A new RAND Corporation Study
Cost of family caregiving in U.S. estimated to be $522 billion a year, study says
Article By Fredrick Kunkle October 28 2014
The cost of informal caregiving for aging family members in the United States is estimated to be $522 billion a year, or about 15 percent larger than Virginia's entire economy, a new study has found.
The RAND Corp. arrived at the estimate by tallying the hours friends and family devote to elder care and calculating the cost if that work were performed by unskilled workers earning the minimum wage. The cost would be higher - an estimated $642 billion a year - if skilled nursing care was used instead, the nonprofit organization said. By comparison, Virginia's total GDP in 2013 was about $453 billion, according to the U.S. Commerce Department's Bureau of Economic Analysis.
The study also found that three out of five of those family caregivers were also holding down jobs and often sacrificed income to balance their caregiving needs.
"These numbers are huge and help put the enormity of this largely silent and unseen workforce into perspective," Amalavoyal V. Chari, a University of Sussex lecturer and the study's lead author, said in a written statement. Informal arrangements among family and friends are the primary method of elder care in the United States. Previous estimates have found that about one of every five adults is providing care to a relative or friend who is 50 years old or older.
RAND said the study, which was published online in the Health Services Research journal, took advantage of a new U.S. Bureau of Labor Statistics database, known as the 2011 and 2012 American Time Use Survey, to offer a more accurate assessment of the costs of informal caregiving. The BLS survey asks respondents to report the time they spent helping aging relatives with daily activities and their own employment status. RAND researchers said previous attempts to pin down the cost suffered from a lack of detailed, nationally representative data.
National Caregiving Statistics
- Caregiver age has been found to be a major factor associated with informal care.
- The average age of caregivers in the U.S. is 46, and 58% of the caregivers are between the ages of 18-49
- Spousal caregivers were as likely to be men as women, and men were more likely to provide informal care without assistance from others.
- Women tend to maintain the caregiving role longer than men and are less likely than men to request additional informal support.
North Carolina Caregiving Statistics
Who would you call to arrange for short or long term care? Survey Sample Size: 2,997
- Relative or Friend: 20.5%
- Self: 22.4%
- Medical Support: 22.4%
- Religious Support: .2%
- Area department on Aging 1.9%
- Other 3.5%
- Don't know: 26.8%
Average NC Long-Term Health Costs (2007)
|Assisted Living Care
(per year, private room)
|Home Health Aide
Work, Family and Work, Family and Caregiving in North Carolina: Perspectives from Employers and Employees- AARP NC Surveys:(Source)
- 68 percent of employees report that they have been a caregiver, and 88 percent saying that it is emotionally stressful
- 51 percent of employers say that an employee has asked for time off for caregiving, while 32 percent say an employee has requested time off under the Family Medical Leave Act. 62 percent say that caregiving has a major or minor effect on employee performance.
Characteristics and Health of Caregivers and Care Recipients --- North Carolina, 2005:(Source)
- Caregivers reported more days (4.3 days out of 30 days) that their mental health was not good than noncaregivers (3.0 days).
- Most care recipients (67.2%) were female and older than the general population; 64.3% of care recipients were aged >65 years, and 82.8% were cared for by a relative
- Caregivers averaged 20.1 hours per week of care, 13.6% provided >40 hours per week.
- Nearly half (47.3%) of caregivers lived within 20 minutes of the care recipient; 24.9% resided in the same household
- Greatest difficulties experienced from caregiving:
- 29.9% of caregivers cited stress,
- 27.9% cited not enough time for themselves or their families,
- 12.0% indicated that caregiving had created a financial burden,
- 3.5% of caregivers said caregiving created or aggravated health problems,
- 3.7% reported sustaining an injury while caregiving.
Unmet Needs of North Carolinians
- 22.460% of North Carolinians cope with caregiver stress by seeking advice.
- Over 20% of respondents on both surveys indicated needing more help or information in making end of life decisions, managing emotional and physical stress, balancing work and family, and keeping the care recipient safe at home.
- Unlike the national response, caregivers in North Carolina demonstrated a substantial need(37.1%) for more information on "easy activities" to do with the care recipient. This ranks as the second greatest unmet need for North Carolinians and is substantially higher than the 27.1% of respondents nationally who indicated a need for help in this area.
All caregiving statistics for this report taken from:Caregiving: A National Profile and Assessment of Caregiver Services and Needs
Family Caregivng: The Facts from the Centers for Disease Controls and Prevention
- 53.4 million caregivers in the United States provide an estimated $257--$389 billion worth of unpaid care annually to persons of all ages with disabilities and chronic illness.
- 34 million US adults (16% of population) provide care to adults 50+
- North Carolina (2004) has estimated 840,345 family caregivers providing 900 million hours of care per year, worth close to $9 billion.
- The person most likely to be providing care to an older person is an adult child: 41% of all caregivers (caring for person 65+).
- As care recipients age, there is a much higher likelihood of receiving care from a spouse. Nearly one-quarter (22%) of caregivers who are themselves 65+ are caring for a spouse.
- A significant portion of those in the workforce are also providing elder care to family members. Between 25% to 35% of all workers report that they are currently providing, or have recently provided, care to someone 65+.
- Nearly half of caregivers provide fewer than eight hours of care per week, while nearly one in five provide more than 40 hours of care per week.
- The duration of caregiving can last from less than a year to more than 40 years. In a 2003 study, caregivers were found to spend an average of 4.3 years providing care. In another national study, over 40% of caregivers had been providing assistance for 5 or more years, and nearly one-fifth had been doing so for 10+ years.
- Studies have found that caregivers may have increased blood pressure and insulin levels, may have impaired immune systems, and may be at increased risk for cardiovascular disease, among other adverse health outcomes.
- A study of elderly spousal caregivers (aged 66-96) found that caregivers who experience caregiving-related stress have a 63% higher mortality rate than non-caregivers of the same age.
- Depression appears to be the most common psychological disorder, with 20% to 50% of caregivers reporting depressive disorders or symptoms. The higher levels of depression are mostly attributed to people caring for individuals with dementia. Studies show that 30% to 40% of dementia caregivers suffer from depression and emotional stress.
- What is the estimated economic value of informal caregiving? If the services provided by informal caregivers (i.e. family, friends, neighbors) had to be replaced with paid services, it would cost an estimated $257 billion (in 2000 dollars).
- Most people who need long-term care depend exclusively on their family and friends. The vast majority of adults (78%) in the U.S. who receive long-term care at home get all their care from unpaid family and friends, mostly wives and adult daughters. Another 14% receive some combination of family care and paid help; only 8% rely on formal care alone.
- People with moderate dementia have been able to defer institutionalization by nearly a year when their family members receive caregiver support services, including counseling, information and ongoing support.
From the National Clearinghouse for the Direct Care Workforce (NCDCW) and the Paraprofessional Healthcare Institute (PHI) (source)
- Direct-care workers, often called paraprofessionals, include nursing assistants, certified nursing assistants (CNA), home health aids, personal or home-care aids. The majority of these workers are women between the ages of unmarried, and without college degrees. About 50% are white, 30% African American, and 14% Latino.
- In 2003, the Bureau of Labor Statistics (BLS) counted approximately 2.4 million workers in the three direct-care categories it tracks: nursing aides, home health aides and personal assistant workers/aides.
- The direct-care worker at a glance (2007)
- Female: 88%
- Male: 12%
- Average Age: All direct-care workers: 41
- In nursing care facilities: 38
- In home health care: 43
- Self-employed or working directly for private households: 49
- Race/Ethnicity: Minority: 52%
- African American, non-Hispanic: 30%
- Spanish, Hispanic or Latino: 14%
- Immigration Status: Foreign born: 21%
- High school diploma or less: 58%
- Some college or advanced degree: 42%
- Head of Household: Single parent, grandparent or caretaker: 18%
- According to the Bureau of Labor Statistics (2007), home-care aids and home health workers will be the two of fastest growing occupations between 2006 and 2016.
- As the overall demand for direct-care workers is projected to increase by 34 percent over the next decade, adding one million openings by 2016, the number of women aged 25-54, the main labor pool from which these workers are drawn, is projected to increase by less than 1 percent, down from over 18 percent just two decades ago.
- In 2007, the median hourly wage for all direct-care workers was $10.22. This is significantly less than the median wage for all US workers ($15.10).
- Earnings. Assuming full-, year-round employment, median annual earnings in 2007 were:
- $23,160 for Nursing Aides, Orderlies and Attendants
- $20,010 for Home Health Aides
- $18,480 for Personal and Home Care Aides