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The Coming Age of the Family Caregiver

The next 30 years will be defined by the quality of care we provide for our elders. How will the baby boomers age and die? How are we as their kids going to care for them well and honor their memory and legacy? What kind of lives will we review?
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I love listening to life stories. As a hospice chaplain, I loved sitting with our patients and their loved ones engaging in what many hospice teams call "life review." When did you meet your spouse? When was Reggie born? What is your favorite holiday? When did you learn you were ill? These are the types of questions asked when doing life review, and the stories come pouring forth.

Of late, I've been listening to the life stories of Gen X individuals whose baby boomer mom or dad, stepmom or stepdad, died in the fall of 2010. Each story is unique and beautiful, full of grace-filled surprises found in the midst of daily survival. As they review the life of the parent who has died through the lens of caregiving and grieving, we catch a glimpse of how the first wave of the baby boomers is aging and dying.

Most baby boomers are fascinated by the project and actually volunteer to talk with me themselves. I have to then explain that although I'm sure that their life story is fascinating, it's really their story as seen through their children and stepchildren's eyes that we are wanting. So, in order to be a part of the project they would have to die. Their eyes widen and they proclaim, "Die? What?!?!?" Mortality seems anathema to many boomers, which should not surprise us since optimism has long defined this massive generation. A recent survey conducted by the McKinsey Global Institute highlights the enduring optimism of aging boomers: 86 percent say that "I have always believed I deserve a good life," and 78 percent believe that they control their own destiny and can handle anything life throws at them.

Despite a robust, optimistic outlook, the baby boomers will soon live the adage: "Time and death waits for no one." As they baby step into old age, our society will face the burden of the largest elderly population ever. According to the Federal Intragency Forum on Aging:

"The baby boomers (those born between 1946 and 1964) will start turning 65 in 2011... The older population in 2030 is projected to be twice as large as their counterparts in 2000, growing from 35 million to 72 million and representing nearly 20 percent of the total U.S. population. The U.S. Census Bureau projects that the population age 85 and over could grow from 5.7 million in 2008 to 19 million by 2050. Some researchers predict that death rates at older ages will decline more rapidly than is reflected in the U.S. Census Bureau's projections, which could lead to faster growth of this population."

Baby boomers will live longer and in greater numbers than ever seen before with few youngsters to support them financially and physically. According to page 10 of The Coming Generational Storm, Kotlikoff and Burns compute that "by 2030, the senior to kid ratio will be three to one!"

What will ensure that the baby boomers have space and time to age gracefully? Who will take up that mantle? That our current healthcare system is less than adequate to support the needs and expectations of the "silver tsunami" of the baby boomers is far from new. Volumes have been and continue to be written on how Medicare and the long-term care system need massive overhaul, and so I won't enter that minefield. My mind goes to the home. I think of how as the boomers begin to age, they will need "informal" or "family" caregivers by the thousands. "Informal caregiving" can be defined as "unpaid care given voluntarily to ill or disabled persons by their family and friends." (For a good overview of informal caregiving, see the 1998 study on informal caregiving conducted by the U.S. Department of Health and Human Services.) Informal caregivers assist a parent, friend or neighbor with completing normal activities of daily living ranging from driving, grocery shopping, taking medication, managing money, to even more personally vulnerable activities like bathing, dressing, using the toilet or eating.

In past generations, a less debilitated spouse would tend to be on the front line of caregiving, but there are a shockingly high number of single boomers. According to the same survey of the McKinsey Global Institute, by 2015, 46 percent of all boomers aged 65 and above will be unmarried, creating 21 million unmarried households. For the same age group in 1985, there were only 10 million unmarried households. In an age marked by high rates of divorce, either the role of an ex-spouse will change or an adult child will be forced to move forward in line to act as the primary caregiver and decision maker for an aging parent. Considering that already the most common form of informal caregiving relationship is that of an adult child assisting an elderly parent, the increased caregiving burden on Gen X and Millenials of the future will demand creative work, family, financial and practical solutions that just don't exist yet.

According to the AARP, most informal caregivers provide an average of 21 hours of care per week, so basically a part-time job. They paint a picture of informal caregiving where caregivers assume responsibility for their loved one's day to day care, triage any health care crises, absorb financial burdens big and small, and tend to underestimate how much time and how stressful being a caregiver will truly be. As a mother of three, these observations sounded a lot like caring for a toddler. It shouldn't have surprised me then when their data showed that "a typical caregiver in the US is a 46-year-old woman who works outside the home."

Hmm... That sounds a lot like me and my friends in a few years... We have jobs, kids, friends, hobbies and parents... and my anxiety rises as I think about 2030! How will my life story be changing?

Rosalynn Carter once said, "There are four kinds of people in this world: those who have been caregivers, those who currently are caregivers, those who will be caregivers and those who will need caregivers."

The next 30 years will be defined by the quality of care we provide for our elders. How will the baby boomers age and die? How are we as their kids going to care for them well and honor their memory and legacy? What kind of lives will we review?

For more by Rev. Amy Ziettlow, click here.

For more on caregiving, click here.

To read more from Amy Ziettlow on aging, death, and dying visit To learn more about the project, "Homeward Bound: How We Live When a Parent Dies," see here.

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