Government Funding for Family Caregiving

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The demand for caregivers will continue to grow as the American population continues to age. Baby boomers have been entering their senior years at a time when medical advances have extended lifespans. The expanding population of older adults who are coping with chronic disabling conditions has increased demand for certified nursing assistants in assisted-living facilities as well as home health and personal care aides. 

Shortages of workers in the caregiving industry have been well documented. Increasing demand for caregivers is driving the shortage, but low pay for physically and emotionally demanding work has contributed to the problem.

Family members often act as unpaid caregivers for parents and grandparents. Family caregiving allows ill and disabled seniors to age in place, but caregivers often make substantial sacrifices to help their loved ones. Family caregivers often reduce their work hours, work from home for less pay, or remove themselves from the workforce. They spend less on their own needs, give up the opportunity to travel, and experience physical and mental health problems related to the stress of caregiving.

The sacrifices that family caregivers make to care for older relatives could be minimized if the expense of outside caregivers were covered by Medicare or health insurance. Medicare Part B does pay for caregiver services for homebound patients who receive the care under a doctor’s supervision, but does not pay for 24-hour care. Some Medicare Advantage plans might pay for additional services, but private insurance plans rarely cover the fulltime care that many older adults need.

Changing Attitudes

A recent study found that 61% of Americans in 2012 supported a caregiving system that placed the primary responsibility on families to act as caregivers. The same survey found that 44% of Americans believed that older adults or their families should pay for any outside caregiver services they need, while 37% believed the government should pay.

The 2012 survey results may reflect the importance in American culture of self-reliance. Some scholars suggest that public resistance to “government handouts” and using taxes to fund healthcare programs explains why the United States does not assure that its citizens receive the medical attention they need. The unfortunate result for Americans is poorer health and shorter lives than citizens of countries that provide universal healthcare.

While self-reliance continues to be an American value, the belief that families should take care of aging parents without help from the government is changing. The same survey questions in 2022 revealed a change in attitudes. In 2022, 48% of Americans believed that family members should have the primary responsibility to act as caregivers. Only 28% believed that families should pay for outside caregivers, while 51% agreed that the government should pay.

The study’s authors speculate that the pandemic may have contributed to changing attitudes. Having witnessed the disproportionate impact that the pandemic had on older adults, Americans may have realized that families endure significant hardships when they take responsibility for the health care needs of older relatives.

Younger Adults Are More Receptive to Government Funding of Caregivers

It might be tempting to think that attitudes are changing because, as people enter their retirement years and realize they may need assistance from caregivers, they are driven by self-interest to support government funding of their present or potential needs. In fact, the surveys do not support the notion that the self-interest of older adults drives attitudes about the government’s role in supplying and paying caregivers.

The survey found that the attitudes of Americans under the age of 65 have changed more than those of older Americans. The percentage of Americans older than 65 who believe the government should pay for caregivers increased only slightly between 2012 and 2022. While 39% of Americans under the age of 65 thought that the government should fund caregivers in 2012, that percentage increased to 55% in 2022.

The authors speculate that self-interest may be driving the change of attitude in younger Americans. As larger numbers of parents grow older, a larger number of children and grandchildren may be envisioning the sacrifices they would need to make to act as caregivers. That reality may shape the growing belief that in a country as affluent as the United States, sacrifices should be shared by all in the form of government subsidies to fund caregivers, rather than placing the burden on family members who may need to stop working so they can care for aging relatives. 

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