During the month of November, one focus of our thoughts is the upcoming Thanksgiving holiday and the blessings of family and friends. Thus, November is a very appropriate month to celebrate National Family Caregivers Month. Family caregivers provide the majority of long-term care in our country. Often, people associate family caregiving with its social benefits for individuals and society, such as being able to remain in one’s own home. The financial impacts of family caregiving, however, cannot be overlooked. In a 2015 article, the AARP Public Policy Institute reported the economic value of family caregiving in 2013 (the most recent year for which figures were available) as $470 billion, which is about equal to the annual sales of Walmart (2013-2014), the world’s largest company. Therefore, the individuals who are the recipients of care are not the only ones who should be thankful for their caregivers. Society as a whole needs to appreciate the role of family caregivers in helping maintain a semblance of social and economic stability within our nation.
Those individuals who have not had the experience of providing care for another person may have difficulty understanding some of the challenges that family caregivers face. Time is probably the easiest one to begin with, since we all tend to lead busy lives. Family caregivers must not only find the time to manage the daily details of their own lives, but they often must handle some or all of these daily details for their loved one as well. Shopping, bill paying, medical appointments, and potentially home maintenance/housekeeping tasks must all be squeezed in to a caregiver’s schedule which may already include a part or full time job. If the caregiver has children at home, scheduling becomes even more daunting. Caregivers may not be able to set aside much time for rest, exercise, or personal enjoyment, all of which are important in order to help maintain a sense of balance and the energy to meet the demands of life.
Family finances are another area which can be challenged by caregiving. Depending on the type of care needed, there may be additional expenses for supplies, equipment, and services which the care recipient needs. If routine supervision or extensive physical care is needed, a caregiver may need to reduce working hours or leave an outside job altogether. This situation creates long-term implications, as not only are wages lost for the time one is unable to work at a regular job, but future earnings for the caregiver’s retirement decline, and opportunities for career advancement may be missed as well. Health insurance coverage for the caregiver may also be dependent upon a job outside of the home.
Changes in family relationships also have implications for individuals who provide assistance to loved ones. Historical relationships between family members will affect each person’s attitude toward giving and receiving assistance, as well as the type and frequency of help to be given or received. Reversal of roles in a parent/child relationship may be uncomfortable and require adjustment by all involved, as some independence may need to be relinquished by the parent while at the same time the child seeks to ensure the preservation of as much of the parent’s dignity as possible. In this situation, a need for help with personal care tasks can be especially challenging. When a husband or wife is caring for a spouse, patterns within the marital relationship will be altered to accommodate changes in physical or intellectual skills. For example, a wife may need to assume responsibility for the couple’s finances, even though the husband traditionally managed this task. The wife may have a steep learning curve if she had not previously been involved in financial decisions, and the husband may face an emotional challenge in giving up control in this area. Relationships can easily become redefined by caregiver/care recipient roles. The ability to spend time in one another’s company simply as family members is overshadowed, especially as care needs increase.
A final part of the equation is the skills which are needed for caregiving. Providing personal care for another adult is different from providing personal care for a child. In addition, care needs are becoming more complex as people live longer with one or more chronic conditions, and new technologies develop to treat certain conditions. Learning to perform some complex care tasks, such as wound care or home dialysis, can be intimidating and have to be accomplished quickly , yet tasks such as these may be critical to the health of the care recipient.
Although caregiving can be physically and emotionally draining, many caregivers experience the satisfaction of knowing that they did the best that they could for their loved one. Their best efforts can be made even better with the support of others. When society understands the challenges which caregivers face; relationships, services, and benefit programs can be adjusted to reinforce and strengthen the foundation that these caregivers need in order to continue to fulfill this vital role. In his proclamation for National Family Caregivers Month 2016, President Barack Obama stated, “This month, and every month, let us lift up all those who work to tirelessly advance the health and wellness of those they love. Let us encourage those who choose to be caregivers and look toward a future where our politics and our policies reflect the selflessness and open-hearted empathy they show their loved ones every day.”
Karen Kaslow, RN