Whether you are an older American or have parents or family members who are getting on in years, you need to be aware that the burdens of long-term caregiving will increasingly fall more heavily on families and friends. The financial and demographic forces behind this trend are so powerful that the shift to increased self-reliance is unavoidable.
Like other problems that have been hiding in plain sight for years, the factors behind this trend are not new:
1. Senior populations are exploding. By 2030, 1 in 5 Americans will be at least 65 years old. The country's fastest growing age group is made up of people who are 85 and older.
2. This growing group of seniors is living longer, thanks to healthcare and lifestyle changes. But this also means adding years to the time periods during which many of these longer-lived people will need some form of ongoing care.
3. Republicans and Democrats are arguing over cuts to senior programs—Social Security, Medicare, and Medicaid—as they debate how to close the yawning federal deficit. But neither the nation nor its taxpayers will be able to afford the growing price tag for supporting rising numbers of aging baby boomers.
4. Still reeling from recessionary conditions, American families increasingly can't afford the price tag for nursing homes, assisted care facilities, and other long-term care services.
While these forces are raising the need for family caregiving, the nation's family structure has splintered in recent decades. Increasingly, older Americans don't live with or even near younger family members. There is some evidence that Americans have recently begun placing more emphasis on access to family members when they move. But such migration has ground to a halt because of falling home values and the difficulty of selling or buying new homes.
Of course, before Medicare and Medicaid, and before the rise of nursing homes and assisted living facilities, American families used to take care of aging family members. Multigenerational households were the norm, not the exception.
Economic pressures have recently triggered a rise in multigenerational households. That's due in part to caregiving needs, but is being driven more by children being forced to move back in with their parents because they can't afford to live on their own. As the economy slowly recovers and young-adult employment prospects brighten, most will move back out.
As senior advocates continue to battle budget and program cutbacks that affect caregiving, experts also advise families about caregiving planning and needs.
Consider multigenerational living. According to a recent caregiving survey by the National Family Caregivers Association and Allsup, a fee-based benefits advisory company, two-thirds of caregiving involves people living in the same home and 96 percent of all caregiving involves family members.
Understand what caregiving entails. There is a wide range of caregiving requirements based on the needs of the family member requiring care. If you're a caregiver, it's important to understand the care needs of the person you're helping. People who are thrown into caregiving in a crisis report high levels of stress and anxiety about their roles.
Explore local caregiving support services. There is an extensive network of nonprofit and government services for at-home caregiving. With budget pressures, some programs are shifting their attention from institutional care to at-home care. It's cheaper and people prefer staying in their homes. There also are substantial differences among the states in how family caregiving is supported.
Make your home caregiving "friendly." It's important that your home remain your home and not be turned into a hospital. But your home also needs to accommodate a person needing care. Learn about ways to make your home navigable to someone who might be disabled or need a wheelchair. Focus especially on bathrooms, the kitchen, and bedrooms.
Don't go it alone. Caregiving is hard and often unrelenting work. The health of many caregivers declines over time, which is not only bad for them but can also reduce the quality of care they can provide. If you think there's a period of extended care responsibility in your future, take steps to give yourself some time off. Recruit other family members or friends to help out from time to time. If you can afford it, hire a trained caregiver from time to time. Caregivers' Monday, a healthcare non-profit, recently produced a list of best-practice tips for family caregiving.