The gap between how many caregivers the United States needs and the number of them available puts a strain on family caregivers. There is a definite caregiver shortage. Caregivers often pay a price in stress, financial loss, and physical strain. The "care chasm" is big and growing wider.
According to the Institute of Women's Policy Research, nearly four million people now fulfill direct care worker positions. The openings though are wide. It is estimated that one million more direct care workers will be needed in 2018. The home health aide care and personal care fields are each projected to grow by about 50%. However, entry numbers into these generally low paying, high demand jobs are lagging. Also, it is estimated that half of all direct care workers leave the field each year.
In addition to paid caregivers, there are tens of millions of unpaid family caregivers. Dhruv Khullar, of the New York Times, estimated that 40 million Americans provide care for elderly persons. A 2016 report by the National Academies of Sciences, Engineering and Medicine (NASEM) put the number at 17.7 million. Both sources agree that the situation is untenable.
Statistically, life expectancies are growing. Yet, older people are not escaping chronic health conditions that render them dependent on help and care, sometimes for years. People are also marrying less and having fewer children. Thus, the family caregiving network has fewer supportive threads but is carrying heavier loads.
As the NASEM report notes, in 2015, each elderly person over 80 years of age had about seven potential caregivers. However, by 2030, the pool will have shrunk to four people. By 2050, there will be a pool of only three potential caregivers.
This does not mean an elderly person in 2050 will have a choice among three available persons. It means that of three adults--some or all still in the workforce, raising their children, and running their households-one of them or a combination will be compelled to provide caregiving.
Coupled with 50% of the professional caregiving workforce quitting the field each year, and shortfalls in people entering it, something must be done to help the caregiver shortage besides continued reliance on family caregivers.
Seniorsmatter.com has reported that family caregivers suffer financial risk. Many reduce work hours, take unpaid leaves, or even quit their jobs to give care. Caregivers are often women and part of the "care chasm" is the gap between the services women, including daughters-in-law, offer compared to men. If anyone leaves the workforce early, they not only lose hundreds of thousands of dollars in wages, but their Social Security benefits are compromised also.
The strain is not only economic. The stress on caregivers is enough to be deadly. A study in the Journal of the American Medical Association found that spouses who cared for disabled spouses had a 63% higher risk of dying than the non-caregiving person over a period of four years. This was after the scientists controlled for sociodemographic factors that influence mortality, as well as existing diseases, including incipient cardiovascular disease. Caregivers literally risk their lives for their care-needing charges.
The caregiver shortage is growing and while family caregivers strain to fill the gap, they will be unable to meet the demands in the long term. Society must do more to help family caregivers who have nobly thrown themselves into an unbridgeable breach.
Hale, John. (December 8, 2016). Paid Caregiver Shortages Will Affect Everyone. The Des Moines Register. Available online at: http://www.desmoinesregister.com/story/opinion/abetteriowa/2016/12/08/paid-caregiver-shortages-impact-everyone/94764864/. Last visited January 17, 2017.
Institute for Women's Policy Research. (February 2013). Increasing Pathways to Legal Status for Immigrant In-Home Care Workers. Washington, D. C. Available at https://iwpr.org/wp-content/uploads/wpallimport/files/iwpr-export/publications/I924_.pdf. Accessed March 1, 2017.
Khullar, D. (January 19, 2017). Who Will Care for the Caregivers? The New York Times. Available at https://www.nytimes.com/2017/01/19/upshot/who-will-care-for-the-caregivers.html?_r=0. Accessed March 3, 2017.
National Academies of Sciences, Engineering, and Medicine. (2016). Families caring for an aging America. Washington, DC: The National Academies Press. Doi: 10.17226/23606. Accessed February 14, 2017.
Schultz, R., Beach, S. R. (December 15, 1999). Caregiving as a Risk Factor for Mortality: The Caregiver Health Effects Study. JAMA, 282(23):2215-2219. Available at http://jamanetwork.com/journals/jama/fullarticle/192209. Accessed March 3, 2017.