Caregivers and Care Receivers:Understanding the Impact on Families

Part 1: Caregivers’IssuesJanuary 22, 2017

Second Presbyterian Church

Presenters

Charles Harlan - Certified Structured Settlement Consultant

Cindy Levering - Associate of the Society of Actuaries

We’re all in this together!

Have you had personal experience caring for a family member?

What challenges did you face?

What resources did you access?

What resources were missing?

Today’s Agenda

Understanding the data

Defining “caregiving”

Dealing with stress factors

Summary

Identifying resources

Preview of Part 2

Questions

Key Data on Caregiving

• By 2030 there will be 72.1 million older

Americans age 65+

• 22.6% of the current U.S. population

• Of that group, over 50 million will

experience a long-term assisted care event

• 30% of Americans currently providing

long-term assisted care for a family

member

Key Data on Caregiving

• Largest segment of caregivers between 45

and 64 years of age.

• 47% of working caregivers reduce or deplete

savings to cover caregiver expenses.

• 80% of primary and 50% of secondary

caregivers have reduced their retirement

savings to cover care assistance expenses.

Key Data on Caregiving

• 43.5 million adults have provided unpaid

care to an adult or a child in past 12 months.

• Estimated number of adult caregivers is 39.8

million (12.5% of U.S. population).

• Estimated number of child caregivers (under

age 18) is 6.5 million.

Key Data on Caregiving

• Caregivers by gender: 60% female; 40%

male

• 82% of current caregivers are taking care of

one person.

• The average age of a caregiver is 49.

Key Data on Caregiving

• 85% of caregivers are caring for a relative

and 49% for a parent or in-law.

• One in 10 caregivers are caring for a spouse.

• “High-hour” caregivers are almost four

times as likely to be caring for a spouse or

partner.

Key Data on Caregiving

• Three in five care recipients have long-term physical

conditions.

• More than a third have short term physical conditions.

• 25% have memory problems and 37% have multiple

conditions.

• 18 million caregivers are routinely marginalized and

ignored within the health care system

Define CaregivingCaregiving starts with assistance for

Instrumental Activities of Daily Living

(Lawton IADL Scale):Ability to Use the Telephone

Shopping

Food Preparation

Housekeeping

Laundry

Mode of Transportation

Responsibility for Own Medications

Ability to Handle Financeshttp://micmrc.org/system/files/IADL.pdf

Define Caregiving

Caregiving progresses to assistance with

Activities of Daily Living (Katz ADLs):

Transferring (43%)

Dressing (32%)

Toileting (27%)

Bathing (26%)

Feeding (23%)

Incontinence (16%)

https://consultgeri.org/try-this/general-assessment/issue-2.pdf

Define Caregiving

• Family caregivers are increasingly

performing tasks nurses typically perform,

such as injections and tube feedings.

• Over 50% of caregivers self-reported that

they had no choice in taking on their

caregiving responsibilities.

https://www.caregiver.org/caregiver-statistics-demographics

Stress Factors

• One in five caregivers reports a high level of

physical strain resulting from caregiving

• Two in five consider caregiving to be

emotionally stressful.

• One in five caregivers reports a high level of

financial strain

Stress Factors

• Six in ten caregivers report being employed at

some point in the last year.

• Among them 56% reported working full-time.

• Average amount of work: 34.7 hours a week.

• Caregivers working 30 hours a week are more

likely to report having workday interruptions as

a result of caregiving.

Stress Factors

Six in ten caregivers reported making

accommodations such as:

* Cutting work hours.

* Taking a leave of absence.

* Receiving a warning about attendance.

SOA 2015 Risk Survey

• Online Survey

• Sample size: 2,233 total (1,035 pre-retirees, 1,005

retirees, 193 oversample of retired widows)

• Ages 45 to 80

Paid long-term care can be a financial

disaster for most families

• Those who step in to manage finances are often

involved in other aspects of care

• The need for long-term care arose primarily because of

cognitive issues caused by dementia, a stroke, or other

neurological event

• Very few have long-term care insurance

• Many care for someone who lived at home until the

burden of care became too high

• Care costs can run in the hundreds of thousands of

dollars

More than half of retired widows have

provided care for others during their

retirement

Pre-retirees are somewhat more likely to anticipate

providing care by arranging outside services and

helping with personal needs

Arranging outside services

Helping with personal needs such

as getting in and out of bed,

getting dressed, toileting, bathing,

or feeding

Administering medications

Something else

Most common types of care provided

Checking in regularly to see how

they are doing

Helping with household chores,

such as preparing meals,

housework, or shopping

Providing transportation

Communicating with healthcare

professionals on their behalf

Managing finances

Easing the Financial Burden

Hire professional advice

Talk to utility companies

Check out thrift stores

Utilize social media

Take time making financial decisions

http://money.usnews.com/money/personal-finance/family-

finance/articles/2016-12-09/how-family-caregivers-can-ease-the-financial-

burden

Easing the Personal Burden

Take a quick break

Invite others in

Carve out “down time”

Turn to friends

Consider adult day care

Squeeze in exercise

Revel in nature

http://money.usnews.com/money/personal-finance/family-

finance/articles/2016-12-09/how-family-caregivers-can-ease-the-financial-

burden

Easing the Personal Burden

Listen to music

Calm your mind

Resist isolation

Join a “festival”

Find support

Share your story

Give yourself credit

http://money.usnews.com/money/personal-finance/family-

finance/articles/2016-12-09/how-family-caregivers-can-ease-the-financial-

burden

Summary

• Our population is rapidly aging.

• The number of available family members in

younger generations is diminishing.

• Nearly 40 million Americans who provide

unpaid care to an adult are an extension of, and

a partner with, our formal healthcare and long-

term services supports (LTSS) systems.

Summary

It is essential to support caregivers by –

• Identifying and helping those who are most at risk for

deteriorating health, financial security and quality of

life.

• Identifying and advocating for programs that could

make a real difference in their well-being as well as

their ability to continue to provide care.

• Helping them balance employment and unpaid care.

Summary

It is essential to support caregivers by –

• Encouraging families to proactively plan and discuss

aging and health/disability.

• This includes plans for future care and scenarios where

the current unpaid caregiver may no longer be able to

provide care.

Summary

It is essential to support caregivers by –

• Extending training to caregivers who perform ADLs,

medical/nursing tasks, and other activities

• This includes communicating and interacting with the

formal care system.

• One third of caregivers say health care providers, such

as a doctor or a nurse, or a social worker has asked

about what the caregiver needs to take care of

him/herself.

Summary

It is essential to support caregivers by –

• Advising them to document their identity in the care

receiver’s medical record and check those records at

every visit for emergency contact information.

• Encouraging them to acknowledge and discuss their

abilities and limitations as a caregiver.

• Helping them understand their HIPAA privacy rights.

ResourcesWays Family Caregivers Can Ease The Financial Burden

http://money.usnews.com/money/personal-finance/family-

finance/articles/2016-12-09/how-family-caregivers-can-ease-the-financial-

burden

Registered Nurse In-Home Assessment (Independent)http://caregivingexchange.com/agis/caregiver-exchange/rn-in-home-

assessments

Caregivers Mallhttp://www.firststreetonline.com

Caregivers Kithttp://www.agis.com/caregiverkit/default.aspx

Monthly Online Caregivers Articles and Resources

Resources

Maryland Department of Aging (and its resources)http://aging.maryland.gov/Pages/default3.aspx

American Psychological Association (and its resources)http://www.apa.org/pi/about/publications/caregivers/faq/index.aspx

Overview of Maryland’s CARE Act (effective 10/1/16)http://www.mhaonline.org/docs/default-source/publications/update-

links/care-act---what-hospitals-need-to-know.pdf

Resources

Ombudsman Program

http://aging.maryland.gov/Pages/Ombudsman.aspx

Society of Actuaries’ Decision Brief –

https://www.soa.org/Files/Research/research-pen-long-term-care.pdf

AARP Care Connectionhttps://careconnection.aarp.org/en/home.html

AARP Care Card & other resourceshttp://states.aarp.org/help-family-caregivers-2/?CMP=RDRCT-STATES-

MD-CAREGIVING-100316

CARE Card

Preview of Part 2

• Available strategies to finance long-term

assisted care risk

• How to conserve assets and “planned for” later

life income

• Transfer of assets at death for designated

purposes, including charitable organizations

Questions?