Why do Family Caregivers Exist?
Three factors that have led to the Family Caregiver role.
This is the third post in a series about Family Caregivers. Start with my first post 👉 Helping Family Caregivers
The prevalence of Family Caregivers is a relatively new development. There’s no single factor that is universally attributed to the growth of the role. Instead, a slew of factors have created a healthcare environment that forces those that need care to rely on those that are closest to them.
💰 Cost of Care
The cost of care is the #1 reason Family Caregivers exist. Simply put, a family member takes on the role of caregiver because because professional care services cost too much. In the spirit of brevity, I’m going to resist the urge to dive into exactly why care cost so much. Instead, we’ll review what average care costs today and what it may look like in ten years. Below are the estimated care costs for a family that lives in Massachussetts.
Non-Medical Home Care: This is the most common type of care. Caregivers help with non-medical tasks such as bathing, feeding, and clothing. This type of care has a number of different titles but keep in mind that it is the most basic service you can purchase.
- Estimate annual cost of care in 2018: $57,000
- Estimate annual cost of care in 2028: $79,000
Let’s assume our family member requires care from the age of 70 today. Assuming they live another ten years their care will cost $570,000.
Assisted Living Facility: Assisted living facilities provide places for the elderly and disabled to live that include non-medical home care services. There are many different flavors of assisted living facilities so the costs and type of care provided can vary widely. Let’s assume it’s a traditional facility that only provides non-medical care.
- Estimate annual cost of care in 2018: $67,000
- Estimate annual cost of care in 2028: $93,000
Let’s assume our family member moves into a facility at the age of 70 today. Assuming they live another ten years their living and care costs will total $670,000.
Nursing Home: Nursing homes are another option for those that need a place to stay and require care. Nursing homes typically provide care that skews more medical and complex compared to assisted living facilities.
- Estimate annual cost of care in 2018: $149,000
- Estimate annual cost of care in 2028: $207,000
** Assuming the care recipient has a private room.
Let’s assume our family member moves into a facility at the age of 70 today. Assuming they live another ten years their living and care costs will total $1,490,000.
Admittedly, there are a lot of assumptions baked into those numbers. Length and frequency of care being the biggest two. Regardless, the cost of care is tremendous. I’ve found that most find the cost of non-medical care to be the most surprising. Worth noting that additional costs such as medication, doctor appointments, and treatments are not factored into the above estimations. With the sky high cost of care in mind, it’s no surprise that family members are beginning to take on the role of caregiver. Whether it be to protect an inheritance or to provide care that otherwise cannot be afforded, the high cost of care is the biggest reason most Family Caregivers exist.
🥚 Retirement Savings
Closely related to the cost of care, retirement savings is another key factor that has led to the growth of the Family Caregiver role. Guess what you think the average American family has saved for retirement… the answer is a few lines down.
…consider non-techies too Medium community ;)
…what’s your number?
“The average savings of families close to retirement — ages 56 to 61 — is $163,557” 
I’m going to go out on a limb and say that was nowhere near what you had predicated. Not even close, right? Me neither. I had guessed a million bucks. The real number is scary but not that surprising if we make sure to leave the tech and finance bubble many of us on Medium live within. Similar to the cost of care, I’m going to refrain from going down the rabbit hole of why retirement savings are so low. Let’s blame it on avocado toast for the time being. Regardless of the reason, low retirement savings simply means your ability to pay for care is limited. Considering the cost of care numbers we reviewed in the section above, here’s how long you can take advantage of the care services mentioned if you have $150,000 saved at retirement…
- Non-medical home care: 2.6 years.
- Assisted Living Facility: 2.2 years
- Nursing Home: 1 year
What about if you have $500,000 saved?
- Non-medical home care: 8.7 years.
- Assisted Living Facility: 7.4 years
- Nursing Home: 3.3 years
The reality is that long term care is called that for a reason. Even with $500,000 saved the average family can only rely on a relatively short period of care for their family member. Especially if the person requires any sort of complex treatment such as chemotherapy or skilled care services that will increase costs tremendously.
Mixing high costs of care coupled and low retirement savings unsurprisingly results in family members being creative with how they take care of their sick, elderly, or disabled loved ones. Family Caregivers take on the role of care provider until professional care is absolutely required. Typically, that means end of life care.
🗺 Care Availability
Let’s be honest, cash constraints is an obvious reason why family members adopt the role of caregiver. Access to care is a lesser known issue. I live in Los Angeles, California. Access to care is not an issue for me. I live within a mile of a world class hospital, a couple of home care agencies, one large skilled nursing facility, and a slew of doctor offices. Assuming I decided to live in the same area and the same businesses existed for the next fifty years I could potentially age in place with little to no issue. Unfortunately, that’s not the case for everyone.
Whether it’s in the middle of the country or even slightly close to the coasts, care options can be limited. It’s common for some areas to have zero facilities or agencies that service their immediate area. Sharing of districts is common as agencies and facilities strive for larger footprints to increase their customer count.
While availability is certainly a big concern, limited availability can easily lead to poor care quality. For example, a town of 5,000 may have one home care agency. That agency has little incentive to ensure the quality of care is maintained as they have no competitors. When care quality begins to dip then more serious care incidents rise in frequency. Incidents such as falls and costly hospital readmissions.
Note: I am not claiming that agencies that exist in small towns provide poor care. That’s not the case. My point is that it’s logical that few competitors and an extremely small pool of potential employees has the potential to lead to a poor quality of care. There are thousands of agencies that exist in small towns that provide outstanding care.
It’s common for businesses that exist in large cities to be constantly searching for the best employees. Quality of care rules are extremely strict and if a caregiver or nurse breaks them then there’s a pool of candidates to tap immediately. Candidate pool restrictions that low population areas create can have a negative impact on care outcomes.
High costs, low savings, and limited availability of care professionals in certain areas are three factors that have contributed to the growth of the Family Caregiver role. Unfortunately, none of the above mentioned factors are in danger of changing any time soon. Family Caregivers not only step up when their loved one needs them but also when there is no other option for care.