Our seminar yesterday on the challenge of caregiving for older people drew a large audience who wanted to learn about and discuss what we can do about the anticipated increase in the number of persons over 75 who will require care for longer periods than ever before.
We identified what we called the "challenge of today" and the "potential crisis of tomorrow".
The challenge of today derives from two facts: (1) More older people need care for longer periods of time; and (2) Caregivers are experiencing increasing physical, mental, and financial strains as a result of caregiving. While studies are not definitive, some good, initial research suggests that the increasing strains on caregivers have manifested themselves in worsened health (perhaps 15% of caregivers), more stress and worry (90%), more frequent use of alcohol or prescription drugs (10%), and overall more symptoms of depression and more physical ailments. Articles in the media have documented the extreme steps that spouses and adult children of older people have taken to cope with the financial demands of caregiving - in some cases selling homes and depleting savings to purchase what's needed.
The potential crisis of tomorrow derives from the fact that the current challenge will intensify because the Baby Boom generation, as it ages, will increase the number of older people, without a similar increase in the younger generations that follow them. For many individual Boomers and their families, this will mean a shortage of caregivers; for society as a whole, it will mean an increased "dependency ratio".
We saw broad implications for public policy, business, the care industry, and philanthropy. One of these implications we called the need to "increase caregiver awareness" and to build this awareness into all of our approaches to aging issues, health care, the workforce, and anywhere else that is relevant. Another implication is that the service system needs to make caregiving assessment and support a standard part of its activities. This includes providing an equal role for informal caregivers in planning. (They implement most of the care plans anyway.)
For business, the key implication is human resource flexibility. Options and support need to exist for employees who are caregivers, or else they will either not remain as employees or will work with highly compromised productivity. Options need to exist for older employees to remain working full or part time, in the same or different roles, if they choose to do so. Employees within a decade of the traditional retirement age should see some incentives to shape the next stage of their careers in ways that will help employers to ease the major transition that will occur as Boomers, with their accumulated experience and wisdom, begin to leave the labor force in large numbers.
On the positive side, society will see an increasing number of healthy, retired 65 to 74 year old people. Some of them undoubtedly will want to volunteer. Caregiving should be promoted as an attractive option.
Community-based programs, e.g., block programs and faith-based programs, social support networks, partnerships among service organizations, intermediary organizations and community organizations (where agencies working collaboratively can do more than working in parallel) - these are some ways to help meet the challenge of today.
Preventing, or at least lessening, the crisis of tomorrow will require creativity and flexibility. We may need to make changes in policies that now deter volunteers from doing caregiving (e.g., liability policies or finance/tax policies). More attention to prevention and wellness among healthy older adults may trim slightly the numbers who develop problems that will require caregiving, or might delay the onset of such problems.
Nobody has all the answers, but many good people are concerned and working on it. We are pleased to be part of that effort.