How do you put a value on caring for family members who are chronically ill or disabled?
AARP estimates it at about $450 billion a year.
That's how much it might cost for the unpaid care that roughly one in every four adults provide; helping loved ones get dressed, take medications, and myriad other tasks.
The advocacy group released a report Monday that estimates the economic value of family caregiving in 2009. The total was up 20 percent, from $375 billion in 2007, with the increase reflecting both an increase in the number of family caregivers and in the hours of care they provide. Given the continued rise in health-care costs, it's likely the estimate would be higher today.
AARP said about 42.1 million individuals are caring for relatives and close friends at any time during the year _ but about 61.6 million provide care at some point during the year. They put in an average of 18.4 hours of care per week, up 9 percent from its prior study. The organization arrived at its dollar value estimate by assuming the work of caregivers is worth an average $11.16 per hour.
"Today, families remain the most important source of support to older adults," the study said. "Many individuals who provide assistance and support to a loved one with chronic illness or disability do not identify themselves as `caregivers' but rather describe what they do in terms of their relationship with the other person: as a husband, wife, partner, daughter, daughter-in-law, son, grandson, niece, or close friend, for example."
Beyond handling simple household chores or taking care of the bills and insurance paperwork, AARP noted that caregiving is getting more medically involved, due to factors like shorter hospital stays and more home-based medical technologies. Caregivers "often have little training or preparation for performing these tasks, which include bandaging and wound care, tube feedings, managing catheters, giving injections, or operating medical equipment."
And caregivers typically work full time as well. The study found that the average individual is a 49-year-old woman with an outside job, who spends nearly 20 hours per week caring for her mother for nearly five years. That's one of the reasons the hidden costs for caregiving are increasing as well.
The study found that family care can have negative effects on the caregivers' own financial situation, retirement security, physical and emotional health and careers. "The impact is particularly severe for caregivers of individuals who have complex chronic health conditions and both functional and cognitive impairments," it said. For caregivers over 50 years old who leave the workforce to care for a parent, lost wages, income and pension benefits average $283,716 for men and $324,044 for women.
Another impact comes in the workplace, through lost productivity and higher health care costs for employers. The study notes that caregivers themselves frequently have higher medical costs, which can be borne by employers.
The situation got worse amid the economic downturn, AARP found, with agencies that provide caregiver support services seeing a 67 percent increase in requests for help from late 2007 to 2009. But government budget problems often mean that even when demand rises, less money is available through government programs and grants.
AARP noted that demographics show that when health care providers include caregivers in planning and decision making, the results are positive. Involving caregivers in planning when a patent is discharged from a hospital, for instance, can help prevent readmission to the hospital.
The study includes recommendations for involving family caregivers in ways that will result in improved care for the aging patient. It also details steps that government policy makers and health professionals could take to make caregiving easier. For example, it points to new laws that allow caregivers of veterans injured in the recent wars to get paid for providing care, and programs that provide grants for caregiver support services as examples.
"The 2009 estimate of the value of family caregiving is conservative," the study said, "because it does not quantify the physical, emotional, and financial costs of care."