The Impact and Cost of Long-term Care on the Family
Long-term care can be needed for a variety of reasons from accident injuries, debilitating and long-term illness, or simply due to becoming elderly. There are sometimes when persons cannot care for themselves and must rely on others for their daily needs. Sometimes the care takes place in a facility designed to provide such services. However, sometimes the burden of caring for loved ones falls on family members or even friends. Long-term care places a strain on people financially. This has been the primary focus of health care policy regarding long-term care in the past. However, there is an often-overlooked aspect of long-term care.
Long-term care has many emotional issues associated with it as well, not only for the patient, but for the caregiver as well. These issues can cause a variety of difficulties including depression, fatigue, stress and can even lead to the break up of a family. These issues place an even greater burden on the system and society as a whole. These issues must be considered when making new long-term health care policies. These issues will be the focus of the following research.
The problems associated with long-term health care of the elderly and sick have many facets. Long-term health care in facilities, such as nursing homes is expensive. The United States is facing a growing shortage of health care workers to care for the elderly and this trend is expected to worsen. In many cases families choose to care for the person at home rather than incur potentially devastating costs. When family care is not an option and the family does not have the resources to pay, the government must foot the bill. Caring for a patient at home is expensive as well, and often places an incredible financial strain on the family. The following research will explore these issues from many angles and will discuss potential solutions.
Social Factors Affecting Care Giving
There was a time when long-term care facilities did not exist and the entire burden of caring for the elderly or sick was always placed on the family. There are many who feel that this the way it still is and should be, However, the family structures are changing and this concept has now been shown to be a myth (Montgomery, 1999). This shifting family structure means that an increasing number of elderly persons are relying on long-term care facilities to replace the traditional family role. The following will explore some of the issues behind these trends.
Divorce rates have been climbing for many years and the traditional idea of the nuclear is quickly being re-defined. As a result, there are now more elderly people who are divorced. The effects of this trend can be shown in the long-term care that these elders are likely to receive from their children. Divorce can harm family ties and often creates feelings of resentment or rejection in many family members. According to a study conducted by Shone and Pezzin, (1999) divorce makes it less likely that families will help each other financially or in terms of physical care. The key findings of this study were that adult children of divorced children were less likely to receive financial assistance from their parents. In addition, stepparents were less likely to receive care from their children than biological parents were. The study found that remarriage reduced the likelihood that an elderly person would receive care even further (Shone and Pezzin, 1999).
A history of abuse or neglect in the family may be a factor in whether elderly persons receive care from their children. Child abuse and neglect severs family ties and can have an impact on whether the person receives care in their elder years (CASA, 2001). This issue is often an overlooked effect of child abuse. Many consider the immediate social costs of child abuse. However, the willingness to care for the elderly is a long-term effect of childhood abuse and neglect. Current studies only focus the effects to the abused person themselves. They fail to consider the effects of the broken family ties later in life.
Studies have indicated that men and women neat retirement age, whose parents are still living, are spending less time caring for them or helping with daily tasks such as household chores (Johnson and Lo Sasso, 2000). Women are playing a greater role in the workforce and this may have an impact on these figures. Parental health was found to be a key predictor in determining whether the elderly person would receive assistance from their children (Johnson and Lo Sasso, 2000). Health was factor in determining whether children provided basic case, such as feeding or dressing, however, was not a factor in helping with daily chores and errands (Johnson and Lo Sasso, 2000).
Other factors that were determined to be a predictor of whether children helped to care for their parents were the vicinity in which they lived. Children who lived closer to their parents were more likely to provide help than those who lived far away (Johnson and Lo Sasso, 2000). When both parents were alive, the children were less likely to provide help, as the other surviving spouse was likely to provide care. In addition, children in their mid-life who had small children or problems within the immediate family, such as an ill spouse, did not decrease the likelihood that the adult child would provide help for the parent (Johnson and Lo Sasso, 2000).
The Long-term Care Worker Shortage
As the population grows increasingly more elderly, the United States is facing a shortage of worker to care for them (Weiner, et. al., 2000). According to Weiner and associates (2000) poor working conditions are partially to blame for he current crisis. Long-term care workers face low wages, poor benefits, heavy workloads, and poor working conditions and a lack of respect. This makes the profession subject to high turnover rate and difficulty in recruiting new workers. This problem is expected to get worse before it gets better.
Formal Long-term Care: The Impact on Society
The number of elderly receiving formalized long-term care, from a licensed long-term care facility is expected to double over the next 30 years (Johnson and Lo Sasso, 2000). Much of this long-term care will be funded with public funds, placing a growing financial burden on government budgets. Nursing home expenditures have increased from $17.4 billion in 1970 to $84.7 billion in 1997 (expressed in 1997 dollars) (Health Care Financing Administration, 1998).
Long-term care places a growing strain on society as a whole.
When a family decides to care for a loved one at home, many do not realize the costs involved. Some of these costs are financial and some are less easily measurable. The person providing the care must often balance working a paid job with providing the care. A 1996, study revealed that approximately 10.5% of all elderly patients that were being cared for at home were unable to perform basic tasks such as feeding themselves, getting out of bed, or dressing (Johnson and Lo Sasso, 2000). Adult children account for 42% of all caregivers for unmarried elderly persons receiving nonistitutional care (Johnson and Lo Sasso, 2000).
Results on Caregiving in foreign countries and among ethnic groups in the Untied States revealed different results than those conducted on mainstream populations. For instance in Japan, one study found that those caring for elderly persons who were totally disabled showed more signs of stress than those who were caring for partially disabled persons (Yumiko and Washio, 1999). It has been found that socio-cultural factors should be considered when evaluating Caregiving and caregivers in ethnic groups. Family structure was found to be a key issue in ethnic issues (Dilworth-Anderson and Gibson, 1999). Ho, et. al. (2000) found that minority caregivers to persons with dementia used fewer outside social and medical services than white, European-American caregivers. The study focused on and Latino caregivers and sites cultural and other factors as reasons for this. The same study found the minority caregivers often suffered from a higher level of stress than their European counterparts. Another study focused only on African-Americans and found similar results (Cox, 1999).
Caring for an elderly parent leaves less time for other activities, such as work. The more assistance the person needs, the greater the time spent caring for them. Activities such as meal preparation and transportation to doctor's visits can make it difficult to work regular hours on a job. It is difficult to measure the true effects of elderly care on the…