To prevent burnout, caregivers need care, too

Caregivers are being empowered to take care of themselves for a change.

Caregivers are often doing so much for their loved ones, and balancing so many other responsibilities, that they might not prioritize their own health. Empowering caregivers to stay well—emotionally and physically—and prevent burnout is more important than ever because of the COVID-19 pandemic. As the population of older people needing care grows, the number of people with disabilities live longer and the pandemic continues, more of us will be depending on caregivers.

The question is: can a health insurance company offer the right kind of support without adding another item to a caregiver’s to-do list?

Anna Gosline, executive director of the Massachusetts Coalition for Serious Illness Care and senior director of strategic initiatives for Blue Cross Blue Shield of Massachusetts (BCBS Massachusetts), is the champion behind a new effort to help caregivers take care of themselves. Gosline says it's often easy to find resources to help caregivers be better at caregiving. But resources to support their own mental and physical health needs aren't so abundant. She hopes a new tool the insurer is testing, called TCare, will change that.

A clinical approach to prescribing solutions

TCare is an evidence-based program facilitated by trained BCBS Massachusetts professionals who gather in-depth data about a caregiver’s needs and prescribe the right resources based on clinical evidence. That in-depth data comes from a conversational assessment, which allows the interviewer to gain real insight into a caregiver's concerns and stresses. The program evaluates not only a caregiver’s responsibilities but also information about their health, social and emotional needs. And then the program recommends just two to three resources that, based on their unique situation, the evidence suggests will be most likely to improve their overall well-being. The recommendations can be anything from marriage and family counseling, to an exercise class or respite care for their loved one.

“No one wants a laundry list of resources to sort through,” says Gosline, referring to the experiences some caregivers have when reaching out for support. “You want a program that funnels down the information you need, right then and there. You want a co-pilot.” Caregivers are then followed and reassessed over time.

“The idea is to do more than prevent caregiver burnout, but improve their health,” says Gosline. “And that may ultimately improve the health of the person being cared for.”

BCBS Massachusetts associates will be among the first to try TCare, after a pilot with Medicare Advantage and with the caregivers of seriously ill commercial members.

Recognizing that caregivers need their own support system

Gosline says the realization that caregivers needed more support grew out of BCBS Massachusetts’ commitment to improving the care of people with serious illnesses. Case managers for those patients often found themselves talking to the caregiver on the phone, and not necessarily the patient. And they were the first to recognize that caregivers were under tremendous stress.

Gosline says more research showed the causes of that stress weren’t just the physical burdens, or the number of hours spent caregiving, or even money problems. “It’s also a lack of social and emotional support, of recognition about just how hard caregiving can be on all aspects of our lives” says Gosline. New research from the Blue Cross Blue Shield Association has found that caregivers are also at higher risk for chronic conditions, like hypertension and diabetes.

Recognizing caregiving in all its forms

Gosline says BCBS Massachusetts is paying close attention to the needs not only of its members but its own associates as well. "We’re hosting bi-weekly mental health chats for employees with our psychiatrist leaders," she says. One of the big themes being the additional stress parents are feeling caring for kids, working and managing remote schooling. Since the pandemic hit, the company has added significantly to its caregiver support benefits, including unlimited crisis childcare and elder care, with options to receive direct payments for family, friends or neighbors, as well as free and discounted subscriptions to a variety of childcare and eldercare platforms and services.

Caregivers of members with Alzheimer's disease or cancer can also find support. Gosline says the health plan works with the Alzheimer’s Association in Massachusetts to connect Medicare Advantage member caregivers with a specialist to provide advice, support and connection to services. They have also added Robin Care as a program that employers can elect, which is designed to help and support cancer patients and their caregivers through their treatment journey.  

Blue Cross Blue Shield of Massachusetts is an independent licensee of the Blue Cross Blue Shield Association, an association of independent, locally operated Blue Cross and Blue Shield companies.

RobinCare is an independent company offering a personalized cancer support program and is in no way affiliated or endorsed by the Blue Cross Blue Shield Association.

Massachusetts Coalition for Serious Illness Care in an independent organization comprised of more than one hundred Massachusetts-based organizations with the mission to ensure that health care for everyone in Massachusetts is in accordance with their goals, values and preferences at all stages of life and in all steps of their care. Massachusetts Coalition for Serious Illness Care is in no way affiliated or endorsed by the Blue Cross Blue Shield Association.