Caregiving

A Public Health Priority

Caregivers provide assistance to someone who is, in some degree, incapacitated and needs help (Family Caregiver Alliance, 2005).  The recipients of care live in both residential and institutional settings, and range from children to older adults.  Typically, they have a chronic illness or disabling condition and need ongoing assistance with everyday tasks to function on a daily basis (Family Caregiver Alliance, 2006a).

Caregiver demand is partially driven by the steady increase in our older adult population.  As the number of older Americans rises, so does the number of needed caregivers (Talley & Crews, 2007).  In 2030, when all baby boomers will be at least 65 years old, the population of adults in this age group is projected to be 71 million (Administration on Aging, 2007). The number of people 65 years old and older is expected to rise by 101% between 2000 and 2030, at a rate of 2.3% each year.  Unfortunately, however, over that same 30-year period the number of family members who are available to provide care for these older adults is expected to increase by only 25%, at a rate of 0.8% per year (Mack & Thompson, 2001).

Caregiving exacts a tremendous toll on caregivers’ health and well-being, and accounts for significant costs to families and society as well. Family caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality (Kiecolt-Glaser & Glaser, 2001; Light & Martin, 1996; Schulz, O'Brien, Bookwala, & Fleissner, 1995; Schulz & Beach, 1999).  Over half (53%) of caregivers indicate that their decline in health compromises their ability to provide care (Evercare & National Alliance for Caregiving, 2006).

Research over the past several decades has yielded a wealth of information on interventions to support caregivers and improve their health and well-being.  Some important examples related to family caregivers for persons with Alzheimer’s disease (Belle et al., 2006; Burgio, Collins, Schmid, Wharton, McCallum, & DeCoster, 2009; Mittelman, Haley, Clay, & Roth, 2006).

References

Administration on Aging. A profile of older Americans: 2005.(2007). Washington, DC, Department of Health and Human Services.

Belle, S. H., Burgio, L., Burns, R., Coon, D., Czaja, S. J., Gallagher-Thompson, D. et al. (2006). Enhancing the quality of life of dementia caregivers from different ethnic or racial groups: a randomized, controlled trial. Ann.Intern.Med., 145, 727-738.

Burgio, L.D., Colline, I.B., Schmid, B., Wharton, T., McCallum, D., & DeCoster, J. 2009.  Translating the REACH caregiver intervention for use by Area Agency on Aging personnel:  The REACH OUT program.  The Gerontologist, 49, 103-116.

Family Caregiver Alliance (2005). Fact Sheet:  Selected Caregiver Statistics. Available: http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=439

Kiecolt-Glaser, J. K. & Glaser, R. (2001). Stress and immunity: Age enhances the risks. Current Directions in Psychological Science, 10, 18-21.

Light, J. K. & Martin, R. E. (1996). American Indian Families. Journal of American Indian Education, 26.

Mack, K. & Thompson, L. Data Profiles, Family Caregivers of Older Persons: Adult Children.  (2001). Georgetown University, The Center on an Aging Society.

Mittelman, M. S., Haley, W. E., Clay, O. J., & Roth, D. L. (2006). Improving caregiver well-being delays nursing home placement of patients with Alzheimer disease. Neurology, 67, 1592-1599.

Schulz, R. & Beach, S. R. (1999). Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. JAMA, 282, 2215-2219.

Schulz, R., Martire, L. M., & Klinger, J. N. (2005). Evidence-based caregiver interventions in geriatric psychiatry. Psychiatr.Clin.North Am., 28, 1007-38.

Schulz, R., O'Brien, A. T., Bookwala, J., & Fleissner, K. (1995). Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes. Gerontologist, 35, 771-791.

Talley, R. C. & Crews, J. E. (2007). Framing the public health of caregiving. Am.J.Public Health, 97, 224-228.