PITTSBURGH _ The nearly 18 million family caregivers of America's older adults are an overlooked and stressed part of the health care system sorely in need of a new national strategy to help them, according to a comprehensive report released Tuesday.
The 297-page "Families Caring for an Aging America" report, produced by the National Academies of Sciences, Engineering and Medicine, seeks to have the next presidential administration place a new emphasis on identifying and assisting those caregivers most in need of help because of their own physical, mental or economic hardships.
"The system has no mechanism for identifying these individuals," said Richard Schulz, a University of Pittsburgh psychiatry professor who chaired the committee producing the report. "There are no assessment systems in place and caregivers are assumed to be there to provide care, but paradoxically they're not included in health system care planning."
Schulz, a leading researcher on caregiving, is part of a collaboration between Pitt's Health Policy Institute and the RAND Corp. on a $1 million project, to be detailed Wednesday, that aims to survey local caregivers and implement best practices of helping them.
The issue is not a new one. It has been recognized for years that America is an aging society in which increasing numbers of people will need help at the same time the number of family members close by to assist them is shrinking.
"Families have fewer children, older adults are more likely to have never married or to be divorced, and adult children often live far from their parents or may be caring for more than one older adult or their own children," the report noted. The traditional reliance on stay-at-home females to handle caregiving tasks is no longer applicable because of their involvement in and need to be part of the paid workforce.
The report stated it is taken for granted that family caregivers will be there to support their parents, spouses or other family members who are discharged from hospitals or otherwise in frail condition, but they receive little training or support. "Family caregivers describe learning by trial and error and fearing that they will make a life-threatening mistake," the report stated.
More than two dozen states require hospitals to educate caregivers about necessary procedures to assist patients being discharged. That is one of the improvements encouraged in the national report, which includes among other recommendations:
_Through government-funded programs such as Medicare and Medicaid, develop ways to identify caregivers in need and pay health care providers to assist them via training and services.
_Expand federal and state programs that ease financial hardship on those who take time off from work, such as through providing them paid leave or protecting them from harm to their future Social Security income.
_Find methods of converting known research about effective caregiving support into actual practices that assist those in need.
Schulz said that while there are costs associated with the various recommendations, those may be offset by reduced use of hospitals and other health care settings by frail individuals who are able to get better caregiving support.
