Caring for the caregivers: The next generation (part 1)

By 2030, all the baby boomers will be 65 or older and joining the ranks of being a senior right along with their parents.

Per the U.S. Census Bureau, many of those who reach age 65 will likely live an additional 10-20 years, and 13% of us can expect to live to the age of 85 or beyond. The trend to live at home as an aging adult with the support of a family caregiver is also increasing. Based on Pew Research data, we know that one in five Americans in 2018 lived in a multigenerational household, with over 25% of those consisting of three generations. In multigenerational homes, 21% of people were over 65 years of age and almost a quarter between the ages of 55-64. That means that the Gen Xers are now coming of age, so to speak, as they currently fall within the 41-to-56-year age bracket.

The current state of the caregiver

It appears that a perfect storm is brewing—people are living longer and the family caregivers are aging as well.

Blue Cross and Blue Shield’s The Impact of Caregiving on Mental and Physical Health, published in September 2020, stated that 2.6 million members were identified as part of the baby boomer generation. The average age of the caregiver was 59 years old, and the Gen Xers accounted for 45% of all caregivers in the study (3.1 million) with an average age of 46. 

The report cited caregivers as having higher rates of adjustment disorder, anxiety, major depression, tobacco use, obesity, and hypertension compared to the benchmark. This begs the question: How are caregivers coping with the emotional, mental, and physical issues that are more prominent for this group? Per caregiver self-reports, alcohol, medication, and food were the go-to self-prescribed remedies to ease their feelings of stress.

What does this mean for the next generation of Medicare recipients? Current family caregivers (those caring for aging parents and spouses) will most likely experience more health issues, not only creating a burden on our current healthcare systems but likely also creating similar stressors on future generations. What should be a blessing—our elderly being able to live safely at home—could become a curse due to the negative impact on the emotional and physical well-being of the caregivers and the loved ones they are caring for, resulting in long-term mental and physical health issues.

Check out any caregiving support group on social media and one can see that the caregivers are stretched to the limit physically and emotionally. They are trying to provide physical support without the necessary equipment or “muscle,” and they oftentimes are seeking out answers to medical and care management questions from their online support community. It is safe to assume these challenges have contributed to mounting frustration, exhaustion, and anger for the caregivers who are doing the best they can to care for their family members with limited support and resources.

Professional caregivers—employed by an agency or a care facility—are trained and certified to provide care, but how many family caregivers in the home are given that same training? Likely very few, given limited programming, cost, and time constraints. Agency or facility caregivers also clock in and out, working a set number of hours per day. This is not true for most family caregivers because it is a 24/7 job when a loved one is living in the home. Many times there is no one else in the family willing or able to step in and give the caregiver respite time. In facilities and agencies, there also is a care team who develops the care plan and coordinates care. Many caregivers in the home do not have access to—or do not know how to access—a care management team that can support them.

When a caregiver is on the edge of burnout, it can lead to a host of issues for the one on the receiving end of the care. Frustration, feelings of overwhelming anger at non-supportive family members, and fear over financial burdens can be unintentionally released towards the person being cared for through physical or psychological harm. Per the Office of the Inspector General Social Security Administration, “nearly 1 in 10 American senior citizens are abused or neglected each year."

Conversely, when a caregiver has the appropriate training, easy access to a medical support team, appropriate durable medical equipment, and a supportive family to help ease the burden, care of their loved one can improve quality of life both physically and emotionally.

The prescription for the future of family caregiving

It is paramount that payers proactively and programmatically address the physical and emotional needs of the caregiver. Considering caregivers as key consumers of Medicare plans and investing in caregiver research to inform the development of caregiver engagement programs will have a significant impact on cost of care for both caregiver and seniors. As new generations become Medicare-eligible, mitigating mental and physical health challenges of today’s caregiver will create a positive effect on tomorrow’s healthcare costs. Quality care will be the standard for today’s member—a true prescription of success!

Payers will be well-served to invest in the needs of the family caregiver as part of the member’s care plan through:

• Caregiver education
• Care management team support for the caregiver and the patient
• Digital support systems
• Health and wellness resources for the caregiver

Investing now in the physical and emotional health and wellbeing of the caregivers will reap rewards in the future—not only for those caregivers who will be soon entering the Medicare-eligible healthcare systems themselves, but also for the loved ones they are caring for today and tomorrow. It is a win-win opportunity for payers, providers, and the members they serve.

In part two of this series, we will take a deeper dive into these four areas of support payers should be investing in to create an upgraded and transformative model of caregiving in the home for the 21st century.