America Is Running Out of Family Caregivers, Just When It Needs Them Most
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For generations, the nation has relied on family members to keep aging loved ones in their homes. Today, many Americans are growing older without family nearby, offering a glimpse of what the future may hold for the cohort of Americans who are approaching retirement.
The caregiving crunch comes at a time when Americans reaching retirement age are in a squeeze unseen in generations. Their median incomes, including Social Security and retirement fund receipts, haven’t risen in years. They have high average debt, some incurred from taking care of their own aging parents. And if they’re counting on family to care for them, too, they may well find their families too small and far-flung to meet the task.
Today, an estimated 34.2 million people provide unpaid care to those 50 and older. These caregivers, about 95% family, and long the backbone of the nation’s long-term care system, provide an estimated $500 billion worth of free care annually—three times Medicaid’s professional long-term care spending—and help keep people out of costly institutions, according to a 2017 Merrill Lynch study.
But the supply of these caregivers is shrinking just as the nation needs them most. Every day, 10,000 people turn 65. In 2020, there will be 56 million people 65 and older, up from 40 million in 2010.
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“Families have fewer children, older adults are more likely to have never married or to be divorced and adult children often live far from their parents or may be caring for more than one adult or their own children,” noted a 2016 study by the National Academy of Sciences.
The private sector isn’t an option for many older adults. Demand for private home health aides is expected to exceed supply by more than three million in the next decade. Many can’t afford it even if it was available. A full-time home-health aide costs, on average, $49,000 a year, according to a 2017 Cost of Care Survey by Genworth, a long-term-care insurance company.
Public support hasn’t kept pace either. Medicare and other government programs provide a fraction of the long-term supportive services that people need to remain in their own homes. Medicare generally doesn’t pay for long-term care stays in nursing homes, which can cost close to $100,000 a year for a private room.
After a person has spent down resources, like bank accounts and stocks, Medicaid, a needs-based state and federal program, will pay for most nursing home costs, but coverage and eligibility varies by state. Families are putting together a patchwork of support, which can fray at the first broken hip. Ex-spouses are taking care of former spouses. Childhood friends watch out for parents of peers who moved away. Some grow old on their own.
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Technology can alert remote caregivers to emergencies and keep families in touch, but it doesn’t take the place of having someone there to make sure there is food in the refrigerator. Geriatric care managers, often nurses or social workers, manage care locally but can cost between $50 and $200 an hour.
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https://www.wsj.com/articles/america-is-running-out-of-family-caregivers-just-when-it-needs-them-most-1532094538 (paid subscription)
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