Dr. William Cabin, an assistant professor in the School of Social Work, has been selected to present two papers at the Seventh International Conference on Sociology and Social Work in Prague, Czechoslovakia, September 7 and 8.
The papers discuss Cabin’s research into how limited access to psychosocial care through the Medicare Home Health Benefit affects persons with Alzheimer’s disease (PWAD) and their families and caregivers. In his work he examined Medicare policy and interviewed and surveyed more than 60 individuals to learn about their unmet needs and frustrations.
In “Spiritual Care for Death; Not Living: Medicare Hospice versus Home Care in the U. S.” Cabin offers a historical and policy analysis comparing the Medicare Home Health Benefit, designed for homebound persons 65 and older with acute physical conditions, against the Medicare Hospice Benefit, designed for persons 65 and older with a prognosis of six months or less to live due to a terminal illness. While the hospice benefit provides spiritual care and a wide array of psychosocial interventions, the home health benefit supports very limited psychosocial care and virtually no spiritual care.
"This is a sad situation when Medicare and Congress decide that evidence-based spiritual care and psycho-social interventions can be funded only for persons near death; not those living and coping with multiple disease conditions." Cabin says.
Cabin’s second presentation, “Medicare Denies Knowledge to Home Care Nurses, Social Workers, Patients and Caregivers,” discusses his interviews with patients and caregivers and describes the disconnect between educating and training nurses and social workers to use effective evidence-based interventions and the Medicare Home Health Benefit’s failure to cover such interventions.
"With all the emphasis on teaching evidence-based practice, it is both ironic and poor practice that Congress and Medicare actually block psychosocial evidence-based care for these populations, resulting in reduced quality of life for PWAD and their caregivers and increased costs for PWAD, their caregivers, and the Medicare and Medicaid programs,” he says.