CT Golden Years: Burden of Home Care Falls on Females

Maybe this was just something we knew all along, but now it is official – women take on most of the burden not just of bearing children in their early years, but more of the physical and mental toll of taking care of aging spouses and other relatives in later years too.

Part of it could be the affects of living up to a nurturing stereotype or part of it could be biological or even sheer demographics, but as reported in the New York Times an ongoing study on various aspects of being a caregiver has shown that regardless of the cause, women take in on the chin.

First, women still live longer than men although the gap is narrowing. So unfortunately right out of the gate, it is more likely that women will be caring for a dying spouse than vice versa.

Ron Winter

“Women tend to marry men older than themselves, and men generally have more health problems and shorter lives. So it’s typically the woman taking care of the man,” according to John Cagle, a research fellow in geriatrics at UCSF who was a lead author on the study.

This is not to say that men don’t take care of dying spouses too, they do, and they do all the things that women do.

The Times reported that results from 1998 to 2008 in the national Health and Retirement Study, conducted every other year, Dr. Cagle found few gender differences in the hands-on tasks that spouses undertook — the so-called activities of daily living. Both husbands and wives were likely to help with dressing and bathing during the final three months of life.

However, the husbands were significantly more likely than wives to say they “helped” with meals and grocery shopping during those months. “I suspect these are partly due to gender expectations,” Dr. Cagle said. “If traditionally a wife prepares meals and the husband doesn’t, she may not recognize this as ‘help.’ It’s just their routine.”

But, routine or not, the stress of caring for a dying spouse weighs more heavily on the women.

For instance, women showed higher rates of depression, poorer health and higher need for help both before a spouse has died and in the year afterward. And I don’t want to cast any aspersions on anyone but it appears that men who have cared for a dying spouse recover more quickly than the women.

Although many spouses elect to be the primary caregiver themselves, the increasing age in the population, both nationally and in Connecticut is creating a growing need for caregivers to help out in the home. This issue already is being addressed by the Connecticut Commission on Aging.

Data provided by the CoA shows there are approximately 711,000 unpaid caregivers in Connecticut providing support to older adults and persons with disabilities, generally their spouses, parents, or friends. These unpaid caregivers are generally female with an average age of 48 who spend on average 20.4 hours a week providing care.

Half of all unpaid caregivers work full-time and of those working full-time, 70 percent report encountering work-related difficulties due to their dual role as caregivers. The economic value of unpaid care giving in Connecticut was estimated at $5.8 billion in 2009, double the amount Connecticut spent on Medicaid long-term care.

The CoA data also shows that Connecticut has more than 506,000 residents over the age of 65 and is home to almost 1 million baby boomers. This coupled with a declining working-age population, are expected to have profound impact on both the paid and unpaid direct care workforce both in the amount of time and effort required to provide care, and the overall cost.

They also will have a profound impact on future budgets as half the state and federal governments split the costs of Medicaid funding.

The study referenced in the New York Times article indicates that far more work needs to be done to fully understand the impact of care-giving on males in our society. But for the moment it is clear that regardless of who is providing the care now, far more people – both family and trained professionals – will be needed in the near future.

The CoA is actively engaged in the Money Follows the Person initiative which seeks to increase the number of Medicaid recipients who receive care in a home or community setting rather than in an institution, and to provide an adequate supply of trained care-givers. We’ll go into the advantages of that program in future columns.

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