The results suggest that knowledge translation about the CCB could be targeted toward caregivers earlier on in the disease progression before the terminal diagnosis, and knowledge tools must be disseminated to more locations. These results may be valuable to policymakers and palliative care providers, as well as theorists interested in ongoing applications of time geography in knowledge translation and the consumption/production of care.

Grandfather caregivers: race and ethnic differences in poverty

We use data from the 2006 American Community Survey to examine race and ethnic differences in the effects of marital status and co-residence of the middle generation on the likelihood of poverty among grandfathers who have primary responsibility for co-resident grandchildren (N = 3,379). Logistic regression results indicate that race/ethnicity and household composition are significant predictors of poverty for grandfather caregivers: non-Hispanic white grandfathers, those who are married, and those with a co-resident middle generation are the least likely to be poor. The effects of race/ethnicity, marital status, and the presence of a middle generation are, however, contingent upon one another. Specifically, the negative effect of being married is lower among grandfathers who are Hispanic, African American, non-Hispanic, and non-Hispanics of other race/ethnic groups compared to whites. In addition, having a middle generation in the home has a larger negative effect on poverty for race/ethnic minority grandfathers than for non-Hispanic whites. Finally, the combined effects of marriage and a middle generation vary across race/ethnic group and are associated with lower chances of poverty among some groups compared with others. We use the theory of cumulative disadvantage to interpret these findings and suggest that race/ethnicity and household composition are synergistically related to economic resources for grandfather caregivers.

Hierarchization and segmentation of informal care markets in Slovenia

The article is the result of qualitative research of informal care markets in Slovenia in the field of childcare, elder care, and cleaning. The author assesses Slovenia's position in the “global care chain” and finds that “local care chains” prevail in the field of childcare and elder care, while a co-occurrence of female gender, “other” ethnicity, and poverty is typical in the field of household cleaning. The main emphasis of the article is on the analysis of hierarchization of the informal market of care work according to following two criteria: social reputation of individual type of care work and citizenship status of care workers.

Care of older people in migration contexts: local and transnational arrangements between Peru and Spain

Care arrangements for the elderly are becoming a main social process in contemporary societies due to socio-political and lifestyle changes over the last few decades. The family and the State play a basic role in the construction of care systems and in the establishment of strategies to access care resources. In the present context of migration, these resources interact at a transnational level, challenging family and State migratory regimes. These new realities need the recognition of basic international social rights, as the experiences of Peruvians living in a migration context in Spain show.