We are a nation of caregivers. Every day over 44 million adults serve as unpaid caregivers to ailing or disabled relatives or friends, and annually 65 million do so—yet this form of work often goes uncompensated and is largely invisible. Unsurprisingly, inadequate awareness of the issues leads to inadequate policies and solutions.
Caregiving takes a huge toll on the economy. About 17% of full and part-time employees are also caregivers (in fact 73% of all caregivers are employed at another job). Businesses lose $34 billion/year in productivity from employees being distracted, cutting back hours, or leaving the workforce. Caregivers forsake income: their total estimated lost wages, pension and Social Security benefits is nearly $3 trillion.
Caregivers and care recipients span all demographics, but they are primarily women (66%) and ages 35-64 (64%). Of the 65 million adult caregivers, 4 million care for children, 49 million care for adults, and 13 million care for both adults and children.
Caregiving can be highly demanding. It involves far more than healthcare-in-the-home; it is about helping with life: activities of health and wellness (medications, therapies, exercise, tracking of symptoms, appointments, etc.); basic living (bathing, grooming, toileting, dressing, eating, etc.); basic chores (cooking, cleaning, shopping, money management, etc.) as well as social engagement and emotional support.
On average, caregivers spend 20 hours per week; a third average 47 hours per week. And it can go on for many years: on average 4.6 years, while 15% have been providing care for over 10 years. Unsurprisingly, the non-economic impact — physical and mental health deterioration of caregivers and the fraying of family relationships — is significant.
Demographic and economic realities are increasing need for (and demands on) family caregivers. People are living longer, and there are fewer offspring to handle their care. Paid home care workers are not filling the need. While the projected demand for such workers for 2008-18 is 50%, the growth of the 25-54 age female population (the main labor pool from which these workers are drawn) is only 2%. Low pay (barely above minimum wage) and low status of home care workers spurs high turnover, further aggravating the situation. Outsourcing is not an option, as few caregiving tasks can be performed remotely. Healthcare trends — cutbacks due to government and employer cost cutting, shorter hospital stays, and more home-care technologies — intensify the family caregiving burden.
Policy makers, technologists and entrepreneurs must appreciate the prevalence, toll and context of caregiving in order to address this growing crisis. Caregiving is not a simple one-to-one relationship, but usually involves networks of relatives and friends. It is not only a healthcare issue, but also about managing life. And it is not just a brief crisis requiring heroic actions, but an overwhelming (and seemingly unending) series of wide-ranging, mundane tasks with minimal (if any) compensation.
Caregivers step up to help friends and family in need; similarly, we must step up to provide support and solutions to help shoulder the burden of care. Much can be done; I suggest a couple of starting points. Design caregiver-support policies such that they acknowledge the primacy of the family in caregiving. Recognize that caregiving is about life and not just health, by reducing requirements for presence or approval of healthcare professionals. Develop tools and services that make management and coordination of daily caregiving easier, that are designed for long-term use, and are sufficiently flexible to accommodate un-foreseeable changes in specific care tasks. A brighter future is possible, if we can come together to create tools, systems and policies to accommodate the changing nature of how we take care of ourselves and others throughout life.
For more information:
- New Realities of an Older America
- Caregiving in the U.S. 2009
- The Cost of Caregiving to the U.S. Economy
- The Growing Contributions and Costs of Family Caregiving
- The MetLife Study of Caregiving Costs to Working Caregivers
- The MetLife Caregiving Cost Study: Productivity Losses to U.S. Business
- Caring in America: A comprehensive analysis of the nation’s fastest-growing jobs: home health and personal care aides
posted by Rajiv Mehta, consultant and entrepreneur focused on technologies for personal and family health; co-organizer of the Quantified Self.