Rural Family Caregiving AgrAbility Conference Burlington, Vermont November 2005 Gail Gibson Hunt...
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![Page 1: Rural Family Caregiving AgrAbility Conference Burlington, Vermont November 2005 Gail Gibson Hunt National Alliance for Caregiving.](https://reader036.fdocuments.in/reader036/viewer/2022082417/56649ebf5503460f94bca774/html5/thumbnails/1.jpg)
Rural Family CaregivingRural Family Caregiving
AgrAbility Conference
Burlington, Vermont
November 2005
Gail Gibson Hunt
National Alliance for Caregiving
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Family Caregiving in the US
• Latest research shows:
• 44.4 million caregivers (1 in 5 people)– 34 million caring for those 50+
• Profile: 46-year-old baby boomer woman who works and cares for her mother who lives nearby
• Nearly 40% are men
![Page 3: Rural Family Caregiving AgrAbility Conference Burlington, Vermont November 2005 Gail Gibson Hunt National Alliance for Caregiving.](https://reader036.fdocuments.in/reader036/viewer/2022082417/56649ebf5503460f94bca774/html5/thumbnails/3.jpg)
More About Caregivers In General
• 80% of care provided to older people is unpaid care by family and friends
• Economic value of caregiving to society: $257 billion/year
• 15-20% of the workforce
• Average $200/mo. out-of-pocket
![Page 4: Rural Family Caregiving AgrAbility Conference Burlington, Vermont November 2005 Gail Gibson Hunt National Alliance for Caregiving.](https://reader036.fdocuments.in/reader036/viewer/2022082417/56649ebf5503460f94bca774/html5/thumbnails/4.jpg)
Who are the care recipients?
• 83% are relatives, most often mother, mother-in-law, grandmother
• Average age of older care recipient: 75• 23% have Alzheimer’s or other
dementia• Principal problems or diagnoses: “old
age”, cancer, diabetes, heart disease
![Page 5: Rural Family Caregiving AgrAbility Conference Burlington, Vermont November 2005 Gail Gibson Hunt National Alliance for Caregiving.](https://reader036.fdocuments.in/reader036/viewer/2022082417/56649ebf5503460f94bca774/html5/thumbnails/5.jpg)
Intensity of Caregiving
• Average of 21 hours per week• Those who say “constant care” (40+
hours per week) tend to:– Be co-resident– Be in fair or poor health themselves– Care for someone with Alzheimer’s– Have lower income
• ADLs and IADLs
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Helping with IADLs
Percent
Transportation 82
Grocery shopping 75
Housework 69
Managing finances 64
Preparing meals 59
Helping with medication 41
Managing services 30
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Helping with ADLs
Percent
Getting out of beds and chairs 36
Getting dressed 29
Helping bathe or shower 26
Getting to and from the toilet 23
Feeding care recipient 18
Dealing with incontinence or diapers
16
![Page 8: Rural Family Caregiving AgrAbility Conference Burlington, Vermont November 2005 Gail Gibson Hunt National Alliance for Caregiving.](https://reader036.fdocuments.in/reader036/viewer/2022082417/56649ebf5503460f94bca774/html5/thumbnails/8.jpg)
Unmet NeedsPercent
Finding time for myself 35
Keeping the person I care for safe at home 30
Balancing my work and family responsibilities 29
Managing my emotional and physical stress 29
Easy activities I can do with the person I care for 27
How to talk with doctors 22
Making end-of-life decisions 20
Moving or lifting the person I care for 16
Managing challenging behaviors, such as wandering 14
Choosing an assisted living facility 13
Choosing a home care agency 13
Managing incontinence or toileting problems 11
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Impacts of Caregiving
• Financial: $200 per month out-of-pocket• Emotional: One-third report caregiving is • somewhat or very stressful• Physical: Only 15% report strain• Health:
– 17% of all caregivers report fair or poor health– 35% of those doing most intense caregiving– More physician visits
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Caregiving and Work
• About 60% of caregivers work
• Percent of those who make any workplace accommodation: 62%
Total %
Come in late, leave early
57
Took leave of absence
17
Full-time to part-time
10
Lost job benefits
5
Turned down promotion
4
Chose early retirement
3
Gave up work entirely
6
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MetLife Studies
• 1997 Employer Costs for Working Caregivers
• $11.4b to $29b per year
• Juggling Act Study• $659,000 loss in terms of wages,
pensions and social security over a “career” of caregiving
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Who are the rural caregivers?
• 27% of caregivers live in rural areas: approx 12 million people
• Demographically, look very similar to urban/suburban caregivers
• Some differences: rural caregivers are more likely to
– Be married; have kids under 18 living with them– Be Caucasian– Have less formal education and lower income– Less likely to be employed
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Some other differences of rural caregivers
• More likely to use prayer as a coping mechanism
• Less likely to turn to the Internet for information; more likely family and friends
• Less likely to use support groups, adult day care services, transportation services
• More likely to be Level 5 in intensity; 20% are doing “constant care”
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Who are the rural care recipients?
• 27% live in rural areas• Typically a mother (23%); grandmother
(10%); or father (9%)• More likely to still be married• Most common illnesses: arthritis; blindness;
diabetes; mobility; less dementia• Somewhat less likely to need incontinent care• Two-thirds live nearby or in the same house
as the caregiver
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More characteristics of rural care recipients
• Their caregivers are more likely to experience financial hardship: between $24-34/month more in out-of-pocket
• More likely to be a vet
• More likely to report home modifications
• Their caregivers are less likely to get unpaid help other than themselves
![Page 16: Rural Family Caregiving AgrAbility Conference Burlington, Vermont November 2005 Gail Gibson Hunt National Alliance for Caregiving.](https://reader036.fdocuments.in/reader036/viewer/2022082417/56649ebf5503460f94bca774/html5/thumbnails/16.jpg)
Interface between formal and informal care not well understood
• Presumption that limited access to formal care increases importance of informal care
• Shenk’s view that rural elders may be more independent and hesitant to seek help vs. Buckwalter & Davis’s view that they lack information on services and hesitate to use because of “welfare” stigma
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Important factors in designing rural services
• Recognition that rural communities are diverse in population characteristics, values and culture.
• Initiatives that involve local residents during the design, planning and implementation stages.
• Recognition that geographic distance is not only a geographic barrier, but a psychological barrier as well.
• Initiatives that recognize the importance of fictive kin, neighbors and friends in rural support systems that may contain few close relatives because of out-migration.
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More important factors in designing rural services
• Service and access hours that reflect the needs of working caregivers – on a variety of work shifts.
• Outreach and service design factors that do not stigmatize the caregiver or the care recipient.
• Mobile options that bring assessment, services and support to the caregivers and their care recipients.