What’s Different About Family Caregiving Today?

This is a pivotal time. Converging sociodemographic trends and more complex care needs are contributing to historically unprecedented challenges in family care of older people in the U.S.

For most of human history, requiring help in old age was uncommon. As Atul Gawande writes in Being Mortal, “The natural course was to die before old age.”

Only 41 percent of people born in 1900 survived to age 65.

In sharp contrast, an estimated 84 percent of people born in 2010 will live to age 65 or older. In the past three decades, the population 90 years and older has nearly tripled. The majority of the very old have one or more disabilities and need supportive services.

There is no going back to the “old days” of family caregiving.

Historically, most care for older relatives was short term. It was an expected role of women, who typically did not work outside the home. Care was provided within the privacy of the extended family, all usually living nearby.

Today, families and care needs are changing at a dizzying pace.Young and old holding hands

The caregiving tasks we ask of families are more complex, overwhelming, costly and difficult to manage than ever. And the situation is urgent: A new study shows that boomers will drive up Alzheimer’s-related costs from $307 billion in 2010 to $1.5 trillion by 2050.

Although recent research shows that 90 percent of unpaid caregiving for people 65 and older currently is provided by family members, we face a growing care gap. Reliance on families to provide care in the way it was delivered in the past is unsustainable.

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The modern family looks very different than our grandparents’ generation.

Never before have so many women, the traditional family caregivers, been in the paid labor force. Yet, unlike the old days, a woman’s “provider” role is no longer confined to staying home and taking care of families’ everyday living needs.

Today, two wage earners are needed in most households to support families economically and to ensure retirement security. Among 55- to 64-year-olds (the most common age group to take on eldercare responsibilities), older women’s labor force participation increased from 41 percent in 1980 to 59 percent in 2012 — and is projected to reach 67 percent by 2020.

Several demographic shifts illustrate the dramatic changes in family composition, creating complex family structures for caregiving. The share of U.S. adults who have never married is at a historic high. About 1 in 5 (20 percent) adults (25 and older) have never been married, up from 9 percent in 1960. Greater divorce among people 50 and older, and more remarriage (especially among older adults) may also affect patterns of family care in the future.

Public policies need to adjust to the realities of the changing American family.

Many experts believe that our nation’s lack of a comprehensive, coordinated and affordable long-term care system intensifies family caregivers’ insecurity. Working families are increasingly left on their own to fill greater care gaps.

New policies are needed for a better system of community-based long-term care and family support. Also needed is a larger and higher-quality paid workforce to provide supportive services and mechanisms to help families afford paid care.

Lynn Friss FLynn Friss FFeinberg2einbergeinberg is a senior strategic policy adviser for the AARP Public Policy Institute. She has conducted policy analysis and applied research on family caregiving and long-term services and supports issues for more than 30 years.






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mk33958407 5pts

Rewarded? I feel abused both by banks and social services. After my father died, my mom is bed bound- stroke! I am the only daughter and caregiver. yes, I have to work as well and pay my son's college. I am trying very hard to help my mother the best I can but I do not feel that it is deemed important or valued by anyone.

cr6943 5pts

Generally, this may be true, but my grandmother took care of, in her small home, not only her parents but her husband's parents, while working and raising an adopted child 16 years younger than my mother, and after raising her youngest sister, of 11 children, after her mother contracted TB. She was in her 40s and early 50s then but seemed much older to me due to the fact she married and took on family responsibilities at a much younger age than we do now.  Additionally, her husband was older than she and left her a widow, and a single wage earner, at a relatively early age.  This was during the mid-1940s into the early 1960s.   My mother, despite the new opportunities for her own career, brought on by the women's movement and ERA, took care of her mother in our home.  This demonstrates that even though we may be living longer, women have assumed the primary caretaker role, whether it has been early in their lives or later as is the case now for women who have delayed marriage and/or childbirth.  A more modern development is for men to assume the stay at home dad role and along with it, assist with care and oversight of their parents.

Bottom line, women traditionally have been the primary caregivers, and/or raising children full time, but yet we continue to lack national tax polices or other means of compensating and acknowledgement of the societal and economic benefits of family care taking --whether it be women or men.  We need to establish the worth and value to society of this important work which has been done silently for decades -- and is work that adds untold value and worth to our GNP.

cr6943 5pts

Generally, this may be true, but my grandmother took care of, in her home, not only her parents but her husband's parents, while working and raising a child 16 years younger than my mother, and after raising her youngest sister, of 11 children, after her mother contracted TB.  This was done on a limited salary, with some financial assistance from her sister for the care of their mother and father, all through the 1940s and the early 1960s.  She was probably in her 40s.