{"id":11482,"date":"2018-03-02T02:04:09","date_gmt":"2018-03-02T02:04:09","guid":{"rendered":"http:\/\/www.lifeandnews.com\/articles\/?p=11482"},"modified":"2018-03-03T02:09:35","modified_gmt":"2018-03-03T02:09:35","slug":"why-the-daunting-economics-of-elder-care-are-about-to-get-much-worse","status":"publish","type":"post","link":"https:\/\/www.lifeandnews.com\/articles\/why-the-daunting-economics-of-elder-care-are-about-to-get-much-worse\/","title":{"rendered":"Why the daunting economics of elder care are about to get much worse"},"content":{"rendered":"

Patricia Smith<\/a>, University of Michigan<\/a><\/em><\/span><\/p>\n

My sister Carol loves movies, but she hasn\u2019t been out to see one in years. When she tries to watch one at home, she\u2019s frequently interrupted. She shrugs this off, saying \u201cWho needs to see movies when you\u2019re living one?\u201d <\/p>\n

You see, my sister is living the plot from the movie \u201cGroundhog Day<\/a>.\u201d She takes care of our mother, who suffers from dementia. Our mom asks the same questions over and over and only wants to watch a handful of classic TV shows, like \u201cThe Golden Girls<\/a>\u201d reruns. For this my sister earns nothing.<\/p>\n

I marvel at how hard my sister works and how much she contributes to our mother\u2019s quality of life and yet how little our society recognizes the scope of what family caregivers like her are contributing. As an economist, I also see in her predicament a microcosm of a much bigger problem. Just as our family can\u2019t expect my sister to keep this up<\/a> indefinitely, nor can our society count on unpaid caregivers to perpetually tend to the growing needs of the nation\u2019s elderly. <\/p>\n

Valuing unpaid elder care<\/h2>\n

Carol belongs to an army of more than 43.5 million people<\/a> who provide their loved ones with what AARP estimates to be US$470 billion worth of care<\/a> \u2013 an amount that exceeds the gross domestic product of 170 of the world\u2019s 195 nations<\/a>.<\/p>\n

Because no money changes hands, economists don\u2019t count unpaid caregiving when they tabulate GDP \u2013 the sum of all economic activity. But this work does count tremendously in terms of the well-being, economic and otherwise, of the elderly and the disabled and their relatives. <\/p>\n

Expecting that everyone in my mom\u2019s predicament will have adult children able and willing to care for them is becoming increasingly unrealistic. Demographers expect that the number of Americans over age 65 will more than double<\/a> in less than 50 years, rising from 46 million in 2016 to 98 million in 2060. The many seniors with one or more chronic conditions<\/a> will require professional and informal assistance. <\/p>\n

Who will take care of all these additional seniors? <\/p>\n

The average number of children<\/a> women have has declined, falling to 1.9 in 2016 from 3.7 in the 1960s. That leaves fewer children to care for the growing number of elderly parents. And since the share of women who earn a living<\/a> in the paid workforce rose from about 1 in 3 in the mid-1950s to more than 1 in 2 by the 1980s, grown daughters have become less available to care for their parents at a time when the majority of people providing for seniors are still women<\/a>. For example, sons caring for a parent did 16 percent of this unpaid caregiving<\/a> while daughters did 31 percent, in 2011.<\/p>\n

Caring for elderly and disabled family members takes a big financial toll<\/a>, including hundreds of thousands of dollars in lifetime earnings if it means retiring early<\/a> to do it, according to Fidelity, the investment company.<\/p>\n

\n \"\"<\/a>
\n U.S. women are having fewer kids, making big families less common and creating consequences down the line for elder care.<\/span>
\n Dasha Petrenko\/Shutterstock<\/a><\/span>
\n <\/figcaption><\/figure>\n

Paid caregivers<\/h2>\n

When no relative steps up to serve as an unpaid caregiver when the need arises, families hire paid caregivers<\/a> or move their loved one into a nursing home<\/a>, where a private room may cost $100,000 or more per year. Medicare rarely covers nursing home stays<\/a>, and eligibility for Medicaid coverage is limited<\/a>, so institutional care like that is generally out of reach for all but the wealthiest Americans or those with long-term care insurance<\/a> \u2013 which also costs a lot<\/a>.<\/p>\n

The Bureau of Labor Statistics<\/a> predicts that caregiving jobs will be among the fastest-growing in the years to come, with the number of home health aides increasing by 41 percent from nearly 3 million in 2016 to more than 4.1 million<\/a> within a decade.<\/p>\n

However, many states already face a shortage of these workers<\/a>. Partly that\u2019s because these jobs pay very little \u2013 averaging $22,170 per year<\/a> in 2016 for home health aides \u2013 and offer scant benefits. Compensation is so low that about half of paid caregivers rely on some form of government assistance<\/a> to make ends meet. <\/p>\n

The industry\u2019s low pay helps explain why roughly a quarter of home health workers are immigrants<\/a>. Until now, foreign-born labor has narrowed this labor gap. The Trump administration\u2019s efforts to crack down on undocumented immigration<\/a> and reduce the number of immigrants with legal status, therefore, are sure to make it harder for families seeking someone to care for an aging relative to hire workers.<\/p>\n

I believe any serious debate over immigration policy should consider the growing need for paid caregivers<\/a> and establish more ways for immigrants willing and able to do this work with a path to citizenship. There are specific visa programs for agriculture<\/a> and hospitality<\/a>. Why not caregiving?<\/p>\n

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