6th Grade Georgia Teacher Donates His Kidney to Save Student's Life: 'There Is No Greater Gift'

A Georgia teacher helped save his student’s life by donating his kidney — after he was inspired by his own son’s experience with kidney failure.

Kaden Koebcke was 2 years old when he was diagnosed with a kidney disease. While he received a kidney from his father, his body rejected the transplant and he’s spent the last 10 years in and out of hospitals, on dialysis and waiting for a kidney donor to save his life, according to Fox 5.

His miracle came in the form of his sixth-grade teacher, William Wilkinson, who taught him technology at the Grace Christian Academy in Powder Springs, Georgia, according to the Atlanta Journal-Constitution.

Kaden, 12, underwent the transplant surgery on Tuesday.

His mother, Cami Koebcke, told the newspaper she was beyond grateful for Wilkinson’s donation.

“There are no words to even begin to describe how this is making me feel for Will to give this amazing gift to my son,” she said. “There is no greater gift.”

Wilkinson revealed to Fox 5 that he was inspired to donate his kidney as he knew what Kaden’s parents were going through.

“My son was actually in kidney failure when he was 2½,” Wilkinson told the outlet. “So, I remember being in that position as a parent wanting someone to help.”

Kaden did not know of his teacher’s decision until just before the surgery, as usually the doner’s identity is kept private, but then Wilkinson stopped by his home at the end of the school year and gave him the news.

“Would you like to know who the donor is?” Wilkinson reportedly asked Cami, who said yes and was consequently shocked by the revelation.

“We almost fell to the floor,” Cami told the outlet.

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His family created a Facebook page chronicling Kaden’s journey. On Wednesday, the family shared an update post-surgery, writing, “Kaden and Will are both doing well!”

“Kaden had a great night. He feels pretty good. Thanks to your prayers and our faithful God, his urine output is great! Prayer works!!! He had a plasmaphoresis [sic] treatment this morning and he’s doing well,” the post read.

“Will had a good night as well. He has some discomfort at times but handling it well. He’s already been up 2x to take a walking lap and he sat up in the chair for 2 hours,” the post continued. “Can’t thank you all enough for your prayers. We appreciate you. But it’s not over yet…more recovery to take place so please keep praying!”

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One Reason Why Kidney Transplants Fail

WEDNESDAY, Aug. 15, 2018 — Scottish scientists say they’ve found new clues to why some kidney transplants fail.

It has to do with the amount of “wear and tear” a transplanted kidney has and how that affects its work in the recipient, the new study says.

It was known that the age of the donor could affect how well a transplanted kidney worked, but this is the first time that the “burden of lifestyle and life events” experienced by the donor has been introduced as having an impact, according to the researchers.

They studied kidneys that failed to work after transplant, resulting in either the loss of the kidney or recipients having to go on dialysis until the new kidney started working.

The kidneys had significant changes in key genes and evidence of aging that was consistent with higher levels of “wear and tear,” according to the study authors.

“We now have strong evidence that an organ’s biological age, in combination with physiological stress, plays a major role in … impaired function, occurring. The findings also suggest that these effects are driven by donor characteristics, which may be more of a factor than transplant stress itself,” said researcher Paul Shiels, of the Institute of Cancer Sciences at the University of Glasgow.

“Our findings are important because, not only have we identified the reason why some kidney transplants don’t work when transplanted, we also demonstrate that miles on the biological clock affect the physiological function of organs,” he said in a university news release.

“This isn’t just clinically important, but is also relevant to how we age and how we can maintain good health in old age,” Shiels said.

“By using the signature set of genes from this study to identify less resilient organs before they meet a new recipient immune system, transplant stress could be reduced and outcomes improved,” he concluded.

About 10 to 12 percent of adults worldwide have chronic kidney disease, which can lead to kidney failure and the need for either dialysis or a kidney transplant.

The study was published Aug. 13 in the journal Aging Cell.

More information

The National Kidney Foundation has more on kidney transplants.

Posted: August 2018

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Talazoparib Beneficial in Patients With Advanced Breast Cancer

WEDNESDAY, Aug. 15, 2018 — Single-agent talazoparib provides significant benefit over standard chemotherapy for patients with advanced breast cancer and germline BRCA1/2 mutation, according to a study published online Aug. 15 in the New England Journal of Medicine.

Jennifer K. Litton, M.D., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues conducted a randomized phase 3 trial involving patients with advanced breast cancer and a germline BRCA1/2 mutation. Participants were randomized to receive talazoparib (287 patients) or standard single-agent therapy of the physician’s choice (144 patients).

The researchers found that, compared with the standard therapy group, the talazoparib group had significantly longer median progression-free survival (8.6 versus 5.6 months; hazard ratio for disease progression or death, 0.54; 95 percent confidence interval, 0.41 to 0.71; P < 0.001). For death, the interim median hazard ratio was 0.76 (95 percent confidence interval, 0.55 to 1.06; P = 0.11). The talazoparib group had a higher objective response rate than the standard-therapy group (62.6 versus 27.2 percent; odds ratio, 5.0; 95 percent confidence interval, 2.9 to 8.8; P < 0.001). Overall, 55 and 38 percent of patients who received talazoparib and standard therapy, respectively, had hematologic grade 3 to 4 events. Outcomes reported by patients favored talazoparib, with significant overall improvements and significant delays noted in the time to clinically meaningful deterioration according to the global health status-quality-of-life and breast symptoms scales.

“Talazoparib resulted in a significantly longer progression-free survival than standard-of-care chemotherapy,” the authors write.

The study was funded by the Pfizer company Medivation, which manufactures talazoparib.

Abstract/Full Text

Posted: August 2018

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Reasons for Undergoing Cosmetic Procedures Explored

WEDNESDAY, Aug. 15, 2018 — As well as enhancing physical appearance, patients seek cosmetic procedures for emotional and psychosocial reasons, according to a study published online Aug. 15 in JAMA Dermatology.

Amanda Maisel, from Northwestern University in Chicago, and colleagues conducted a prospective study to estimate the relative importance of factors that motivate patients to seek minimally invasive cosmetic procedures. A total of 511 patients were enrolled and completed a survey instrument.

The researchers found that in addition to motivations pertaining to aesthetic appearance, including the desire for beautiful skin and a youthful, attractive appearance, other motives that were commonly reported were related to physical health, such as preventing worsening of condition or symptoms (53.3 percent), and psychosocial well-being, such as the desire to feel happier and more confident or improve total quality of life (67.2 percent), treat oneself or celebrate (61.3 percent), and look good professionally (54.8 percent). In general, cost- and convenience-related motivations were rated as less important (14.1 percent). Most of the motivations were internally generated and designed to please patients, with patients themselves making the decision to undergo cosmetic procedures. Psychological and emotional motivations were more likely among patients seeking procedures such as body contouring, acne scar treatment, and tattoo removal (86.4, 85.7, and 72.7 percent, respectively).

“This initial prospective, multicenter study comprehensively assessed why patients seek minimally invasive cosmetic procedures,” the authors write. “Common reasons included emotional, psychological, and practical motivations in addition to the desire to enhance physical appearance.”

One author disclosed financial ties to the biotechnology industry.

Abstract/Full Text (subscription or payment may be required)

Posted: August 2018

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Healthy fat cells uncouple obesity from diabetes

About 422 million people around the world, including more than 30 million Americans, have diabetes. Approximately ninety percent of them have type 2 diabetes. People with this condition cannot effectively use insulin, a hormone made by the pancreas that helps the body turn blood sugar (glucose) into energy.

The inability to use insulin, called insulin resistance, results in increasing levels of blood sugar, which, if not controlled, can significantly raise the risk of major health problems such as blindness, kidney failure, heart attacks, stroke and lower limb amputation. In 2015, the World Health Organization estimated that 1.6 million deaths were directly caused by diabetes. Until recently, this type of diabetes was only seen in adults, but it is now also occurring increasingly and more frequently in children.

“Obesity is the most significant risk factor for type 2 diabetes and other metabolic conditions, and affects one in three adults worldwide,” said Dr. Sean Hartig, assistant professor of medicine and of molecular and cellular biology at Baylor College of Medicine. “Although medical consensus recommends making life style changes toward a healthy diet and increased physical activity to both prevent and help control diabetes, this strategy has shown to be difficult to implement and maintain by most people.”

Hartig and his colleagues are exploring alternative ways to control obesity and type 2 diabetes that may involve the use of therapies that would complement the current efforts to educate the public about healthy diets and exercise routines. To achieve this goal, they are studying the cellular and molecular mechanisms involved in fat metabolism using both genetic mouse models and human tissues.

Subcutaneous white fat versus belly fat dictates metabolic health in obesity

Although obesity significantly increases the risk of diabetes, about 30 percent of obese people do not show insulin resistance and do not develop type 2 diabetes or other metabolic conditions, such as fatty liver disease. What leads to obesity while maintaining insulin sensitivity is not well understood; however, scientists know that the condition is associated with the body’s ability to expand the storage of subcutaneous white adipose (fat) tissue.

“Subcutaneous white fat represents 80 percent of all fat tissue in mice and people and it is stored in the hips, arms and legs. When energy intake (food) overwhelms the ability to store calories in subcutaneous white fat, fat ‘spills over’ into organs that are not specialized for storing fat, such as the liver, the pancreas and muscle,” said co-author Natasha Chernis, research technician at Baylor College of Medicine. “People who develop diabetes have more abdominal (belly) fat. Our idea is to find ways to expand subcutaneous white fat depots in obesity, so fat is not stored in places like the abdomen or the liver, where it can cause metabolic problems.”

Another key player in the obesity and diabetes puzzle is the immune system. Obesity leads to developing a low-grade inflammatory response that can interfere with the metabolic functions of subcutaneous white fat tissue. This inflammatory microenvironment likely disturbs this fat tissue’s ability to respond to insulin, contributing in insulin resistance and type 2 diabetes. This is supported by findings that increased levels of pro-inflammatory cytokines, such as interferon-gamma, correlate with insulin resistance, reduced subcutaneous white fat expansion and accumulation of abdominal fat. However, this brings the question, what is different in obese individuals who do not develop insulin resistance and diabetes?

Another piece of the puzzle, miR-30a

“When we started this project six years ago, our goal was to better understand fat metabolism and identify potential ways to help people lose weight,” Hartig said. “We found a microRNA called miR-30a — a small non-coding RNA molecule that regulates gene expression — that could stimulate pathways important for fat metabolism. Originally, we thought that expressing miR-30a would lead to weight loss because it would be driving fat metabolism, but we observed something different. We found miR-30a did not correlate with leanness; instead, it was associated with a form of obesity in which subjects actually maintained insulin sensitivity.”

Hartig and his colleagues discovered that reduced miR-30a expression in fat tissue correlated with insulin resistance in both obese mice and obese humans. Interestingly, overexpressing miR-30a in subcutaneous white fat tissue of obese mice significantly improved insulin sensitivity, reduced levels of blood lipids and decreased buildup of fat in the liver without altering body weight. In addition, the researchers found that miR-30a expression reduced inflammation in subcutaneous white fat tissue.

“We have provided evidence that expression of miR-30a protects fat cells by attenuating inflammation derived from mediators such as interferon gamma and leads to improved insulin sensitivity in obese mice,” Hartig said.

These findings open the possibility of developing therapeutic entry ways for many forms of diabetes, not just diabetes aligned with obesity. For instance, targeting components of the immune system locally within adipose tissue may enable subcutaneous white fat to expand appropriately in lipodystrophies — conditions characterized by abnormal distribution of body fat — where diabetes occurs in patients without obesity.

“We are interested in this idea that we can uncouple obesity from co-morbidities such as heart disease and insulin resistance,” Hartig said. “It has become clear in the past 10 years that obesity doesn’t mean diabetes. We are interested in learning how to manipulate the inflammatory response inside fat tissue of people with insulin resistance or type 2 diabetes so they expand the subcutaneous white fat deposits and become metabolically healthy.”

Read all the details of this study in the journal Diabetes.

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Does Mountain Dew kill sperm? The truth

Though Mountain Dew does not affect fertility, many other unrelated factors can lower sperm counts and affect male fertility. These include:

  • low testosterone
  • smoking
  • obesity
  • diabetes

Exercising, quitting smoking, and losing weight are some ways to improve fertility. Listed in this article are several other proven methods a person can try to boost their fertility.

Does Mountain Dew affect fertility at all?

Mountain Dew does not affect fertility. It has acquired the reputation of impacting fertility mainly due to caffeine and yellow dye 5:

Does caffeine affect fertility at all?

The Nutrition Journal reviewed 28 studies that looked at different sperm measurements.

The researchers concluded that results were not consistent enough to be conclusive, despite some evidence of negative effects.

Mountain Dew has a higher amount of caffeine in a 12-ounce (oz) serving than some other soft drinks, which has lead to people taking it as proof that Mountain Dew affects fertility.

Comparing 12 oz servings of Mountain Dew and other drinks shows only a small difference in the amount of caffeine in each:

  • Pepsi-Cola: 37.5 milligrams (mg)
  • Coca-Cola Classic: 34.0 mg
  • Diet Coke: 45.6 mg
  • Mellow Yellow: 52.8 mg.
  • Mountain Dew (in various flavors): 55.0 mg.

People should still watch their caffeine intake, although caffeine is unlikely to affect fertility. But it is doubtful that Mountain Dew’s caffeine content would affect fertility when consumed in moderation.

Does yellow dye 5 affect fertility?

Yellow dye 5 is one of the most commonly used food additives.

The chemical name of yellow dye 5 is tartrazine. Tartrazine is what gives Mountain Dew its yellow color. Also, people often cite that tartrazine is a potential allergen as part of the myth.

There are not many current studies on the effects of tartrazine on fertility. One study in rats, although dating back to 1988, was published in Food and Chemical Toxicology and indicated no adverse effects to consuming tartrazine.

The U.S. Food and Drug Administration (FDA) have approved color additives, including tartrazine, for use in both food and drugs.

Tartrazine does pose a risk of allergy to a small portion of the population. People who are allergic to tartrazine may experience side effects from its consumption.

Side effects of tartrazine include:

  • hyperactivity
  • eczema
  • asthma

People who are allergic to tartrazine should avoid its consumption in food and beverages, but not because of any concerns about effects on fertility.

Yellow dye 5, as well as other food dyes, may be contaminated with carcinogens or substances that convert to carcinogens in the body, according to the Center for Science in the Public Interest (CSPI).

Food dyes are among many additives that the CSPI recommend to avoid for a variety of health reasons.

Several proven factors can lower sperm counts and affect male fertility.

According to a review of studies in Biochemistry & Analytical Biochemistry, risk factors for lowering male fertility include:

  • age, which sees testosterone in the blood fall, affecting sperm count from around 30 years of age onward
  • smoking, which can slow sperm down
  • obesity, which affects the number of viable sperm
  • excessive exercise, which may lower sperm count
  • occupational risks, such as regularly working with poisonous chemicals
  • prolonged exposure to heat from a laptop, which can reduce sperm count
  • excessive alcohol consumption
  • scrotal temperature
  • stress levels
  • therapeutic drugs
  • diabetes and raised blood sugars

The same review of studies explored medical causes of male fertility issues, including:

  • varicocele, a condition affecting the testicular veins
  • infections in the male reproductive tract
  • endocrine disorders affecting male hormones
  • disorders that affect male ejaculation
  • genetic and chromosomal defects
  • immunological factors where sperm antibodies form

Changes that can help improve fertility or sperm count include:

  • losing excess weight
  • reducing added and refined sugars in the diet
  • increasing fiber intake from food
  • exercising regularly
  • eating walnuts regularly
  • having a healthful diet rich in nutrients including iron, zinc, and other vitamins and minerals
  • taking folate and antioxidant supplements
  • getting plenty of sleep
  • limiting alcohol consumption
  • reducing soy intake

Takeaway

Mountain Dew does not cause infertility or lower sperm count when consumed in moderation.

Other factors can cause a person to be less fertile, but Mountain Dew does not appear to cause more health effects than other soft drinks.

Mountain Dew is not a healthy drink. People should avoid drinking excessive amounts of any soft drink and sugar-sweetened beverages, including Mountain Dew, so they control their blood sugars and weight, both of which are factors that can affect fertility.

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Stroke: Time not the only factor in emergency care

Neurologist Dr. Camilo R. Gomez pronounced in an editorial published in the Journal of Stroke & Cerebrovascular Diseases in 1993 that “Time is brain!”

“Unquestionably,” he wrote, “the longer therapy is delayed, the lesser the chance that it will be successful.”

In the meantime, however — with the help of new tools — researchers have been taking a closer look at what happens in the brain during and after a stroke, particularly at patterns of blood circulation.

Stroke occurs when the blood supply to a part of the brain stops and cells begin to die due to lack of oxygen and nutrients.

There are two main types of stroke: ischemic and hemorrhagic. Ischemic strokes, which result from clots or blood vessel constrictions, are by far the most common. Hemorrhagic strokes occur when vessels burst.

‘Collateral circulatory competence’

Now, in a new paper published in that same journal, Dr. Gomez — a stroke specialist from Loyola University Medical Center in Maywood, IL — argues that time should not be the only factor to dictate how ischemic stroke is treated.

The effect of time is likely to be different in different cases, depending on what is known as the person’s “collateral circulatory competence.”

When an ischemic stroke occurs, cells in a “core of brain tissue” start to die. However, the cells that surround the core — which is known as the penumbra — can still receive oxygen and nutrients and stay alive if there is good collateral circulation. The more robust the collateral circulation is, the longer the cells live.

In his paper, Dr. Gomez explains how use of a computational model helped identify four types of ischemic stroke that differ by pattern of collateral blood circulation.

He notes that modeling the types allows “forecasting of the fate of the ischemic process over time.”

Time is not the only factor

An optimal pattern “was predictably associated” with a slower injury rate in the affected area and a longer window of opportunity for therapy, for example.

“It is no longer reasonable to believe that the effect of time on the ischemic process represents an absolute paradigm,” argues Dr. Gomez.

He notes that there is increasing evidence of “considerable variability” in the volume of tissue that becomes injured within a given time after the onset of stroke. He also explains that this is “in large part due to the beneficial effect of a robust collateral circulation.”

It’s clearly evident that the effect of time on the ischemic process is relative.”

Dr. Camilo R. Gomez

He concludes that because we can now “readily identify” distinct collateral circulation patterns for different people, it is possible to predict how the aftermath of stroke is likely to affect the brain.

This improves opportunities to analyse the stroke process and select the best treatment.

Acting FAST saves lives

Dr. Gomez’s suggestions affect decisions made in the emergency room, so it is still important to call 911 and get help immediately if you think that someone is having a stroke.

FAST action can save a life. FAST is a simple checklist for helping you decide if someone is having a stroke. It stands for Face, Arms, Speech, Time, as follows:

    • Face: When you ask the person to smile, does one side of their face droop?
    • Arms: When you ask them to raise both arms, does one “drift downward?”
    • Speech: Do they slur their speech when you ask them to “repeat a simple phrase?”
    • Time: If the answer to any of these is “yes,” call 911 straight away.

    In the United States, around 140,000 people die from stroke every year, accounting for some 1 in 20 deaths.

    For 1 out of every 4 of the 795,000 people in the U.S. who have a stroke, it is not their first; and in 87 percent of cases, the stroke is ischemic.

    The total cost of stroke in the U.S. is in the region of $34 billion per year. This includes healthcare, medication, and lost productivity.

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    Effectively expressing empathy to improve ICU care

    In nearly every intensive care unit (ICU) at every pediatric hospital across the country, physicians hold numerous care conferences with patients’ family members daily. Due to the challenging nature of many these conversations — covering anything from unexpected changes to care plans for critically ill children to whether it’s time to consider withdrawing life support — these talks tend to be highly emotional.

    That’s why physician empathy is especially important, says Tessie W. October, M.D., M.P.H., critical care specialist at Children’s National Health System.

    Several studies have shown that when families believe that physicians hear, understand or share patients’ or their family’s emotions, patients can achieve better outcomes, Dr. October explains. When families feel like their physicians are truly empathetic, she adds, they’re more likely to share information that’s crucial to providing the best care.

    “For the most part, our families do not make one-time visits. They return multiple times because their children are chronically ill,” Dr. October says. “Families who feel we’re really listening and care about what they have to say are more likely to feel comfortable as they put their child’s life in our hands a second, third or fourth time. They’re also less likely to regret decisions made in the hospital, which makes them less likely to experience long-term psychosocial outcomes like depression and anxiety.”

    What’s the best way for physicians to show empathy? Dr. October and a multi-institutional research team set out to answer this question in a study published online in JAMA Network Open on July 6, 2018.

    With families’ consent, the researchers recorded 68 care conferences that took place at Children’s pediatric ICU (PICU) between Jan. 3, 2013, to Jan. 5, 2017. These conversations were led by 30 physicians specializing in critical care, hematology/oncology and other areas and included 179 family members, including parents.

    During these conferences, the most common decision discussed was tracheostomy placement — a surgical procedure that makes an opening in the neck to support breathing — followed by the family’s goals, other surgical procedures or medical treatment. Twenty-two percent of patients whose care was discussed during these conferences died during their hospitalization, highlighting the gravity of many of these talks.

    Dr. October and colleagues analyzed each conversation, counting how often the physicians noticed opportunities for empathy and how they made empathetic statements. The researchers were particularly interested in whether empathetic statements were “buried,” which means they were:

    • Followed immediately by medical jargon
    • Followed by a statement beginning with the word “but” that included more factual information
    • Followed by a second physician interrupting with more medical data.

    That compares with “unburied” empathy, which was followed only by a pause that provided the family an opportunity to respond. The research team examined what happened after each type of empathetic comment.

    The researchers found that physicians recognized families’ emotional cues 74 percent of the time and made 364 empathetic statements. About 39 percent of these statements were buried. In most of these instances, says Dr. October, the study’s lead author, the buried empathy either stopped the conversation or led to family members responding with a lack of emotion themselves.

    After the nearly 62 percent of empathetic statements that were unburied, families tended to answer in ways that revealed their hopes and dreams for the patient, expressed gratitude, agreed with care advice or expressed mourning — information that deepened the conversation and often offered critical information for making shared decisions about a patient’s care.

    Physicians missed about 26 percent of opportunities for empathy. This and striving to make more unburied empathetic statements are areas ripe for improvement, Dr. October says.

    That’s why she and colleagues are leading efforts to help physicians learn to communicate better at Children’s National. To express empathy more effectively, Dr. October recommends:

    • Slow down and be in the moment. Pay close attention to what patients are saying so you don’t miss their emotional cues and opportunities for empathy.
    • Remember the “NURSE” mnemonic. Empathetic statements should Name the emotion, show Understanding, show Respect, give Support or Explore emotions.
    • Avoid using the word “but” as a transition. When you follow an empathetic statement with “but,” Dr. October says, it cancels out what you said earlier.
    • Don’t be afraid to invite strong emotions. Although it seems counterintuitive, Dr. October says helping patients express strong feelings can help process emotions that are important for decision-making.

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    AMA adopts new policy on housing for homeless

    (HealthDay)—The American Medical Association (AMA) calls for stable, affordable housing, without mandated therapy or service compliance, in order to improve housing stability and quality of life among individuals who are chronically homeless.

    According to the 2017 Annual Homeless Assessment Report to Congress, more than 550,000 people experience homelessness each night in the United States. An estimated 35 percent stay in unsheltered locations.

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    Rural residents lack workplace supports to juggle work and caregiving

    In the U.S., more than 43 million family members or friends provide unpaid care to an ailing adult or child. A new University of Minnesota School of Public Health study shows the situation could be particularly difficult for informal caregivers in rural areas, who often lack the workplace flexibility and support they need to juggle their many responsibilities.

    The study, led by Assistant Professor Carrie Henning-Smith, was recently published in the Journal of Rural Health.

    “The U.S. population is getting older and care needs are increasing, especially in rural areas,” said Henning-Smith. “Meanwhile, lower birth rates, higher divorce rates, lower marriage rates and greater workforce participation all lead to fewer available caregivers. In rural areas, where resources are more scarce, the challenge of balancing work and caregiving is heightened, making it important to look at rural-urban differences in caregiver support.”

    To learn more about those differences, Henning-Smith analyzed survey responses from 635 people living in rural and urban communities across the country who both work and care for a loved one.

    The study showed that:

    • 15 percent of employed rural caregivers have access to supportive programs, such as employee assistance programs, through their workplace, compared with 26 percent of employed urban caregivers.
    • Less than 10 percent of rural caregivers are able to work from home or telecommute, compared with 25 percent of urban caregivers.
    • 18 percent of rural caregivers have access to paid leave, compared with 34 percent of urban caregivers.

    “These findings should raise concern about the well-being of employed rural caregivers who are juggling multiple roles with less support from their workplaces,” said Henning-Smith. “As caregiving needs rise—especially in rural areas—it will become increasingly urgent to find ways to support all caregivers.”

    Henning-Smith suggests that employers who create more supportive work environments for employed caregivers will help a large number of people, and could see greater workplace satisfaction and less turnover from employees. Strategies employers can use to increase the level of support in their work environment could include flexible work hours, telecommuting/working from home, supportive programs, paid leave and paid sick leave.

    Policymakers can also help ease the strain on caregivers by mandating workplace protections, such as expanding access to family leave, and by addressing systemic issues, such as access to broadband Internet, that would make it easier for employers to give rural caregivers flexibility. Health care providers can play a role as well by being aware of a caregivers’ multiple roles and ensuring that they have the support they need to provide high-quality care while taking care of their own health.

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