Originally published July 26, 2011 at 7:58 PM | Page modified July 26, 2011 at 10:01 PM

Home caregivers' unpaid labor worth $450 billion, AARP finds

Most caregivers don't consider their work, "work," says AARP rep.

Scripps Howard News Service

quotes How can anyone believe anything AARP says? Read more


For millions of Americans, long-term health care is as good as an adult spouse, child, partner or friend can provide in a home setting.

Collectively, about 62 million American adults — one in four — were involved in caring for another adult for some period of time during 2009 and 42 million provided year-round care, according to an AARP report issued Monday.

"Most caregivers don't think of what they're doing as work," said Susan Reinhard, a senior vice president at AARP. "They think of it as what families do for each other. They don't think of themselves as caregivers."

Yet the report — based on surveys by AARP, the National Alliance of Caregivers and the federal government — estimated the value of those volunteers' services at $450 billion in 2009.

Other researchers have calculated that some 70 percent of daily care provided for frail elders comes through informal family networks.

In comparison, Medicaid, Medicare and private insurance spend about $150 billion on formal long-term care in nursing homes, rehabilitation centers and home care.

The needs, and the costs, are only expected to soar over the next two decades as 78 million baby boomers become elderly in a society in which traditional family units are often fragmented.

A study last year by the University of Michigan looked at people 51 and older who had chronic health problems and took part in a 2006 national survey.

The researchers found that 40 percent of those chronically ill adults were unmarried and while most had adult children, half of those lived at least 10 miles away. Among those who were married, a majority also had a spouse with at least one chronic illness. Even so, the study found that at 40 percent or more of the older adults relied on adult children for at least some of their care.

The AARP report also noted that family care giving continues to increase in complexity, due both to shorter hospital stays and advances in medical technologies used in the home.

"Some of the things that family caregivers do would make a first-year nursing student shudder," said Reinhard. "But that's what it takes to provide care for people with chronic and sometimes acute medical conditions.'

Medical professionals have been playing catch-up on how to support caregivers, from offering mental health services and stress management to training on how to perform medical procedures.

But there's concern that many labels, switches or instructions on medical devices used in home care are too difficult to understand.

Another report released Monday by the National Research Council — part of the National Academy of Sciences — examines how nonprofessionals use equipment at home and what the Food and Drug Administration and other agencies and medical groups can do to increase safety and ensure effectiveness.

Among the top recommendations from an 11-member committee was that the FDA press for new standards to make labels and instructional materials more understandable to people lacking a nursing or other medical degree.

Training of home caregivers — both paid professionals and friends and family — needs to be improved and standardized through professional societies and patient advocacy groups. And standards also need to be considered for homes themselves in providing advanced medical care, from the availability of rails and handholds to whether the electrical circuits can handle the load from oxygen compressors and infusion pumps.

The experts also urged federal agencies and private enterprise to look for ways to integrate electronic medical record keeping into home-care settings that will allow professionals to monitor patient care from afar.

New technologies — from toothbrushes that can check blood sugar levels to "smart" t shirts or pajama tops that measure and transmit vital signs — are being explored in labs around the world, and must be regulated and certified for home and hospital applications.

(Contact Lee Bowman at

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