1. Family Caregiving and Financial Compensation Maria Claver, PhD, MSW Melanie Horn Mallers, PhD Department of Family & Consumer Sciences Gerontology Program

2. Caregivers • Informal: Family members, as well as friends, partners, and neighbors who provide care to aging loved ones. • Formal : paid nurse aids, personal assistants, and home care staff who provide hands-on care in both home and long term settings.

3. Family Caregiving Population • Family caregiving has become the norm! • In the U.S- more than 50 million people provide care for a chronically ill, disabled or aged family member or friend during any given year. • In CA- over four million family caregivers alone. • Caregivers care for spouses (5%), and parents (40%) as well as grandparents, parents-in-law, other relatives, and friends (55%).

4. Family Caregiving: Availability and Challenges • Availability of care is a major factor in predicting whether or not an older person can remain at home (aging in place) versus being moved to institutionalized care • While the need for care by older adults is increasing, availability is decreasing.

5. Family Caregiving: Availability and Challenges • Family caregivers are essential given that over 40% of U.S. primary care physicians think they don't have enough time to spend with patients • Family caregivers provide the overwhelming majority of long term-care services in the U.S. • The majority of adults living in the community and in need of long-term care depend on family and friends as their only source of help. FAMILY CAREGIVERS MATTER!

6. Economics of Family Caregiving • Family caregivers represent 80% of all home care services and are conservatively valued at $306 billion a year, more than twice the amount spent on paid home care and nursing home services combined. • They are 2.5 times more likely than non-caregivers to live in poverty. • They are five times more likely to receive Supplemental Security Income (SSI). • Caregiving families have median incomes that are more than 15% lower than non-caregiving families.

7. Economics of Family Caregiving • Caregivers comprise 13% of the workforce, but often lose wages and time from work due to caregiving and related role demands. • 59% of family caregivers who care for someone over the age of 18 either work or have worked while providing care • 62% have had to make some adjustments to their work life, from reporting late to work to giving up work entirely. • 10% of employed family caregivers go from full-time to part-time jobs because of their caregiving responsibilities. • Overall, American businesses can lose as much as $34 billion each year due to employees' need to care for loved ones 50 years of age and older.

8. Impact of Family Caregiving • 1/3 experience stress, burnout and exhaustion, possibly resulting in depression. • Family caregivers report having a chronic condition at more than twice the rate of non-caregivers. • Elderly spousal caregivers with a history of chronic illness themselves have a 63% higher mortality rate than their non-caregiving peers.

9. Impact of Family Caregiving: Summmary of Sources Financial • Direct costs of care such as equipment and medicine • Travel costs of long distance caregivers • Reduced hours and income from work • Early retirement • Disruptions at work • Reduced productivity at work • Missed opportunities in career

10. Impact of Family Caregiving: Summmary of Sources Physical • Health problems (headaches, stomach problems, sleep and weight disturbances) • Increased use of drugs and health services • Exhaustion and low stamina • Self neglect • Increased morbidity and mortality

11. Impact of Family Caregiving: Summmary of Sources Emotional • Grief, loss and hopelessness • Guilt, anger and resentment • Giving up time for self, family • Strained social and family relationships • Social isolation • Worry and anxiety • Depression

12. Should Family Members Provide Care? Should they be Financially Compensated? PROS • It will expand capacity and supply of workers • It will increase gender and family equity • It will increase elder’s satisfaction as a consumer • It will decrease administrative and bureaucratic barriers

13. Should Family Members Provide Care? Should they be Financially Compensated? CONS • It will increase family exploitation • It will cause caregiver stress and strain • It will lead to elder abuse and fraud • It will incur increased costs