Thursday, October 16, 2008

Who Cares for the Caregivers?

The economic value of family caregiving in 2006 was $350 billion, according to recent research, a figure that exceeded the total spending for either Medicaid ($342 billion) or Medicare ($300 billion) in 2005. Without the unpaid labor of family caregivers — provided at great physical, emotional and financial cost — the long-term care system in this country (if you can call it a “system”) would collapse. Nursing homes, far and away the most expensive form of care, would burst at the seams with elderly men and women who might otherwise have been supervised in the community by adult children and spouses.
There is widespread agreement that these devoted caregivers, thought to number about 33 million, are an essential national health care resource and will become increasingly necessary. The population of those ages 85 and above is soaring. Many will live for years unable to take care of their most basic needs. Hospital stays grow ever shorter, meaning that very sick people are sent home once their immediate health crises have passed.
And in an effort to rebalance institutional and community-based care, states are experimenting with reimbursement models that make it feasible for more people to stay home. While these are commendable pilot programs, family caregivers will continue to bear primary responsibility even when some subsidized home care is available. Currently, studies show, three-quarters of those who remain in their homes depend solely on family and friends to meet their day-to-day needs with no professional support whatsoever.

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