Who will care for the caregivers?
The caregiver workforce is unsustainable, with the economic value of the care they provide reaching $470bn per year and rising. The average family caregiver is currently a 49-year-old women providing care for an elderly relative, but nearly 25% of caregivers are now millennials and the demand is only growing. In 2015, elderly people over the age of 80 could expect seven potential caregivers to step in; by 2030, this will drop to four, and by 2050, there will be less than three familial caregivers on hand to help. Around one third of caregivers work full time, with 25% working part time and a third providing over 21 hours of care each week. The pressure is leading many caregivers to either reduce working hours, take leaves of absence or allow their work to be affected. The financial strain is unsustainable, with family caregivers over 50 who leave the workforce losing out on over $300,000 in wages and benefits. Despite this growing pressure, the medical industry is relying on them increasingly for care. To combat issues that caregivers frequently find, they should be included within patients’ treatment plans, and adequately trained for the more complex tasks that they are being asked to complete. Providing counseling and other support services could also help. There are changes in policy being made to help caregivers, such as the Caregiver Advise, Record, Enable (CARE) Act, but there should also be increased financial support for paid leave and working flexibility. Reducing the burden on caregivers can help to tackle the issues they face and strengthen the provision of care for patients at the same time.
She hung up and apologized for the interruption. Then she leaned over to pull his socks over his bare feet — socks I’d removed moments before and left on the exam table.

I should have put his socks back on.

There are some 40 million Americans like my patient’s daughter. Every day, they help a parent, grandparent, relative or neighbor with basic needs: dressing, bathing, cooking, medications or transportation. Often, they do some or all of this while working, parenting, or both. And we — as doctors, employers, friends and extended family — aren’t doing enough to help them.

According to AARP and the National Alliance for Caregiving, the typical family caregiver is a 49-year-old woman caring for an older relative — but nearly a quarter of caregivers are now millennials and are equally likely to be male or female. About one-third of caregivers have a full-time job, and 25 percent work part time. A third provide more than 21 hours of care per week. Family caregivers are, of course, generally unpaid, but the economic value of their care is estimated at $470 billion a year — roughly the annual American spending on Medicaid.

A recent report from the National Academies of Sciences, Engineering and Medicine suggests that society’s reliance on this “work force” — largely taken for granted — is unsustainable. While the demand for caregivers is growing because of longer life expectancies and more complex medical care, the supply is shrinking, a result of declining marriage rates, smaller family sizes and greater geographic separation. In 2015, there were seven potential family caregivers for every person over 80. By 2030, this ratio is expected to be four-to-one, and by 2050, there will be fewer than three potential caregivers for every older American.

This volunteer army is put at great financial risk. Sixty percent of those caring for older family members report having to reduce the number of hours they work, take a leave of absence or make other career changes. Half say they’ve gotten into work late, or had to leave early. One in five report significant financial strain. Family caregivers over 50 who leave the work force lose, on average, more than $300,000 in wages and benefits over their lifetimes.