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Who Will Care for You?

By 2030 the United States will need between 5.7 million and 6.6 million caregivers.

There are only four kinds of people in the world: those who have been caregivers; those who are currently caregivers; those who will be caregivers; those who will need caregivers. — Rosalynn Carter

America is facing a critical shortage of competent and compassionate caregivers. Right now about 40 percent of people over 60 and 1.9 million paid caregivers share the burden of providing home care for older or disabled Americans. This doesn't take into account the significant number of people who go completely without the help they need.

The situation will worsen as boomers age. In just 20 years, fully one-fifth of all Americans will have celebrated their 65th birthday. Older people today are healthier than in the past and are living longer. But as they age, boomers will likely require both caregiving for their parents and eventually for themselves. By 2030 the United States will need between 5.7 million and 6.6 million caregivers. The question is, will they be there for us and our loved ones when we need them?

The situation is grave because as a nation we have not been paying attention to the growing problem. Consider this: Paid caregivers can often make more money working in a fast-food restaurant than they can taking care of someone else's family member. And they usually receive no health care benefits, although the nature of the work makes them vulnerable to a variety of physical ailments, particularly back problems as a result of moving patients.

Unpaid family caregivers (61 percent of whom are women) experience significant challenges when they struggle to integrate their family, personal and work responsibilities with the arduous physical and emotional stress of providing care for a loved one. The U.S. economy loses about $33 billion each year in productivity because of employees who are also family caregivers and who must be absent or late to work.

What can be done? One answer to this complex and vexing problem has come from Lawrence Schmieding, an Arkansas businessman and philanthropist who met with difficulties in trying to organize caregiving services for his older brother. He realized that if he, a person of means, was hard-pressed to find caregiving solutions, what about those who lack resources?

So, in 1999 he started the Schmieding Center for Senior Health and Education in Springdale, Ark. In 2006 it joined forces with the International Longevity Center, a policy and education center in New York, to create the Caregiving Project for Older Americans.

What we've found is that America arguably has no caregiving system at all. As the burden on family caregivers grows, the shortage of paid caregivers worsens. There is a critical shortage of direct-care workers. Low wages, few fringe benefits, unpleasant work conditions and lack of career development all contribute to the shortage.

Much needs to be done—figuring out the best ways to recruit and train caregivers; making sure community colleges help them develop career opportunities; and establishing a financial plan to support this huge cadre of health workers. These challenges must be faced and accomplished soon, so that in 2030 no one will have to wonder: "Who will care for me?"

Robert N. Butler is president of the International Longevity Center-USA.

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