Aging Society Challenges Family Caregivers

December 8, 2009 RSS Feed Print
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Much is said about the splintering of the American family, but that view doesn't hold up when it comes to taking care of one another. According to a major survey, more than 65 million of us spend an average of 20 hours a week as unpaid caregivers. Looking only at people being cared for who are at least 50 years old, 90 percent of them are family members. Half of all such caregiving is provided to a mother (36 percent) or father (14 percent). Grandparents and in-laws each receive 11 percent of all caregiving, and spouses care for one another in 6 percent of the cases. MetLife funded the research, which was sponsored by the National Alliance of Caregiving in collaboration with AARP. Comparable surveys were done in 1997 and 2004, and the aging of America is clearly evident over the past 12 years.

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More people—caregivers as well as those being cared for—are older. Among caregivers, 55 percent are older than 50 in the latest survey, compared with 47 percent in 2004 and only 38 percent in 1997. Among people receiving care who are at least 50 years old, 31 percent are 85 and up—the so-called "old old"—versus 24 percent in the earlier surveys. Consistent with aging, more caregivers are providing help with basic daily activities:

  • Get in and out of beds and chairs: 46 percent versus 37 percent in 1997.
  • Get dressed: 34 percent, up from 31 percent.
  • Get to and from the toilet: 28 percent versus 26 percent.
  • Bathe or shower: 26 percent, down from 27 percent in 1997.
  • Dealing with incontinence or diapers: 20 percent compared with 14 percent.
  • Feeding him or her: steady at 19 percent.

Nearly everyone aged 50 and higher (96 percent) takes prescription drugs, and half of these people need help from caregivers with their medications. Half of all caregivers also hold full-time jobs, making for a lot of stress. Most caregiving is for long-term physical or mental conditions, and the average caregiving situation lasts 4.6 years.

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More than two thirds of caregivers get help from other family members, although the more stressful role of being a sole caregiver falls more heavily on older caregivers. The percentage of caregivers who retain paid support fell to 35 percent in the current survey from 41 percent in 2004. The survey didn't ask why people had changed their behavior but survey experts said the recession would be a logical cause. Tougher times would also help explain why caregivers with jobs—73 percent of all caregivers—appear to be taking more time away from work to provide care.

While healthcare reform proposals now being debated in Congress would provide some help to caregivers, survey sponsors agree that unpaid caregiving will continue to create stresses on families. If not better addressed, a breakdown in the structure of family caregiving would overwhelm government safety-net programs. "We know we're not going to be prepared for what is being called a looming national caregiving crisis," said Barbara Dillion, program director for the MetLife Foundation.

[See Caregivers Need Health Reforms, Too.]

Tags:
aging,
healthcare,
retirement

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The last thing any child wants to do is put a parent or loved one into a nursing facility. Yet, that’s the horrendous decision caregivers face when they’re unable to secure the support they need. I served on the Real Systems Change Advisory Board in Illinois, a federally funded pilot project that assessed the financial and clinical feasibility of nursing home patients who wanted to live in the community, not in nursing homes. We found that many patients, with minor arrangements, could live safely and far happier in community apartments. One woman simply needed a building with an elevator, a twice-weekly home health visit and a weekly visit from a nurse to take vitals and review medications.

Sure, the system has its flaws, but the project uncovered policy and funding barriers and advocated together for change. We aren’t talking a major overhaul – we just considered each patient individually and made adjustments that resulted in a happier patient and a family with peace of mind. Nursing home reviews keep uncovering major non-compliance with requirements, over-medicated patients and rising incidents of abuse and neglect. How have we benefitted the patient by tearing them from their stressed-out caregiver and placing them in a nursing home? While advocates work furiously to reform nursing homes, let’s not be so quick to separate caregivers and patients.

Let’s first use screening and assessments, like Project SAFE, so we can put family support and safety in place, to reduce caregiver stress and keep them together. I was manager and a co-creator of Illinois’ Project SAFE, an award-winning child welfare and substance abuse project that screened and assessed addicted, stressed-out parents. Teams of child welfare and substance abuse staff working together put in place viable options, more family supportive services, child care, transportation and treatment services so families could stay together. Having witnessed hundreds of families preserved because of Project SAFE, the elder abuse system would greatly benefit from borrowing from those approaches.

-Maya Hennessey

Consultant, Trainer, Author, and Caregiver Advocate

www.mayahennessey.com

Maya Hennessey of CA 1:44AM January 06, 2010

The Best Life

Philip Moeller, contributing editor for U.S. News Money, writes about achieving success and happiness in older age.

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