December 1, 2025 • 30 mins
It’s one of the stark realities of the world we live in today… 1 in 4 Americans serve as caregivers, with millions providing care for loved ones with disabilities or complex medical conditions. Manny Munoz discussed it with Megan O’Reilly, Vice President of Government Affairs for Health and Family at AARP. AND, nearly 40 million Americans have diabetes, and about half will develop diabetic retinopathy the leading cause of irreversible blindness in working-age adults. Manny got insight on the illness from Dr. Geoffrey Emmerson, President of the American Society of Retina Specialists.
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Speaker 1 (00:01):
Welcome to iHeartRadio Communities, a public affairs special focusing on
the biggest issues in facting you this week. Here's many
munios and welcome to another edition of Iheartradios Communities. As
you heard, I am Manny Muno's and I would love
a follow from you on Instagram at iod Manny as
(00:22):
my handle at iodma Ny. It's one of the stark
realities of the world we live in today. One in
four Americans serve as caregivers, with millions of adults providing
care for loved ones with disabilities or complex medical conditions.
That comes with its own set of problems. Let's talk
(00:43):
about all of it with Megan O'Reilly, Vice President of
Government Affairs for Health and Family at AARP. Megan, I
appreciate the time.
Speaker 2 (00:52):
Oh thank you.
Speaker 3 (00:53):
It's go to be with you.
Speaker 1 (00:54):
You folks have a new report that really paints a
much clearer picture of some of the struggles facing caregivers today.
Tell me about the report sure.
Speaker 3 (01:03):
Yeah ARP with the National Lends for Caregiving released or
report just recently that really tries to look into with
greater clarity what family caregivers are facing in their support
of their loved ones. You know there's sixty three million
family caregivers across this country, and we know that more
and more they are literally lifting up our long term
(01:27):
care system and helping their families. Many of them remain
in their homes and communities as they age. As you mentioned,
nearly one and four adults is a family caregiver. So
we know that we will either be a caregiver, have
been a caregiver, or will be a caregiver in the future.
And what with this report, in this new data, AARP
(01:48):
is looking at is really how can we best support
family caregivers and meet them where they're at knowing the
challenges that they're facing. As I mentioned, more and more
they're performing medical paths and helping to support the healthcare
needs of their loved ones. But they're also taking on
a huge financial component of their family caregiving, having to
(02:10):
dip into savings, reduce retirement, maybe reduce hours, or leave
the workforce altogether. So in addition to the healthcare components
of family caregiving, there's also an incredible economic toll that
it says that families are facing as well.
Speaker 1 (02:24):
Was that one of the most surprising things that you
found in part of this research that maybe kind of
unrecognized that we didn't realize how much money was going
into it.
Speaker 3 (02:34):
Yeah, the numbers are staggering. You know that families on average,
you know, they're paying about seventy two hundred dollars out
of pocket in family caregiving expenses. But it's also I
think the data specific to this report really looks at
what is that financial strain doing to families. The data
that sort of you know, how many family caregivers are
(02:54):
facing financial strains and the questions before them as they
navigate caring for their loved ones, which which we all
want to do. This is about supporting your families and
you know, for many keeping keeping loved ones at home.
But there's really a great need that family caregivers have
(03:15):
for greater support, for economic support to help alleviate some
of those challenges that they're facing.
Speaker 1 (03:20):
I know the report broke these numbers down state by state.
We don't need to go through all of that, but
were there differences between states when it comes to the
caregiver experience and what help they got?
Speaker 3 (03:34):
Yeah, there was variation when we looked at things, you know,
like how much time a family caregiver is spending on
average caring for a loved one, sort of that intensity
of the caregiver. As I mentioned that financial strain. For example,
fifty nine percent of family caregivers in Georgia are facing
(03:54):
that financial strain and that's compared to thirty four percent
in Minnesota. And so again, as we're looking at how
do we meet family caregivers where they're at and the
challenges they're facing, this state by state data really gives
us a clear look on what that what's happening on
the ground across the country.
Speaker 1 (04:09):
What states are doing better, what states are doing worse.
Speaker 3 (04:12):
It varies, you know, it varies based on sort of
different components of the data that we're looking at. I
think that you know, it really is. It varies state
by state. I think that is one thing that I
took from. But we do know that caregiver supports that
are in place do help make a difference when we're
looking at things like strain right, So does the state
(04:33):
have a paid lead program for example, So you know,
some of the supports that are in place across the
country do help alleviate some of these challenges that we're
seeing family caregivers too.
Speaker 1 (04:43):
What did what did the report tell you about? I
imagine many of these caregivers also have to work for
a living, the idea of balancing their jobs and caregiving
workplace policies. Did you see anything that might maybe was
helpful to the these people or or are you heard them?
Speaker 3 (05:03):
Well? So, I think we know seven to ten family
caregivers are working, and a report really looks at as
well is sort of what is the financial impact of
the fair family caregiving responsibilities? Past nationwide are saying that
they've had at least one negative financial impact, one third
have stopped saving, many more are taking on increasing debts,
(05:27):
and you know, I really think this demonstrates that we
are in crisis. We have sixty three million family caregivers
and this number has jumped significantly over the years. More
and more people are taking on this responsibility, and they're
doing so at a time where they're also facing, you know,
challenges to their own financial well beings, their ability to retirement,
(05:49):
and the health cont the health implications that come with
us as well. So you know, it's both. I think
what this data shows is the need to support family
caregivers because of the roles they're playing to help lift
up our long term care system, but also the need
to do so for their own health and well being
as well.
Speaker 1 (06:08):
A couple more minutes here with Megan O'Reilly, Vice President
of Government Government Affairs for Health and Family at a
a RP. We've talked a lot about the financial strain
that that these caregivers go through. Uh, they also go
through a lot of personal stress and I imagine marital stress.
Is that is that something the report looked.
Speaker 3 (06:29):
At, Not on the marital stress side, But I think
what the report does look at is the sort of
that emotional financial talked about and that physical stress, and
really the report looks at what are family caregivers doing,
you know, in day to day, what types of care
are they providing, who are they caring for, you know,
(06:53):
the caregiver's own health, as we've talked about, and then
policies and programs that can support caregivers and sort of
what as I mentioned, what they need, what would help
them alleviate some of these challenges they're facing.
Speaker 1 (07:07):
What did it tell us about policy in terms of
what policies are most helpful to caregivers, What policies need
or should be looked at and implemented to help caregivers.
Speaker 3 (07:21):
So, you know, I think Overall, caregivers report that they
would benefit from financial support in the form of tax credits.
About sixty nine percent of people said that partial paid leave.
About fifty five percent of respondents noted that would be supportive.
Get these learnings as we really again try to meet
(07:41):
the needs of family caregivers how to best support them.
That has led to AARP's advocacy where we're advocating for
a bipartisan family caregiver tax credits called the Credit for
Caring Act. So there's bipartisan legislation before Congress, and we've
seen state houses Nebraska and Oklahoma passed caregiver tax credits.
(08:02):
So if there are policies both before Congress and across
the states that would provide some of this financial relief
that we see through this data is so important.
Speaker 1 (08:10):
Does does Medicare, Medicaid or anything do any something to
help caregivers because report also look, I mean a lot
of times, quite often they're actually delivering the healthcare services
themselves to their loved ones that they're that they're looking after.
Speaker 3 (08:26):
There are programs in Medicaid where beneficiary can pay choose
that their family member is their caregiver through what's called
self direction programs, And so we do know that that
our data showed that direct payment programs about sixty eight
(08:46):
percent of people responded that those would be helpful. So
there are programs through through Medicaid. They can allow someone
to in vary states to state what the programs, what
the qualifications are, but that would allow uh, someone to
have their family caregiver be their paid caregiver.
Speaker 1 (09:05):
Did community resources play any role in this? Churches or
you know, neighborhood groups, volunteer groups, are those things being
leveraged by caregivers the way they should be?
Speaker 3 (09:19):
You know? I think the interesting thing about community engagement
and community involvement that is so important to this conversation
is that so many people don't even recognize that they're
a family caregiver. Right, I'm helping my grandmother, I'm helping
my sibling, I'm helping mom or dad. You don't, you
don't necessarily identify as a family caregiver. And it's through
(09:41):
the conversations across community that you realize, one you're not alone,
and that your neighbors and your friends are and many
you know, people across the community are facing the same uh,
you know, the same issues and trying to care for
your loved one, and it's through that sense of community.
I think it is really powerful in one making sure
(10:02):
that people don't feel alone. I think this data looked
at that component as well, but also leveraging resources and information.
AARP does have a number of resources on our website
where we try to help provide information actionable tools that
family caregivers can refer to and utilize to help their
(10:23):
caregiving journey navigate it. But it really is to your point,
that sense of community at the local level in your neighborhood,
across across all of these different connection points that really
one help family caregivers still connected, but also help empower
them with some of the challenges they're facing day to
day in their caregiving role.
Speaker 1 (10:44):
Yeah, it's funny that you mentioned that, because it strikes
me that a lot of people, probably to your point,
don't even consider themselves being caregivers. They're just taking care
of you know, mom and dad, or their aunt or uncle.
And the way the generations have developed, I think quite
often these very people are also raising their own kids
who are probably still under age, aren't they.
Speaker 3 (11:05):
Absolutely, the increasing number of people who are both caring
for an aging loved one as well as children is
just growing and that again brings on a unique set
of challenges as well. And so that is really where
that community conversation and meeting on one another I think
can really have an impact. And if we look at
policies to help support caregivers, understanding that role of dual
(11:29):
role that they're playing is so important. Another area that
we work on in our advocacy work at ARP is
how can we alleviate some of the navigation challenges We
know caricters are increasingly helping to make medical appointments right,
keeping track of results, or taking someone back in for
an appointment, or following up with a provider, and some
(11:52):
of these navigation issues are so time consuming and can
be so frustrating. I think that's another area where we
have an opportunity to really have impact.
Speaker 1 (12:00):
What about trends With the aging of the US population,
you would think that caregiving demands are only going to multiply.
What what are you most concerned about when it comes
to addressing these issues you know in the next five
ten years.
Speaker 3 (12:18):
So I think as far as the trends, we know
that there are more family caregivers, but we also know
they're taking on increasingly complex tasks. You know, when you
take a loved one home from the hospital, and the
care and the support that you provide, not just in
the daily living activities you know, bathing and grocery shopping
(12:39):
or helping to feed, but the medical tasks I think
are also increasing, and so that is an area where
we're really focused on making sure that they're more training
opportunities and more opportunities to make sure that the doctor
is talking with the family caregiver in real time versus
you take your loved one home and you're like, you
don't know what you're supposed.
Speaker 2 (13:00):
To do or where you go to.
Speaker 3 (13:01):
Ask for help. So the more that we can have
these front end conversations with doctors, with nurses, with other
providers to really help caregivers navigate, you know, the care
challenges that they may face, I think will alleviate a
lot of a lot of stress. But this is an
area I do think that there's a lot of opportunity.
I will say Medicare is now paying providers to train
(13:25):
family caregivers. This was something AIRP advocated for and with
into regulation a couple of years ago. So I do
think there's a recognition within medicare that there's a real
need here and it's another area that we're very focused on.
Speaker 1 (13:39):
Yeah, and I guess depending on the condition and different challenges.
If it's someone who has medical issues, physical issues, or dementia,
those all you know, bring completely different challenges to the caregivers.
Speaker 3 (13:52):
Absolutely that each caregiving experience is unique and so personal,
and that's why it's so important that we meet caregivers
and the loved ones they're caring for where they're at,
that we listen to what they need, and that we're
assessing what those needs are, and that we're connecting them
with tools and resources that can help them perform these rules.
Speaker 1 (14:13):
Your best advice for someone who is a caregiver out
there for them? How they can advocate for themselves or
access information or programs that would benefit them. Where could
they get that information?
Speaker 3 (14:25):
Yes, So I would say three things. First, I would say,
try to have conversations in your family before you're in
a care crisis. The more that families can sit down
and have these conversations ahead of time, I think can
help when you're in that moment of crisis. I would say, Second,
AARP has a wealth of resources on our website AARP
(14:48):
dot org backslash caregiving that has tools and resources that
really try to offer information for caregivers across a variety
of issues. And wait what you make, experience or faith
in your caregiving journey. And third, talk to talk and
tell your story. I think the more caregivers that are
sharing their stories and talking about it out loud, it
(15:11):
really has created such an environment where we're seeing these
issues front and center in a way in which we
never have. And so I would say, if you're a
caregiver and you're comfortable share your story, talk to your neighbor,
talk to your friends, talk to your family, because that really,
that sense of community is so important as you navigate
all of the different issues that you face as a
(15:33):
family caregiver.
Speaker 1 (15:34):
Aa RP dot org slash caregiving AARP dot org slash caregiving.
Megan O'Reilly, Vice President of Government Affairs for Health and
Family at AARP, thank you for the time, the wonderful information.
I appreciate it.
Speaker 3 (15:49):
Be well, thank you you too. Take care.
Speaker 1 (15:53):
Just a reminder, if you have any questions or comments,
you can follow me on Instagram at iod is my
handle at iodma n Y Nearly forty million Americans have diabetes.
About half of them will develop diabetic retinopathy, the leading
cause of irreversible blindness in working age adults. Let me
(16:16):
repeat those two words, which should get your attention, irreversible blindness.
Let's discuss it now with doctor Gregory Emerson. He is
the president of the American Society of Retina Specialists. Doctor Emerson,
I appreciate the time, thanks for joining us.
Speaker 4 (16:31):
Thank you, it's great to be here.
Speaker 1 (16:34):
Anything that has to do with my eyes is a
concern for me. Those numbers are staggering. Forty million Americans
have diabetes, about half will develop this diabetic retinopathy. Explain
what that is.
Speaker 2 (16:49):
Diabetes damages the retina. The retina is a very important
part of the eye. It's a thin layer at the
back of the eye. It's where the photocept so it's
the part of the eye that senses light. And when
that layer gets injured or damaged by diabetes, it causes
blindness or at the very minimum, blurred vision. Like you said,
(17:14):
there's about ten million Americans who already have diabetic retinopathy,
and diabetes is growing in our country, so we want
to detect this problem and prevent the vision loss.
Speaker 1 (17:28):
Obviously, early detection. Anything having to do with our health
is important. Does early detection help prevent blindness.
Speaker 4 (17:37):
For sure, And.
Speaker 2 (17:40):
It's not as easy as you might think because in
the beginning there are no symptoms. It's actually not until
later in the condition that a patient might even notice
a problem. So really, if we want to detect it
before there's a problem, we need to be doing dialetated
eye exams and looking for it.
Speaker 1 (18:03):
This is something that would happen in a yearly check up.
Someone go see their eye doctor every year, I imagine that's right.
Speaker 2 (18:10):
So if a patient has diabetes and they can't remember
the last dilated di exam, they should.
Speaker 4 (18:16):
Go get one.
Speaker 2 (18:18):
And if somebody is starting to notice symptoms like blurred
vision or difficulty reading, or floaters in the vision or
shadows in the vision, then I think it's important to
see a retina specialist because a retina specialist has the
equipment in their clinic to evaluate diabetic retinopathy. And also
(18:42):
we know what the treatments are and we can get
started on preserving that vision.
Speaker 1 (18:46):
Sounds like some of those symptoms that you just mentioned
are very similar to the symptoms that someone might experience
just with normal natural aging.
Speaker 4 (18:57):
That's true.
Speaker 2 (18:58):
There are there are eye conditions that come with age,
like a vitreous detachment that may happen in a normal
fifty year old or sixty year old with floaters, And
there's also blurred vision for reading that comes with just
plain old age. So as a patient you might you
might not know if it's from diabetes or a natural
(19:21):
aging change.
Speaker 1 (19:23):
So what are the symptoms specific to diabetic retinopathy that
we should be on the lookout for even if we're
not diabetic, Because I imagine there are people out there
if they don't, you know, get their checkup every year
with the doctor, might have diabetes and not even realize it.
Speaker 4 (19:39):
Yeah, good point.
Speaker 2 (19:40):
I think difficulty reading, I think is one of those
symptoms that should trigger a bell in your head. You
know that that might be one that tells you to
go in for a checkup. Also, brand new floaters. Floaters
look like bugs or insects flying in the vision, and
if they appear suddenly, that means you should go in
(20:04):
for a checkup.
Speaker 1 (20:05):
Well, why does this condition creep up on people so seemingly?
I guess in a lot of cases quietly, without really
early symptoms. It kind of just comes into play.
Speaker 2 (20:17):
Yeah, I think the eye functions really well part way
or halfway into the disease. Diabetes injures blood vessels actually
throughout the body, but in the retina that's a little
bit more important. When the blood vessels start to leak,
the retina becomes soggy, and then the photoreceptors don't work
(20:41):
as well. In the retina, it's actually nerve tissue that
can't regenerate. So if those cells get injured by the
extra fluid or bleeding or blood vessels not working, then
those cells disappear and they don't grow back.
Speaker 1 (21:00):
Somebody who might be pre diabetic, would they also be
at risk of developing this?
Speaker 4 (21:06):
Yeah, they're at risk.
Speaker 2 (21:07):
Now. Usually somebody who's pre diabetic doesn't really have diabetic
retinopathy yet, but that's a good time to get started
on diabetes control.
Speaker 1 (21:19):
Are people who are not diabetic or pre diabetic ever
at risk of this diabetic retinopathy? Yeah?
Speaker 2 (21:29):
Yeah, it, like many things, the longer it's out of control.
Speaker 4 (21:35):
The worse it gets.
Speaker 2 (21:37):
And so for somebody who maybe diabetes runs in the
family but they don't have diabetes yet, that's actually good
for those that type of person to be plugged in
with their primary care doc and getting getting checked periodically.
Speaker 1 (21:54):
The most frightening part of this at what point does
this diabetic retinopathy become dangerous and irreversible where it would
cause a blindness.
Speaker 2 (22:05):
Well, usually we can do something and say we're really
good at stopping the vision loss with treatments. Sometimes we
can reverse vision loss, and later in the disease it
gets more difficult to recover lost vision. Some patients end
(22:28):
up needing surgery or some very invasive procedures that we'd
like to avoid, just because there are complications when you
get into the surgery and more invasive procedures.
Speaker 1 (22:42):
A few more minutes here with doctor Jeffrey Everett. Emerson
is President of the American Society of Retina Specialists. If
you want to more information, you could go to see
for a Lifetime dot com. That's the word c s
EE for a Life Time time dot com or find
your Retina Specialist dot org, Find your retina Specialist dot
(23:07):
o RG. Are there myths or misunderstandings that you run
into in your practice about diabetic eye disease?
Speaker 2 (23:17):
Yeah, I think the main one is not worrying about
it when when you don't have symptoms. I think if
if you're waiting for there to be symptoms, then you're
you're risking some some problems down the road.
Speaker 1 (23:35):
People who might be a little bit squishy about having
their eyes messed with and decide to go in because
they feel they may be at risk. What exactly does
this this dilation, this this eye pressure test look like?
What do what has done to them? How does it feel?
Speaker 4 (23:54):
Yeah? I agree.
Speaker 2 (23:55):
Some people don't even like getting eye drops in the eye,
and I get that, but we make it comfort comfortable
for patients. I think the important thing is to realize that, uh,
it's it's probably just a check up. It's probably some
bright lights and then maybe just being uh needing to
(24:21):
wear some sunglasses for the rest of the day. That's
what most eye exams are. You know, if you need treatment,
we sometimes do more invasive types of pictures that are
even brighter, but generally speaking, it's a quick half hour
visit and you can go home and not worry about
(24:43):
it again for a year.
Speaker 1 (24:45):
Can someone feel high pressure in their eyes?
Speaker 2 (24:51):
Yes, if it gets severe, then high pressure feels like
a headache, But we really don't want it to get
that high.
Speaker 1 (24:59):
What rolls does blood sugar play in developing this disease
and in preventing vision loss.
Speaker 4 (25:08):
This is really key.
Speaker 2 (25:09):
People who can keep their blood pressure under control really
have much lower risk.
Speaker 4 (25:15):
Of diabetic retinopathy.
Speaker 2 (25:18):
One of the main indicators of glucose control is the
hemoglobin A one c number, and if you can keep
your A one c at seven point five and lower,
those patients do really well long term. Now we're noticing
that with the new treatments for glucose control, including the
(25:41):
GLP one treatments, a lot of patients have just much
better glucose control long term. And that is so good
for diabetic retinopathy.
Speaker 1 (25:53):
But you can't reverse it if you develop it, can you?
Speaker 2 (25:59):
We can't to some degree. It gets harder and harder
the further down the path pathway you get. So somebody
with mild diabetic retinopathy or moderate diabetic great anopathy, we're
pretty good at keeping those patients seen very very well.
But when it gets to the advanced stages of diabetic retinopathy,
(26:20):
now it's more difficult.
Speaker 1 (26:21):
How quickly can the disease progress if somebody ignores it
or doesn't realize they have it.
Speaker 2 (26:29):
I'd say most people don't get diabetic retinopathy in the
first five years that they have diabetes. But beyond five years,
it can, it can, It can appear quite.
Speaker 1 (26:42):
Rapidly certain communities or age groups, sexes where you find
higher rates of this high disease.
Speaker 2 (26:51):
Yeah, good, very good point. It does tend to be
worse in the lower socioeconomic sphere. There are type one
diabetics who get their diabetes at a very young age,
and we worry especially about kids and teenagers with type
one diabetes. But then later in life, type two diabetes
(27:16):
tends to occur more often, and that can run in families,
but it can also be a consequence of poor diet
and being overweight.
Speaker 1 (27:27):
Primary doctors. For those of us who might go get
our yearly check up with our PCP but not necessarily
have vision problems to go to an eye doctor. What
role should a primary care physician be doing it to
help catch this earlier?
Speaker 4 (27:44):
Oh, thank you.
Speaker 2 (27:46):
We're a team basically, so we are always Retina docs
are always communicating with primary care docs and back and forth,
and so we're reminding the PA to go see their
primary doc, and they are reminding the patient to come
see us.
Speaker 4 (28:06):
It's teamwork.
Speaker 1 (28:07):
Let's say somebody has been diagnosed with diabetic retinopathy, what
would the first steps generally be. What kind of treatments
are there to.
Speaker 2 (28:15):
Help Number one, getting the glucose control the best it
can be. Number Two, depending on the stage of the
diabetic retinopathy, we might start injections of medicine into the eye.
These medicines help the blood vessels work better and they
can really stop the disease or sometimes even improve the vision.
Speaker 1 (28:41):
What is the most important message you want to get
out to people who may be diabetic who may not
know their diabetic about November being Diabetic Eye Disease Awareness Month.
Speaker 2 (28:53):
If if you have diabetes and you can't remember your
last eye exam, I really want you to go get one.
That's the best way to find to find a problem
before it becomes a problem. And if you want more information,
our website CE for a Lifetime has a lot of
(29:14):
great information.
Speaker 1 (29:15):
C for a Lifetime dot com. That's c s EE
for a Lifetime dot com. Doctor Jeffrey Emerson, President of
the American Society of Retina Specialist, Doctor Emerson, I really
appreciate the information the time be well, thanks.
Speaker 4 (29:31):
So much, Thank you very much.
Speaker 1 (29:34):
As always, i'd love a follow on Instagram and I
follow back at io d Manny is my handle at
iod m A n n Y. And that'll do it
for another edition of Iheartradios Communities. I'm Manny Muno's until
next time.
Welcome to iHeartRadio Communities, a public affairs special focusing on
the biggest issues in facting you this week. Here's many
munios and welcome to another edition of Iheartradios Communities. As
you heard, I am Manny Muno's and I would love
a follow from you on Instagram at iod Manny as
(00:22):
my handle at iodma Ny. It's one of the stark
realities of the world we live in today. One in
four Americans serve as caregivers, with millions of adults providing
care for loved ones with disabilities or complex medical conditions.
That comes with its own set of problems. Let's talk
(00:43):
about all of it with Megan O'Reilly, Vice President of
Government Affairs for Health and Family at AARP. Megan, I
appreciate the time.
Speaker 2 (00:52):
Oh thank you.
Speaker 3 (00:53):
It's go to be with you.
Speaker 1 (00:54):
You folks have a new report that really paints a
much clearer picture of some of the struggles facing caregivers today.
Tell me about the report sure.
Speaker 3 (01:03):
Yeah ARP with the National Lends for Caregiving released or
report just recently that really tries to look into with
greater clarity what family caregivers are facing in their support
of their loved ones. You know there's sixty three million
family caregivers across this country, and we know that more
and more they are literally lifting up our long term
(01:27):
care system and helping their families. Many of them remain
in their homes and communities as they age. As you mentioned,
nearly one and four adults is a family caregiver. So
we know that we will either be a caregiver, have
been a caregiver, or will be a caregiver in the future.
And what with this report, in this new data, AARP
(01:48):
is looking at is really how can we best support
family caregivers and meet them where they're at knowing the
challenges that they're facing. As I mentioned, more and more
they're performing medical paths and helping to support the healthcare
needs of their loved ones. But they're also taking on
a huge financial component of their family caregiving, having to
(02:10):
dip into savings, reduce retirement, maybe reduce hours, or leave
the workforce altogether. So in addition to the healthcare components
of family caregiving, there's also an incredible economic toll that
it says that families are facing as well.
Speaker 1 (02:24):
Was that one of the most surprising things that you
found in part of this research that maybe kind of
unrecognized that we didn't realize how much money was going
into it.
Speaker 3 (02:34):
Yeah, the numbers are staggering. You know that families on average,
you know, they're paying about seventy two hundred dollars out
of pocket in family caregiving expenses. But it's also I
think the data specific to this report really looks at
what is that financial strain doing to families. The data
that sort of you know, how many family caregivers are
(02:54):
facing financial strains and the questions before them as they
navigate caring for their loved ones, which which we all
want to do. This is about supporting your families and
you know, for many keeping keeping loved ones at home.
But there's really a great need that family caregivers have
(03:15):
for greater support, for economic support to help alleviate some
of those challenges that they're facing.
Speaker 1 (03:20):
I know the report broke these numbers down state by state.
We don't need to go through all of that, but
were there differences between states when it comes to the
caregiver experience and what help they got?
Speaker 3 (03:34):
Yeah, there was variation when we looked at things, you know,
like how much time a family caregiver is spending on
average caring for a loved one, sort of that intensity
of the caregiver. As I mentioned that financial strain. For example,
fifty nine percent of family caregivers in Georgia are facing
(03:54):
that financial strain and that's compared to thirty four percent
in Minnesota. And so again, as we're looking at how
do we meet family caregivers where they're at and the
challenges they're facing, this state by state data really gives
us a clear look on what that what's happening on
the ground across the country.
Speaker 1 (04:09):
What states are doing better, what states are doing worse.
Speaker 3 (04:12):
It varies, you know, it varies based on sort of
different components of the data that we're looking at. I
think that you know, it really is. It varies state
by state. I think that is one thing that I
took from. But we do know that caregiver supports that
are in place do help make a difference when we're
looking at things like strain right, So does the state
(04:33):
have a paid lead program for example, So you know,
some of the supports that are in place across the
country do help alleviate some of these challenges that we're
seeing family caregivers too.
Speaker 1 (04:43):
What did what did the report tell you about? I
imagine many of these caregivers also have to work for
a living, the idea of balancing their jobs and caregiving
workplace policies. Did you see anything that might maybe was
helpful to the these people or or are you heard them?
Speaker 3 (05:03):
Well? So, I think we know seven to ten family
caregivers are working, and a report really looks at as
well is sort of what is the financial impact of
the fair family caregiving responsibilities? Past nationwide are saying that
they've had at least one negative financial impact, one third
have stopped saving, many more are taking on increasing debts,
(05:27):
and you know, I really think this demonstrates that we
are in crisis. We have sixty three million family caregivers
and this number has jumped significantly over the years. More
and more people are taking on this responsibility, and they're
doing so at a time where they're also facing, you know,
challenges to their own financial well beings, their ability to retirement,
(05:49):
and the health cont the health implications that come with
us as well. So you know, it's both. I think
what this data shows is the need to support family
caregivers because of the roles they're playing to help lift
up our long term care system, but also the need
to do so for their own health and well being
as well.
Speaker 1 (06:08):
A couple more minutes here with Megan O'Reilly, Vice President
of Government Government Affairs for Health and Family at a
a RP. We've talked a lot about the financial strain
that that these caregivers go through. Uh, they also go
through a lot of personal stress and I imagine marital stress.
Is that is that something the report looked.
Speaker 3 (06:29):
At, Not on the marital stress side, But I think
what the report does look at is the sort of
that emotional financial talked about and that physical stress, and
really the report looks at what are family caregivers doing,
you know, in day to day, what types of care
are they providing, who are they caring for, you know,
(06:53):
the caregiver's own health, as we've talked about, and then
policies and programs that can support caregivers and sort of
what as I mentioned, what they need, what would help
them alleviate some of these challenges they're facing.
Speaker 1 (07:07):
What did it tell us about policy in terms of
what policies are most helpful to caregivers, What policies need
or should be looked at and implemented to help caregivers.
Speaker 3 (07:21):
So, you know, I think Overall, caregivers report that they
would benefit from financial support in the form of tax credits.
About sixty nine percent of people said that partial paid leave.
About fifty five percent of respondents noted that would be supportive.
Get these learnings as we really again try to meet
(07:41):
the needs of family caregivers how to best support them.
That has led to AARP's advocacy where we're advocating for
a bipartisan family caregiver tax credits called the Credit for
Caring Act. So there's bipartisan legislation before Congress, and we've
seen state houses Nebraska and Oklahoma passed caregiver tax credits.
(08:02):
So if there are policies both before Congress and across
the states that would provide some of this financial relief
that we see through this data is so important.
Speaker 1 (08:10):
Does does Medicare, Medicaid or anything do any something to
help caregivers because report also look, I mean a lot
of times, quite often they're actually delivering the healthcare services
themselves to their loved ones that they're that they're looking after.
Speaker 3 (08:26):
There are programs in Medicaid where beneficiary can pay choose
that their family member is their caregiver through what's called
self direction programs, And so we do know that that
our data showed that direct payment programs about sixty eight
(08:46):
percent of people responded that those would be helpful. So
there are programs through through Medicaid. They can allow someone
to in vary states to state what the programs, what
the qualifications are, but that would allow uh, someone to
have their family caregiver be their paid caregiver.
Speaker 1 (09:05):
Did community resources play any role in this? Churches or
you know, neighborhood groups, volunteer groups, are those things being
leveraged by caregivers the way they should be?
Speaker 3 (09:19):
You know? I think the interesting thing about community engagement
and community involvement that is so important to this conversation
is that so many people don't even recognize that they're
a family caregiver. Right, I'm helping my grandmother, I'm helping
my sibling, I'm helping mom or dad. You don't, you
don't necessarily identify as a family caregiver. And it's through
(09:41):
the conversations across community that you realize, one you're not alone,
and that your neighbors and your friends are and many
you know, people across the community are facing the same uh,
you know, the same issues and trying to care for
your loved one, and it's through that sense of community.
I think it is really powerful in one making sure
(10:02):
that people don't feel alone. I think this data looked
at that component as well, but also leveraging resources and information.
AARP does have a number of resources on our website
where we try to help provide information actionable tools that
family caregivers can refer to and utilize to help their
(10:23):
caregiving journey navigate it. But it really is to your point,
that sense of community at the local level in your neighborhood,
across across all of these different connection points that really
one help family caregivers still connected, but also help empower
them with some of the challenges they're facing day to
day in their caregiving role.
Speaker 1 (10:44):
Yeah, it's funny that you mentioned that, because it strikes
me that a lot of people, probably to your point,
don't even consider themselves being caregivers. They're just taking care
of you know, mom and dad, or their aunt or uncle.
And the way the generations have developed, I think quite
often these very people are also raising their own kids
who are probably still under age, aren't they.
Speaker 3 (11:05):
Absolutely, the increasing number of people who are both caring
for an aging loved one as well as children is
just growing and that again brings on a unique set
of challenges as well. And so that is really where
that community conversation and meeting on one another I think
can really have an impact. And if we look at
policies to help support caregivers, understanding that role of dual
(11:29):
role that they're playing is so important. Another area that
we work on in our advocacy work at ARP is
how can we alleviate some of the navigation challenges We
know caricters are increasingly helping to make medical appointments right,
keeping track of results, or taking someone back in for
an appointment, or following up with a provider, and some
(11:52):
of these navigation issues are so time consuming and can
be so frustrating. I think that's another area where we
have an opportunity to really have impact.
Speaker 1 (12:00):
What about trends With the aging of the US population,
you would think that caregiving demands are only going to multiply.
What what are you most concerned about when it comes
to addressing these issues you know in the next five
ten years.
Speaker 3 (12:18):
So I think as far as the trends, we know
that there are more family caregivers, but we also know
they're taking on increasingly complex tasks. You know, when you
take a loved one home from the hospital, and the
care and the support that you provide, not just in
the daily living activities you know, bathing and grocery shopping
(12:39):
or helping to feed, but the medical tasks I think
are also increasing, and so that is an area where
we're really focused on making sure that they're more training
opportunities and more opportunities to make sure that the doctor
is talking with the family caregiver in real time versus
you take your loved one home and you're like, you
don't know what you're supposed.
Speaker 2 (13:00):
To do or where you go to.
Speaker 3 (13:01):
Ask for help. So the more that we can have
these front end conversations with doctors, with nurses, with other
providers to really help caregivers navigate, you know, the care
challenges that they may face, I think will alleviate a
lot of a lot of stress. But this is an
area I do think that there's a lot of opportunity.
I will say Medicare is now paying providers to train
(13:25):
family caregivers. This was something AIRP advocated for and with
into regulation a couple of years ago. So I do
think there's a recognition within medicare that there's a real
need here and it's another area that we're very focused on.
Speaker 1 (13:39):
Yeah, and I guess depending on the condition and different challenges.
If it's someone who has medical issues, physical issues, or dementia,
those all you know, bring completely different challenges to the caregivers.
Speaker 3 (13:52):
Absolutely that each caregiving experience is unique and so personal,
and that's why it's so important that we meet caregivers
and the loved ones they're caring for where they're at,
that we listen to what they need, and that we're
assessing what those needs are, and that we're connecting them
with tools and resources that can help them perform these rules.
Speaker 1 (14:13):
Your best advice for someone who is a caregiver out
there for them? How they can advocate for themselves or
access information or programs that would benefit them. Where could
they get that information?
Speaker 3 (14:25):
Yes, So I would say three things. First, I would say,
try to have conversations in your family before you're in
a care crisis. The more that families can sit down
and have these conversations ahead of time, I think can
help when you're in that moment of crisis. I would say, Second,
AARP has a wealth of resources on our website AARP
(14:48):
dot org backslash caregiving that has tools and resources that
really try to offer information for caregivers across a variety
of issues. And wait what you make, experience or faith
in your caregiving journey. And third, talk to talk and
tell your story. I think the more caregivers that are
sharing their stories and talking about it out loud, it
(15:11):
really has created such an environment where we're seeing these
issues front and center in a way in which we
never have. And so I would say, if you're a
caregiver and you're comfortable share your story, talk to your neighbor,
talk to your friends, talk to your family, because that really,
that sense of community is so important as you navigate
all of the different issues that you face as a
(15:33):
family caregiver.
Speaker 1 (15:34):
Aa RP dot org slash caregiving AARP dot org slash caregiving.
Megan O'Reilly, Vice President of Government Affairs for Health and
Family at AARP, thank you for the time, the wonderful information.
I appreciate it.
Speaker 3 (15:49):
Be well, thank you you too. Take care.
Speaker 1 (15:53):
Just a reminder, if you have any questions or comments,
you can follow me on Instagram at iod is my
handle at iodma n Y Nearly forty million Americans have diabetes.
About half of them will develop diabetic retinopathy, the leading
cause of irreversible blindness in working age adults. Let me
(16:16):
repeat those two words, which should get your attention, irreversible blindness.
Let's discuss it now with doctor Gregory Emerson. He is
the president of the American Society of Retina Specialists. Doctor Emerson,
I appreciate the time, thanks for joining us.
Speaker 4 (16:31):
Thank you, it's great to be here.
Speaker 1 (16:34):
Anything that has to do with my eyes is a
concern for me. Those numbers are staggering. Forty million Americans
have diabetes, about half will develop this diabetic retinopathy. Explain
what that is.
Speaker 2 (16:49):
Diabetes damages the retina. The retina is a very important
part of the eye. It's a thin layer at the
back of the eye. It's where the photocept so it's
the part of the eye that senses light. And when
that layer gets injured or damaged by diabetes, it causes
blindness or at the very minimum, blurred vision. Like you said,
(17:14):
there's about ten million Americans who already have diabetic retinopathy,
and diabetes is growing in our country, so we want
to detect this problem and prevent the vision loss.
Speaker 1 (17:28):
Obviously, early detection. Anything having to do with our health
is important. Does early detection help prevent blindness.
Speaker 4 (17:37):
For sure, And.
Speaker 2 (17:40):
It's not as easy as you might think because in
the beginning there are no symptoms. It's actually not until
later in the condition that a patient might even notice
a problem. So really, if we want to detect it
before there's a problem, we need to be doing dialetated
eye exams and looking for it.
Speaker 1 (18:03):
This is something that would happen in a yearly check up.
Someone go see their eye doctor every year, I imagine that's right.
Speaker 2 (18:10):
So if a patient has diabetes and they can't remember
the last dilated di exam, they should.
Speaker 4 (18:16):
Go get one.
Speaker 2 (18:18):
And if somebody is starting to notice symptoms like blurred
vision or difficulty reading, or floaters in the vision or
shadows in the vision, then I think it's important to
see a retina specialist because a retina specialist has the
equipment in their clinic to evaluate diabetic retinopathy. And also
(18:42):
we know what the treatments are and we can get
started on preserving that vision.
Speaker 1 (18:46):
Sounds like some of those symptoms that you just mentioned
are very similar to the symptoms that someone might experience
just with normal natural aging.
Speaker 4 (18:57):
That's true.
Speaker 2 (18:58):
There are there are eye conditions that come with age,
like a vitreous detachment that may happen in a normal
fifty year old or sixty year old with floaters, And
there's also blurred vision for reading that comes with just
plain old age. So as a patient you might you
might not know if it's from diabetes or a natural
(19:21):
aging change.
Speaker 1 (19:23):
So what are the symptoms specific to diabetic retinopathy that
we should be on the lookout for even if we're
not diabetic, Because I imagine there are people out there
if they don't, you know, get their checkup every year
with the doctor, might have diabetes and not even realize it.
Speaker 4 (19:39):
Yeah, good point.
Speaker 2 (19:40):
I think difficulty reading, I think is one of those
symptoms that should trigger a bell in your head. You
know that that might be one that tells you to
go in for a checkup. Also, brand new floaters. Floaters
look like bugs or insects flying in the vision, and
if they appear suddenly, that means you should go in
(20:04):
for a checkup.
Speaker 1 (20:05):
Well, why does this condition creep up on people so seemingly?
I guess in a lot of cases quietly, without really
early symptoms. It kind of just comes into play.
Speaker 2 (20:17):
Yeah, I think the eye functions really well part way
or halfway into the disease. Diabetes injures blood vessels actually
throughout the body, but in the retina that's a little
bit more important. When the blood vessels start to leak,
the retina becomes soggy, and then the photoreceptors don't work
(20:41):
as well. In the retina, it's actually nerve tissue that
can't regenerate. So if those cells get injured by the
extra fluid or bleeding or blood vessels not working, then
those cells disappear and they don't grow back.
Speaker 1 (21:00):
Somebody who might be pre diabetic, would they also be
at risk of developing this?
Speaker 4 (21:06):
Yeah, they're at risk.
Speaker 2 (21:07):
Now. Usually somebody who's pre diabetic doesn't really have diabetic
retinopathy yet, but that's a good time to get started
on diabetes control.
Speaker 1 (21:19):
Are people who are not diabetic or pre diabetic ever
at risk of this diabetic retinopathy? Yeah?
Speaker 2 (21:29):
Yeah, it, like many things, the longer it's out of control.
Speaker 4 (21:35):
The worse it gets.
Speaker 2 (21:37):
And so for somebody who maybe diabetes runs in the
family but they don't have diabetes yet, that's actually good
for those that type of person to be plugged in
with their primary care doc and getting getting checked periodically.
Speaker 1 (21:54):
The most frightening part of this at what point does
this diabetic retinopathy become dangerous and irreversible where it would
cause a blindness.
Speaker 2 (22:05):
Well, usually we can do something and say we're really
good at stopping the vision loss with treatments. Sometimes we
can reverse vision loss, and later in the disease it
gets more difficult to recover lost vision. Some patients end
(22:28):
up needing surgery or some very invasive procedures that we'd
like to avoid, just because there are complications when you
get into the surgery and more invasive procedures.
Speaker 1 (22:42):
A few more minutes here with doctor Jeffrey Everett. Emerson
is President of the American Society of Retina Specialists. If
you want to more information, you could go to see
for a Lifetime dot com. That's the word c s
EE for a Life Time time dot com or find
your Retina Specialist dot org, Find your retina Specialist dot
(23:07):
o RG. Are there myths or misunderstandings that you run
into in your practice about diabetic eye disease?
Speaker 2 (23:17):
Yeah, I think the main one is not worrying about
it when when you don't have symptoms. I think if
if you're waiting for there to be symptoms, then you're
you're risking some some problems down the road.
Speaker 1 (23:35):
People who might be a little bit squishy about having
their eyes messed with and decide to go in because
they feel they may be at risk. What exactly does
this this dilation, this this eye pressure test look like?
What do what has done to them? How does it feel?
Speaker 4 (23:54):
Yeah? I agree.
Speaker 2 (23:55):
Some people don't even like getting eye drops in the eye,
and I get that, but we make it comfort comfortable
for patients. I think the important thing is to realize that, uh,
it's it's probably just a check up. It's probably some
bright lights and then maybe just being uh needing to
(24:21):
wear some sunglasses for the rest of the day. That's
what most eye exams are. You know, if you need treatment,
we sometimes do more invasive types of pictures that are
even brighter, but generally speaking, it's a quick half hour
visit and you can go home and not worry about
(24:43):
it again for a year.
Speaker 1 (24:45):
Can someone feel high pressure in their eyes?
Speaker 2 (24:51):
Yes, if it gets severe, then high pressure feels like
a headache, But we really don't want it to get
that high.
Speaker 1 (24:59):
What rolls does blood sugar play in developing this disease
and in preventing vision loss.
Speaker 4 (25:08):
This is really key.
Speaker 2 (25:09):
People who can keep their blood pressure under control really
have much lower risk.
Speaker 4 (25:15):
Of diabetic retinopathy.
Speaker 2 (25:18):
One of the main indicators of glucose control is the
hemoglobin A one c number, and if you can keep
your A one c at seven point five and lower,
those patients do really well long term. Now we're noticing
that with the new treatments for glucose control, including the
(25:41):
GLP one treatments, a lot of patients have just much
better glucose control long term. And that is so good
for diabetic retinopathy.
Speaker 1 (25:53):
But you can't reverse it if you develop it, can you?
Speaker 2 (25:59):
We can't to some degree. It gets harder and harder
the further down the path pathway you get. So somebody
with mild diabetic retinopathy or moderate diabetic great anopathy, we're
pretty good at keeping those patients seen very very well.
But when it gets to the advanced stages of diabetic retinopathy,
(26:20):
now it's more difficult.
Speaker 1 (26:21):
How quickly can the disease progress if somebody ignores it
or doesn't realize they have it.
Speaker 2 (26:29):
I'd say most people don't get diabetic retinopathy in the
first five years that they have diabetes. But beyond five years,
it can, it can, It can appear quite.
Speaker 1 (26:42):
Rapidly certain communities or age groups, sexes where you find
higher rates of this high disease.
Speaker 2 (26:51):
Yeah, good, very good point. It does tend to be
worse in the lower socioeconomic sphere. There are type one
diabetics who get their diabetes at a very young age,
and we worry especially about kids and teenagers with type
one diabetes. But then later in life, type two diabetes
(27:16):
tends to occur more often, and that can run in families,
but it can also be a consequence of poor diet
and being overweight.
Speaker 1 (27:27):
Primary doctors. For those of us who might go get
our yearly check up with our PCP but not necessarily
have vision problems to go to an eye doctor. What
role should a primary care physician be doing it to
help catch this earlier?
Speaker 4 (27:44):
Oh, thank you.
Speaker 2 (27:46):
We're a team basically, so we are always Retina docs
are always communicating with primary care docs and back and forth,
and so we're reminding the PA to go see their
primary doc, and they are reminding the patient to come
see us.
Speaker 4 (28:06):
It's teamwork.
Speaker 1 (28:07):
Let's say somebody has been diagnosed with diabetic retinopathy, what
would the first steps generally be. What kind of treatments
are there to.
Speaker 2 (28:15):
Help Number one, getting the glucose control the best it
can be. Number Two, depending on the stage of the
diabetic retinopathy, we might start injections of medicine into the eye.
These medicines help the blood vessels work better and they
can really stop the disease or sometimes even improve the vision.
Speaker 1 (28:41):
What is the most important message you want to get
out to people who may be diabetic who may not
know their diabetic about November being Diabetic Eye Disease Awareness Month.
Speaker 2 (28:53):
If if you have diabetes and you can't remember your
last eye exam, I really want you to go get one.
That's the best way to find to find a problem
before it becomes a problem. And if you want more information,
our website CE for a Lifetime has a lot of
(29:14):
great information.
Speaker 1 (29:15):
C for a Lifetime dot com. That's c s EE
for a Lifetime dot com. Doctor Jeffrey Emerson, President of
the American Society of Retina Specialist, Doctor Emerson, I really
appreciate the information the time be well, thanks.
Speaker 4 (29:31):
So much, Thank you very much.
Speaker 1 (29:34):
As always, i'd love a follow on Instagram and I
follow back at io d Manny is my handle at
iod m A n n Y. And that'll do it
for another edition of Iheartradios Communities. I'm Manny Muno's until
next time.
Host
Manny Munoz
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