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Family Caregiving for Older People


Daniel B. Kaplan

, PhD, LICSW, Adelphi University School of Social Work

Reviewed/Revised Apr 2023

Family caregivers Care Providers: Family and Friends Some older people have family members, friends, or neighbors who are willing and able to provide help and care. Such people may be called caregivers. Occasionally, members of religious or other... read more play a key role in caring for chronically ill older people. Although neighbors and friends may help, almost 90% of help in the home (physical, emotional, social, and economic) is provided by family caregivers. One of every six Americans provides care to a family member age 50 years or older. About 38% of people age 80 or older and 76% of people age 90 or older require routine help with personal care and household tasks. Family caregivers who assist with these routine needs can often delay or even prevent the need for care in residential care facilities.

The amount and type of care provided by family members depend on economic resources, family structure, quality of relationships, and other demands on the family members' time and energy. Some family caregivers provide minimal assistance (for example, periodically checking in). Others provide full-time, complex care. On average, family caregivers for an older person spend about 22 hours a week giving care. Sometimes care is needed for a short time, as when a person is recovering from surgery. Often, care is needed for months or years.

Although society tends to view family members as having a responsibility to care for one another, the limits of such obligations vary among cultures, families, and individual family members. The willingness of family members to provide care may be bolstered by the following:

  • Supportive services, such as technical assistance in learning new skills, counseling services, and family mental health services

  • Supplemental services, such as personal care (including help with grooming, eating, and dressing), home health care, adult day care, and meal programs

Changes in demographics and social values have reduced the number of family members available to care for impaired older relatives. These changes include the following:

  • Increased life span: As a result, the population of the very old has been increasing. Thus, their children, who are potential caregivers, are likely to be old also.

  • Delayed childbearing: Combined with increased life span, this delay has created a sandwich generation of caregivers who care simultaneously for their children and their parents.

  • Smaller family size: There are fewer (and older) children to help with caring for their older family members.

  • Increasing mobility of society and the increased divorce rate: Families are more likely to be geographically separated, and family ties may be weakened. Nonetheless, 80% of people 65 or older live within 20 minutes of one child.

  • An increasing number of women in the workforce: Previously, women may have provided care for older parents, but the demands of a job may diminish or eliminate their ability to do so.

  • An increase in the number of dependent and very sick older people due to improved management of chronic conditions

These factors predict an increasing demand for home care services provided by someone other than family members, friends, and neighbors.

Stresses of caregiving

Although caregiving can be very rewarding, it can also have negative effects. Family caregivers may experience considerable stress and subsequent health problems, isolation, fatigue, and frustration, sometimes leading to a sense of helplessness and exhaustion (caregiver burnout Rewards and Challenges Some older people have family members, friends, or neighbors who are willing and able to provide help and care. Such people may be called caregivers. Occasionally, members of religious or other... read more ) or mistreatment of the older person Overview of Elder Abuse Elder abuse refers to harm or the threat of harm to an older person by another person. Older people can be abused by having harmful things done or said to them or by having necessary things... read more . The effect on the caregiver is likely to be greater when an older person has a serious disorder and/or a severe disability and more care is required.

Caregiving may also become a financial burden. Couples in which one partner cares for the other tend to be disproportionately poor. Sometimes a working caregiver needs to leave full-time employment or reduce work hours to accommodate caregiving.

The COVID-19 COVID-19 COVID-19 is an acute respiratory illness that can be severe and is caused by the coronavirus named SARS-CoV-2. Symptoms of COVID-19 vary significantly. Two types of tests can be used to diagnose... read more pandemic created more problems for family caregivers because it required isolation and disrupted formal care, Family caregivers reported substantially more stress, anxiety, depression, sleep disturbances, fatigue, food insecurity, and financial worries. They were less able to interact with other people and participate in their usual social activities.

Caregivers and/or the older person can talk to health care professionals about getting help, and health care professionals should offer such help, which includes

  • Connecting caregivers to social workers

  • Coordinating interdisciplinary care

  • Referring them to services they need, such as counseling (individual, family, and/or group) and education about the older person's condition and available treatments

  • Making sure older people receive all the benefits they are eligible for, including financial support, training, and respite care (time away from caregiving)

  • Providing immediate and ongoing emotional support

  • Suggesting organizations that providing practical help with daily tasks

These measures can often give caregivers the reassurance they need. Caregivers can be given helpful information and/or learn strategies for caregiving from doctors, nurses, social workers, and other health care professionals.

Caregivers can also take the following measures to prepare themselves for caregiving and to avoid caregiver burnout Avoiding Caregiver Burnout Avoiding Caregiver Burnout :

More Information

The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

  • Caregiving in the United States 2020: At this web site, the National Alliance for Caregiving (NAC) and American Association of Retired Persons (AARP) provides information about caregiving in the US, such as the types of caregiving caregivers do, such as help with daily activities (including personal care), coordinating health care from different health care professionals, and helping with medical and nursing tasks (such as injections and tube feedings). Accessed 4/1/23.

  • Medicaid's Home Care Benefits: This web site provides information about the types of home care that are covered and eligibility, waivers, and applications for coverage. Accessed 4/1/23.

  • Family Medical Leave Act (FMLA): This web site provides information about FMLA eligibility and benefits from the US Department of Labor. Accessed 4/1/23.

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