In a nation where the size of the elderly population is rising rapidly, Hawaii stands out as the state with the highest percentage of people 85 and older. Not only do they represent a big part of our population, their ranks are expected to grow by 65 percent over the next two decades.
And yet, like so many other states, we have much to do to make Hawaii truly senior friendly. Legislators took one important step in that direction earlier this year by unanimously passing , the CARE Act, a measure that Gov. David Ige wisely signed into law earlier this week.
Here鈥檚 why that鈥檚 a good thing not only for seniors, but for the rest of Hawaii, too.
The CARE Act simply requires hospitals to offer to explain and demonstrate tasks required of family caregivers before a discharged patient goes home from the hospital or is transferred to another facility. Hospitals are also required to develop a policy in support of that discharge planning 鈥斅爋ne that complies with recent changes to federal law that allow patients to designate caregivers prior to discharge.
To be clear, some hospitals are already doing this, recognizing the best practice of ensuring the continued recovery of their patients by properly educating and training at-home caregivers. Those who aren鈥檛 already on board will now be required to step up, when the bill takes effect in one year.
鈥淭he CARE Act recognizes the critical role of Hawaii鈥檚 unpaid family caregivers who keep family members and friends out of costly institutions, providing them with the tools to safely and efficiently care for loved ones at home,鈥 said Ige in a media release announcing his signature of the bill.
Many caregivers are just family members without medical training, and hospitals now will help them understand how to 聽manage medications, care for wounds and give simple injections, among other things.
Some argue that trained nurses or certified health care aides are better suited to address those needs. That鈥檚 unquestionably true. But in a country that doesn鈥檛 provide universal health care and where private nursing and home health care assistance are often costly, the CARE Act recognizes that the need doesn鈥檛 go away even when the funds to pay for it aren鈥檛 there.
Besides, some of the tasks that caregivers would perform under the CARE Act would be easily and more conveniently performed by family caregivers, without the need to schedule an at-home visit by a professional.
Two additional points: First, this law will be of significant benefit to poor patients of all ages 鈥斅燤edicaid and Medicare patients, as well as patients without any health care coverage or the means to pay. Study after study shows wealthier patients get better care in our system 鈥 providers are more likely to explain more treatment options to them. And, not surprisingly, they have . But for the poor, it may be a godsend.
Second, while the CARE Act will disproportionately help elderly patients, whose care is often more complicated to understand and manage than that of others, it applies to all patients. Whether you鈥檙e a 5-year-old recovering from pneumonia, a 40-year-old coming back from an appendectomy or an 80-year-old hip replacement patient, the law allows you to designate a caregiver and requires the hospital to offer that person education and demonstration of proper after care.
With Ige鈥檚 signature of HB 2252, Hawaii became the 31st聽state or territory (Washington, D.C., Puerto Rico and the U.S. Virgin Islands plus 28 states) to enact a CARE Act. Despite the solid example of other states and the simplicity of the Hawaii measure, as an AARP official noted in an e-mail earlier this week, it took three years to pass this bill.
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