If you are a boomer, chances are good that you are more concerned about providing appropriate care to aging parents than about the help you might need someday. Families are the key caregivers to America's elderly and play a critical role in helping them maintain their independence, according to a new AARP Public Policy Institute (PPI) report. But the future will see fewer family caregivers: Households have gotten smaller, and many boomers have few or no children. If they are unmarried, as many boomers are, they lack one of the prime sources of support in old age -- a spouse.
PPI analysts project a sharp decline in the "caregiver support ratio," defined as the number of people aged 45-64 -- largely boomers at present -- per person aged 80 or older, the age group most likely to need long-term services and support. This ratio falls from 7 to 1 in 2010 to 4 to 1 in 2030. In 13 years, the oldest boomers will start moving into their 80s, the "high risk years of later life." Not so far off when you stop and think about it.
"It is a worrisome development," says caregiving expert Lynn Feinberg, one of the authors of the PPI report. "If people believe, as the majority seem to, that families will be there to provide any needed care and support, they may be in for a painful surprise."
So it probably behooves us all to think about options for a time when we are no longer capable of doing it all ourselves. If we do have siblings, a spouse, or children, will they be able to help? With rising life expectancy, more people in need of care will be very old and infirm; many of their potential caregivers will be up in years as well.
Moreover, more caregivers will likely be in the labor force because they can't afford to retire. Managing a full-time job and caregiving, often from a distance, is a challenge today's boomers know only too well. Take boomer Laurel Beedon, for example, a full-time government program analyst in Washington, DC. For more than a decade, she was responsible for ensuring that her mother, who died not long ago at the age of 101, had the care she needed. This started with help at home and progressed over the years to more formal care arrangements as her mother became increasingly frail. It involved frequent travel to Minneapolis and constant worry that something might happen when she was not on-site to deal with it. Quitting her job and moving back to her hometown was not an option.
"Friends and I talked a lot about our role as caregivers to our parents," Beedon says. I was lucky to be able to visit my mother as much as I did -- many people don't have that option -- but I just wish that there were more official policies and on-the-ground support programs for all caregivers, not just us 'lucky ones.' Of course we wanted to do what we could, but it wasn't easy, especially near the end when the need for assistance and oversight became intense.
I am always amused when I hear people who have not experienced parent caregiving talk about having 'a nice discussion' with your parents and doing some planning and then assuming everything will be all right. No matter how cooperative your parents are and how well you have planned, things will go wrong; the unexpected will happen, and you will have to take care of it."
Gail Hunt, President and CEO of the National Alliance for Caregiving, tackles the issue of eldercare from a professional perspective and is well aware of the failure of public and private-sector policies to help families do all they are called upon to do when it comes to earning a living and providing care. "People who think they will have family members take care of them when they get old should think again. We need to be designing technology that can help people age in place and creating career incentives for home care workers."
Laurel Beedon offers some practical advice for caregivers today: "It is wonderful to be able to work with a team rather than all alone. It is amazing what you can do over the phone. No, I don't mean email; I mean the telephone. Call the nurse; call the home companion; call the visiting clergy person. Talk with these folks directly -- especially if you are caring from a distance -- they can give you on-site information and you can ask questions as you think of them. Parental caregiving is a hard job. Accept help when offered and ask for help when you need it. As we say in Minnesota, 'we are all in this together.'"
That's good advice if you are a caregiver, but it might not do you much good when you need a helping hand and there is no family around to provide one. It's a frightening thought, but ignoring it won't keep it from happening. What can you do? One place to start is by building or reinforcing a support network of people -- friends, neighbors, fellow congregants -- to grapple with these questions and work toward some answers. That might include the establishment of a caregiving Village, alternative housing arrangements à la The Golden Girls, deputizing trusted advisors to act on your behalf if necessary, or other more creative solutions that could be shared with the rest of us. Beedon's advice to "work with a team" applies here as well.
After all, it is not only Minnesotans who are all in it together!
Employment Update: The most recent statistics from the Bureau of Labor Statistics underscore just how many potential elder caregivers are in the labor force--more than 70 percent of people aged 45-64 in August. Women aged 55-64 have seen a particularly sharp increase in participation in recent years.