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The weight of caregiving in NH. Why we need SB 608: Sirrine

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The weight of caregiving in NH. Why we need SB 608: Sirrine


Recently, I met with a husband who had been caring for his wife since her Alzheimer’s diagnosis. Her needs were escalating quickly — appointments, medications, meals, personal care — and he was determined to keep her at home. But the cost to his own wellbeing was undeniable. He was sleep‑deprived, depressed, and beginning to experience cognitive decline himself.

As director of the Referral Education Assistance & Prevention (REAP) program at Seacoast Mental Health Center, which supports older adults and caregivers across New Hampshire in partnership with the CMHC’s across the state, I hear stories like his every week. And his experience is far from unique.

Across the country, 24% of adults are family caregivers. Here in New Hampshire, 281,000 adults provide this essential care, often with little preparation or support. Only 11% receive any formal training to manage personal care tasks — yet they are the backbone of our long‑term care system, helping aging parents, spouses, and loved ones remain safely at home. (AARP, 2025)

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REAP provides short‑term counseling, education, and support for older adults, caregivers, and the professionals who support them. We address concerns around mental health, substance use and cognitive functioning. After 21 years working with caregivers, I have seen how inadequate support directly harms families. Caregiving takes a serious toll — emotionally, physically, socially and financially. Many experience depression, chronic stress, and increased risk of alcohol or medication misuse.

In REAP’s own data from 2024:

  • 50% of caregivers reported moderate to severe depression
  • 29% reported suicidal ideation in the past two weeks
  • 25% screened positive for at‑risk drinking

Their responsibilities go far beyond tasks like medication management and meal preparation. They interpret moods, manage behavioral changes, ease emotional triggers, and create meaningful engagement for the person they love. Their world revolves around the care recipient — often leading to isolation, loss of identity, guilt, and ongoing grief.

The statistics reflect what I see every week. Nearly one in four caregivers feels socially isolated. Forty‑three percent experience moderate to high emotional stress. And 31% receive no outside help at all.

Compare that to healthcare workers, who work in teams, receive breaks, have coworkers who step in when overwhelmed, and are trained and compensated for their work. Even with these supports, burnout is common. Caregivers receive none of these protections yet are expected to shoulder the same level of responsibility — alone, unpaid, and unrecognized.

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Senate Bill 608 in New Hampshire would finally begin to fill these gaps. The bill provides access to counseling, peer support, training, and caregiver assessment for family caregivers of individuals enrolled in two Medicaid waiver programs: Acquired Brain Disorder (ABD) and Choices for Independence (CFI). These services would address the very needs I see daily.

Professional counseling helps caregivers process the complex emotions of watching a loved one decline or manage the stress that comes with it. Peer support connects them with others navigating similar challenges. Caregiver assessment identifies individual needs before families reach crisis.

When caregivers receive the right support, everyone benefits. The care recipient receives safer, more compassionate care. The caregiver’s health stabilizes instead of deteriorating from chronic stress and neglect. And costly options, which many older adults want to avoid, are delayed or prevented.

There is a direct and measurable link between caregiver training and caregiver wellbeing. The spouse I mentioned earlier is proof. Through REAP, he received education about his wife’s diagnosis, guidance on communication and behavior, and strategies to manage his own stress. Within weeks, his depression decreased from moderate to mild without medication. He was sleeping through the night and thinking more clearly. His frustration with his wife dropped significantly because he finally understood what she was experiencing and how to respond compassionately.

The real question before lawmakers is not whether we can afford SB 608. It is whether we can afford to continue ignoring the needs of those who hold our care system together. In 1970, we had 31 caregivers for every one person needing care. By 2010, that ratio dropped to 7:1. By 2030, it is projected to be 4:1. Our caregiver supply is shrinking while needs continue to grow. Without meaningful support, our systems — healthcare, long‑term care, and community supports — cannot function. (AARP, 2013)

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Caregivers don’t ask for much. They want to keep their loved ones safe, comfortable, and at home. They want to stay healthy enough to continue providing care. SB 608 gives them the tools to do exactly that.

I urge New Hampshire lawmakers to support SB 608 and stand with the 281,000 residents who are quietly holding our care system together. We cannot keep waiting until caregivers collapse to offer help. We must provide the support they need now — before the burden becomes too heavy to bear.

Anne Marie Sirrine, LICSW, CDP is a staff therapist and the director of the REAP (Referral Education Assistance & Prevention) program at Seacoast Mental Health Center.



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New Hampshire

More businesses would be exempt from a key state tax under a proposal heading to Ayotte’s desk

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More businesses would be exempt from a key state tax under a proposal heading to Ayotte’s desk


The New Hampshire House and Senate stopped shy of cutting a major state business tax outright Thursday, but did pass a plan to lift the tax’s filing threshold, and spend $2.5 million to lift Medicaid provider rates at state nursing homes.

“What you have before you is a bill that will protect our nursing homes, and protect our small businesses,” said Republican Sen. Tim Lang of Sanbornton.

Under the bill, the threshold on the state business and enterprise tax would be lifted from $297,000 to $400,000, a move GOP leaders expect will exempt about 4,000 small businesses from having to pay the tax.

The bill’s inclusion of money to boost provider rates for nursing homes was a policy the Senate prioritized, and its inclusion in the bill earned the plan some Democratic support. But that evaporated when Republicans in the House pushed to add a trigger to the bill to automatically reduce the rate of the tax when collections from the levy far exceeded estimates.

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“The rate cuts are reckless and irresponsible and would potentially cost hundreds of millions of dollars in the future,” said Sen. Cindy Rosenwald of Nashua.

Under the plan, the tax rate, which now stands at 0.55%, would automatically drop by .005% anytime collections on the tax surpassed estimates by $100 million until the rate of the levy reached 0.25%, equivalent to the rate when the tax was created in 1993. Any reduction would also require the state’s Rainy Day Fund to hold a strong balance.

Cutting business taxes has been a focus for GOP leaders in Concord for years, and they’ve dropped the rate of the Business Enterprise Tax four times since 2016.





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Israel and Lebanon reach an agreement, but ceasefire stalls

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Israel and Lebanon reach an agreement, but ceasefire stalls


Lebanon and Israel provisionally agreed in Washington to a new ceasefire Wednesday. But hours later Israel continued attacks and the militant group Hezbollah said it rejected any ceasefire that did not start with the withdrawal of Israeli forces from Lebanese territory.

The fighting appeared to jettison immediate prospects of a wider ceasefire between the United States and Iran. Iran has said it will not agree to a ceasefire with the U.S. and Israel unless there is one in Lebanon.

UNIFIL, the U.N. peacekeeping operation for Lebanon, announced Thursday that one of its peacekeepers had been killed and others wounded when mortars hit their position near Marjayoun in southeastern Lebanon.

A U.N. source said the mortars appeared to have come from Hezbollah. The attack came as Israel and Lebanon were negotiating a ceasefire in Washington. The person asked not to be identified because they were not authorized to speak publicly on the issue. Hezbollah has been targeting Israeli army installations in the vicinity.

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Iranian Revolutionary Guard Corps commander Esmail Qaani was quoted by Iranian state media Thursday saying that Israel must withdraw to pre-war positions as the first step in a ceasefire with Lebanon. Before the U.S. and Israel attacked Iran on Feb. 28, Israel held five positions across the border in Lebanon. It now occupies large parts of the south of the country.

The U.S. does not speak directly to Hezbollah, which it classifies as a terrorist organization. Lebanon’s negotiations in Washington were carried out without direct inclusion of the Iran-backed group.

Lebanese President Joseph Aoun said Thursday that the ceasefire would come into force within 24 hours of all concerned parties approving it, especially Hezbollah.

A Hezbollah official told NPR that Hezbollah officially informed the Lebanese president that it would not accept any ceasefire that did not begin with the withdrawal of Israeli forces from south Lebanon.

The official asked to remain anonymous because he was not authorized to speak publicly on the issue.

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Israeli defense minister Israel Katz said Israel was demanding the creation of what it called a de-militarized zone within Lebanon while being able to continue attacks against Iran-backed Hezbollah. He said Israel would not be withdrawing from the south.

Jawad Rizkallah contributed reporting from Beirut.

Copyright 2026 NPR





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New Hampshire

New Hampshire Pummels Altoona with 14 Runs on 18 Hits

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New Hampshire Pummels Altoona with 14 Runs on 18 Hits


MANCHESTER, NH – A five-run second inning and an eight-run eighth powered the New Hampshire Fisher Cats (27-23) to a Wednesday night win against the Altoona Curve (23-30) at Delta Dental Stadium, 14-3. In the eighth Inning, third baseman Sean Keys, second baseman Cutter Coffey, and catcher Patrick Winkel all



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