The Cost of Caregiving

Family support is critical to remaining in one’s home and in the community.  If family caregivers were no longer available, the economic cost to the US healthcare systems would increase astronomically.

In 2009, about 42.1 million family caregivers in the US provided care to an adult with limitations in their daily activities at any given point in time.  And, about 61.6 million provided care at some time during the year.

The estimated economic value of their unpaid contributions was approximately $450 billion in 2009, up from an estimated $375 billion in 2007.  The report also explains the contributions of family caregivers, and details the costs and consequences of providing family care.

In today’s economic climate, family caregivers remain the backbone of our nation’s long term care system.  Their unpaid contributions, along with those of friends and neighbors, include not only personal care and help with everyday tasks, but also health related activities, like administering medications.

The “typical” US caregiver is a 46 year old woman who works outside the home and spends more than 20 hours per week providing unpaid care to her mother.

The caregivers are improving the quality of life for the ones they care for and reducing the use of nursing home and inpatient hospital care. This is sometimes at a cost to the caregivers themselves, though.

The estimated economic value of caregiving is calculated based on the number of caregivers at a given point in time, providing an average of 20 hours of care per week, at an average value of a little more than $10 per hour. These estimates were from data collected from various surveys.  What ever the figure calculates to be, the estimate is conservative.

Moreover, the “opportunity costs” of foregone wages and non-wage benefits costs the caregivers themselves.  It often creates economic insecurity due to changes in their work patterns.  The loss of wages, health insurance and other job benefits, retirement savings, and Social Security benefits holds serious consequences for caregivers.  More than one-third (37%) of caregivers, to people age 50 or older, reported quitting their job or reducing their work hours.  Another recent study found that midlife women in the labor force who begin caregiving are more likely to leave the labor force than to reduce their hours.

Caregivers are at risk of becoming “patients” themselves. The greater the intensity in the type or quantity of assistance provided, the greater the magnitude of the health effects, which were largely due to chronic stress.

Evidence that family caregiver support delays or prevents the use of nursing homes continues to accumulate.  People who have family caregivers tend to have shorter hospital stays, while the absence of a family caregiver has been linked to hospital readmissions.  Informal care by adult children reduces Medicare inpatient expenditures of single older people, as well as expenditures for home health and skilled nursing facility care.

The role of family caregivers as critical partners with professionals in the care of patients with chronic illnesses, along with the need for better communication with and support of family caregivers is essential.   Interventions that focus on the roles of family caregivers during care transitions show positive results, ranging from better patient outcomes in functional status and quality of life to reduced re-hospitalizations.  For example, better discharge planning involving family caregivers during transitions from hospital to home may not only improve quality of care, but also help to avert early hospital readmission.

It is essential to prevent family caregivers from being overwhelmed by the demands placed on them. The cost of funding more services and supports for caregivers is minute compared to the value of their unpaid contributions. Moreover, caregivers help contain health and long term care costs by delaying or preventing the use of nursing home care and hospital inpatient care.