Caregivers are the unspoken backbone of the American healthcare system. Providing essential, and often overlooked, care for elderly parents, partners, and loved ones is a selfless act undertaken by over 50 million Americans.
In 2015, 43.5 million Americans were providing unpaid care. Just five years later, in 2020, that number leaped to 53 million. When looking at caregivers for adults over the age of 50, the prevalence has increased 22% to 41.8 million Americans over the same timespan. This trend is set to continue as demographic and care preference shifts continue to play out.
With the Baby Boomer generation (born 1946-1964) now all older than 65, and Gen X now crossing that threshold, an unprecedented wave of aging is on the rise. The number of people age 65 and older is projected to double by 2060 to over 95 million, with 2034 marking the first year ever that people over 65 will actually outnumber people under the age of 18.
In conjunction with the aging population, the need for caregivers is driven by the outsized preference to age in place at home. Nearly 90% of Americans over the age of 50–across all age, race, income, and health status categories–all share the preference to remain at home and age in place. With the aging population remaining at home, family caregivers will take on an ever increasing role in the healthcare system.
Between the lines of the healthcare system lies a support system of family members helping loved ones 24 hours a week on average. Of those caregivers, 99% assist with tasks of Instrumental Activities of Daily Living (IADLs, such as cooking, housework, and transportation); 60% help with Activities of Daily Living (ADLs, such as walking, feeding, bathing); and 58% help with medical/nursing tasks, including injections, tube feedings, catheter and colostomy care, and many other complex care responsibilities.
The Level of Care Index, which measures the level of intensity or complexity of caregiving situations by accounting for number of hours of care given, as well as number of ADLs and IADLs performed, is at an all-time high, with 40% of caregivers working in high-intensity situations.
In all, family caregivers provide $470 billion in unpaid care.
In their noble commitment to provide care to a loved one, caregivers sacrifice more than just their time. Acting as a caregiver takes a measurable emotional, physical, and financial toll.
The US healthcare system is not only impacted by the caregiver's efforts, but also by second order impacts on the caregivers themselves. Caregiver self-rated health has declined from 2015 to 2020, with only 41% of caregivers rating their own health as excellent or very good. The stress associated with caregiving may exacerbate any declines in health that already come with the age of caregivers themselves.
Financially, nearly 8 in 10 caregivers report having routine out-of-pocket expenses related to looking after their loved ones. The typical annual total is significant: $7,242. On average, family caregivers spend 26% of their income on caregiving activities, according to results of the national study of nearly 2,400 caregivers in the spring of 2021.
Not only are family caregivers spending more, but they are also earning less. 61% of family caregivers are employed while providing care, and of those, 6 in 10 report at least one impact or change to their employment situation as a result of caregiving (going in late/leaving early, reducing hours, turning down promotions).
On top of the financial impacts, being a family caregiver also can take a toll on mental and physical health. Nearly 4 in 10 family caregivers report their caregiving situation to be highly stressful, and an additional 28% report moderate emotional stress. Of all caregivers, 23% feel that providing care has worsened their health.
From their outsized role in the healthcare system to the financial and physical stresses caregivers nobly take on, one thing is clear: compensating and supporting family caregivers is imperative for the overall wellbeing of the US.
Failing to support family caregivers means second and third-level consequences on our healthcare system, business productivity, savings and debt, and overall well-being of the country. These ripple effects will be felt by generations to come, whose parents were too overly consumed (and under-supported) with caregiving to prioritize their own financial, physical, and emotional wellness.