Family Caregiving to the Elderly by Employed Persons: The Effects on Working Caregivers, Employers, and Federal Policy

Many trends have combined to prompt concern about whether the supply of family caregivers to the elderly will be sufficient to meet demand.One trend -the increased commitment of women to the labor force -has proved worrisome because of their major role in unpaid caregiving: a caregiver to a frail elder is quite often a married woman who is a middle-aged daughter if her mother is deceased.Although studies tend to confirm that paid work lessens the likelihood of a daughter becoming an informal caregiver, many employed women nonetheless assist older relatives, friends, and neighbors.Some analyses find that full-time work in particular decreases the time spent caregiving.The reduction in caregiving hours could be mitigated if care users have multiple unpaid helpers.However, the comparatively low fertility rate of the babyboom generation suggests that there will be fewer potential caregivers per recipient in the coming decades.Elders could hire home care workers to compensate for needs no longer being met by unpaid caregivers, but this might strain their budgets and cause them to enter nursing homes, which could raise government spending.Coverage of home care services could be expanded to offset a reduction in family caregiving, but this too would affect the government's budget.Despite their multiple responsibilities, employed caregivers spend many hours assisting elders.In order to do so, they often make workplace adjustments (e.g., arrive late/leave early and take leave).Just as accommodation of employees' informal caregiving to paid work may affect the budgets of elders and of government, so too might the adjustment of work to caregiving affect various parties.The productivity of caregivers could be reduced by their concern over frail parents living alone, for example.Caregiving could also increase employers' costs if they must replace employees who take leave or quit.The earnings and retirement income of caregivers who choose to sharply cutback their supply of labor could be reduced as well.This might not only diminish their own standard of living, but also lead to increased government dependency.A slower growing labor force also could curb the rate of economic growth and hence, of the nation's standard of living.Congress passed legislation to encourage caregivers to continue working by making it easier for them to fulfill their many commitments.The Family and Medical Leave Act (FMLA) provides job-protected, unpaid leave to eligible employees at covered employers so that they might, among other things, care for parents and spouses with serious health conditions.In addition, Congress turned to the tax code to offer employees incentives to start or continue caregiving (the Dependent Care Tax Credit and the Dependent Care Assistance Program).Caregivers to the elderly, regardless of employment status, also may receive assistance through the National Family Caregiver Support Program and through home and community-based waivers under Medicaid (e.g., respite care).This report will not be updated.1 National Academy on an Aging Society, "Caregiving: Helping Elders with Activity Limitations," Challenges for the 21 st Century: Chronic and Disabling Conditions, no.7 (May 2000).