Compensating Care

In a recent blog post, I discussed the future of long term care in America. In our policy class, we recently started discussing aging in America and the different facets to that face. One issue I was personally struck by was how many people are unpaid caregivers for a family member or loved one. The National Partnership for Women and Families reports that by 2050 the elderly population is expected to be nearly 88 million people, or 20 percent of our population (NPWF, 2015). These people face a large burden of chronic disease and other medical issues. When health problems arise, often times it is close family members who have to step up to take care of their elders. Unfortunately, there is no financial compensation for this work. Many people are forced to leave their jobs or put their own health on the backburner to work as a caregiver and also maintain another job. Across the United States there are at least 43.5 million unpaid family caregivers. Most of these people have paying jobs that are unrelated to caregiving services. Half of all these people still work full time. When an unfortunate medical event happens, these caregivers need time off to properly take care of their family while maintaining their own mental wellbeing (NPWF, 2015). Seven in ten caregivers report that they have to make accommodations at their workplace to take care of their loved ones. When the average caregiver over 50 loses the workforce to care for their parent, they can expect to lose $303, 880 in private pensions, social security and wages. If they are a woman, that number rises to $324,000 (NPWF, 2015). More than the financial burden these caregivers face, common experiences include depression, frustration, stress, higher rates of chronic disease and a diminished immune response (NPWF, 2015).

     The unpaid caregiver conundrum creates a vicious cycle. We need to institute policies that will help relieve the burden of unpaid family caregivers. There needs to be mandated paid family and medical leave for employees. Currently, only 13% of workers have access to this type of leave. In place we have the Family and Medical Leave Act (FMLA) but that only provides access to unpaid, job protected leave for 60 percent of the workforce. There are still 60 million people who do not have protection under the FMLA. This policy should be expanded to cover everyone, but I also think we need to do more. Many Americans, even if they have FMLA protection, cannot take the leave because they cannot afford to take that unpaid break (NPWF, 2015). As a country we need to institute policy that enacts mandatory paid family and medical leave for people when they have to take on the role of an unofficial caregiver. Employers required to offer health insurance should also offer paid family medical leave. As mentioned earlier, being an unpaid family caregiver, leads to costly negative health outcomes like higher rates of chronic disease. Offering paid family medical leave can lower rates of associated negative health outcomes and thus lower costs of insurance. These policies should be available to anyone no matter their career or where they live. Another beneficial policy would be increased access to mental health services for caregivers. This could be tied into insurance policies. The associated rates of stress and depression that caregivers face require attention. It is like the airplane-oxygen analogy, you have to put your own oxygen mask on before you help others with theirs. If the caregivers slip into poor health, they will not be able to provide adequate care to their loved ones. There should be support groups created to help build community and let people know they are not alone. Overall, these policies represent just the beginning of creating a nation where caregivers are given the compensation they deserve and need. At the same time, this is a step in the right direction for more comprehensive policy related to this issue. As healthcare leaders I believe we have a moral responsibility to lobby for issues that relate to the health and wellness of our population. This particular issue is pressing and I am glad it was brought to my attention through my education!

Report from the National Partnership for Women & Families: http://www.nationalpartnership.org/research-library/work-family/paid-leave/older-adults-and-caregivers.pdf