Guest post by Stien Vandierendonck, Manager of Programs and Communications at the National Alliance for Caregiving. åÊ
Most American caregivers are female and on average 48 years old. They typically take care of a relative, most often a parent, for an average period of 4.6 years.1 The estimated economic value of their unpaid contribution was on average $450 billion in 2009.2
In addition to helping the care recipient with everyday activities, surveys reveal that many family caregivers also provide financial assistance. A study the National Alliance for Caregiving published on caregiving out-of-pocket costs indicates that caregivers spend on average $5,531 each year on caregiving responsibilities. Since the annual median household income is $43,026, you realize that this is a significant burden for many. The highest costs are related to medical, food, and household expenses. For caregivers with limited incomes, it is even harder to cope.3 Another study suggests that caregiving for an older relative is an important factor in the health, medical care expense, and productivity of employees across all age groups. The additional health cost to employers is 8 % more compared to non-caregivers.4
Besides the financial costs, the health of the family caregiver is also a subject of concern. There are studies that indicate that the health of family caregivers (most often a spouse) may be adversely affected, especially as their caregiving continues for an extended period of time and becomes more intense. A study we released in November on caregivers of people with AlzheimerÛªs disease (AD) shows a significant decrease in family caregiver health over time as their care recipientÛªs dementia increases. This study also specifically examined the use of formal health services in a large sample of AD caregivers. The strain of caring for someone with AD can cause family caregivers to use health care services (ER visits, hospital visits and doctor visits) at higher rates than non-caregivers of the same age, at an average annual cost increase of $4,766 per caregiver in personal healthcare expenses.5
The expenses of the impact to personal health of the caregiver, combined with the expenses of caregiving responsibilities, shows the significant economic impact of caregiving on personal costs in this country ÛÒ especially for older caregivers on fixed incomes.
Health professionals can play an important role in identifying caregivers at risk of having their own health decline, by using assessments that may help mediate costs. These assessments look at the caregiverÛªs health, ability and willingness to do what tasks may be required, as well as the caregiverÛªs need for support. For example, when an initial diagnosis of dementia is confirmed, it is recommended to conduct a caregiver assessment at the same time as an initial diagnosis of dementia. That way the family caregiver is integrated into the caregiving team, right from the beginning. As the care recipientÛªs health declines or dementia increases, the family caregiver assessments should be repeated to ensure that the caregiver is getting the support he or she needs. In addition, such assessments can serve to identify potential stress or even physical strain. The ÛÏCaregiver Self-AssessmentÛ is such a tool, which can be downloaded from the American Medical Association or from the National Alliance for Caregiving. A caregiver assessment can also be integrated into the new annual Medicare Wellness Visit.
The efforts that family caregivers make are tremendous and the impact on different aspects of their lives is significant. ThatÛªs why we emphasize the importance of supporting the family caregiver, by integrating them from the beginning in the professional caregiving team as a part of the patient centered care ÛÒ a relatively new, but vitally important, concept in health care. Employers can serve the best interest of their employees by anticipating and responding to the challenges of eldercare for their employees by offering eldercare benefits and wellness programs.4 For the family caregiver themselves, they need information, education and training. Information about the medical condition of the care recipient; coping skills and other relationship issues; better communication; community services; and long-term care planning. Education and training can be given through video, audio, workshops, and one-on one sessions.6
Last but not least, family caregivers want and need respite care so that they can be relieved from the extraordinary and intense demands of ongoing care, thereby strengthening the familyÛªs ability to provide care. It doesnÛªt have to mean going on a vacation. Taking a break before extreme stress and crisis occurs, can also be simply going to a movie or concert or listening to your favorite music, while someone else cares for your loved one.7
References
- National Alliance for Caregiving. Caregiving in the U.S., 2009.
- AARP Public Policy Institute Report: Valuing the Invaluable: 2011 Update, The Growing Contributions and Costs of Family Caregiving.
- National Alliance for Caregiving. Evercareå¨ NAC Caregiver Cost Study, 2007.
- National Alliance for Caregiving. The MetLife Study of Working Caregivers and Employer Health Care Costs, 2010.
- National Alliance for Caregiving. AlzheimerÛªs CaregiverÛªs Healthcare Costs Increase as Person with Dementia Declines, 2011.
- Schmall, VL, Family Caregiver Education and Training: enhancing self-efficacy, Journal of Case Management, 1995 Winter, 4 (4): 156-62.
- Family Caregiving 101. Respite.
Supplied by Amedisys.