Working with Seniors: Health, Financial, and Social Issues

Chapter 7: Caregivers and Caregiving in America

There are only four kinds of people in the world—those who have been caregivers, those who currently are caregivers, those who will be caregivers, and those who will need caregivers. —Rosalynn Carter

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Caregiving can start abruptly with the onset of a serious illness such as a heart attack or stroke; or the need for care can begin when a person experiences slight limitations associated with growing older . . .

Caregivers face a number of challenges. These include learning basic health care skills; coping with physical, emotional, and financial stress; understanding legal options; assessing the service system; and learning how to balance conflicting demands while dealing with potentially stressful family dynamics.

Some caregivers handle these challenges better than others. Caregiving responsibilities can lead to feelings of love, generosity, and a strengthening of family ties. Some caregivers are thankful for the opportunity to provide care and to share in the final days of the older person’s life.

For others these responsibilities can be overwhelming and lead to isolation, physical illness, financial devastation, and loss of employment. In severe cases, caregiver exhaustion can lead to elder abuse—the financial exploitation, neglect, or mental or physical abuse of an older person.

-- Louise Fradkin and Angela Heath, 1992, pp 3, 6)

Introduction

Caregiving is one person giving care to another. It is a process that often involves a tremendous sacrifice of time, energy, and money. It is often emotionally charged and demanding. Because the majority of your senior clients will, at some point in their later years, be both caregivers and care receivers, it is important for you to understand the process and how to help your clients cope with and manage it.

In all its diversity, caregiving is a global issue, as countries around the world face aging populations. In America, caregiving provided outside of institutions is the backbone of the long-term care system. The value of unpaid care for adults is estimated to be $257 billion annually (AARP, 2004). (“Based on 17.9 weekly hours of care at $8.18 hourly wage and 25.8 million caregivers, the mid-range national estimate of the economic value of informal care in 1997 was $196 billion. Comparing it to available national spending for home care [$32 billion], nursing home care [$83 billion] and total health care [$1,092 billion], we see that the economic value of informal care is equivalent to approximately 18 percent of national health care spending and exceeds spending for home care and nursing home care combined” (Tennstedt, 1999.)

In addition to its economic impact, caregiving exacts a toll on caregivers, who often suffer compromised health, personal financial strain, and intense emotional stress.