Written By: TheSeniorList Research Team | Published: February 16, 2023
By the decade's end, every person in America’s second-largest generation – the baby boomers – will be at least 65 years old. Between 2020 and 2030, the number of Americans aged 65 or older will increase by about 30 percent, rising to 73.1 million.
This dramatic increase in the number of older Americans will also increase demand for caregiving services – much of which will be shouldered by close friends or family members. Over the past several years, the number of Americans who provide unpaid care to a family member over 50 has climbed by more than 20 percent. Now, 42 million people are caring for older loved ones.
This increase is partly due to the rising costs of residential care for older people. Nursing home rates are now around $7,000-$8,000 a month. They’re expected to continue to climb by as much as a third over the next decade. If care costs continue to increase, many people may have no choice but to care for their aging family members without professional assistance.
While most people who care for their loved ones in their final years no doubt feel a sense of pride in their work, our research has found several unfortunate side effects of caregiving, such as high rates of anxiety and depression. These conditions are even more common among family caregivers than the general population. We also found that most caregivers do not receive essential support services like respite care, mental health counseling, and financial aid, which would mitigate the emotional impact of caring for family members in their most vulnerable years.
As the massive baby boomer generation ages into their senior years, this caregiver mental health crisis is bound to grow if there are no interventions. To understand the mental toll family caregiving can take and to discover what caregivers need most to ward off mental health crises, we asked nearly 1,500 unpaid family caregivers across the country about their experiences.
The U.S. population will age quickly over the next decade, and family members will care for their loved ones in their final years. Unless these caregivers have increased access to essential support services, a mental health crisis is looming in America’s near future.
The baby boomer generation, made up of people born after World War II between 1946 – 1964, is currently the second largest generation in the U.S. Throughout their lifetimes, people in this group have significantly impacted culture and the economy. Because of the sheer size of this generation, they will continue to influence American society, especially as they move into their senior years.
By 2030, all baby boomers will be at least 65 years old. In fact, between 2020 and 2030, the number of Americans aged 65 or older will increase by about 30 percent. Researchers refer to this demographic shift as a “silver tsunami,” which will have knock-on effects on our labor force and healthcare systems for decades. America’s growing elderly population will also drive demand for nursing homes, home health care services, and family caregivers.
Over the past several years, the number of Americans who provide unpaid care to a family member over 50 has climbed by more than 20 percent. Today, approximately 42 million people are caring for older loved ones, assisting them with housekeeping, shopping, personal care, transportation, and more.
As the number of seniors in the U.S. continues to grow over the next 10 years, so will the number of family members providing care. For many, this will be the most affordable option: Nursing homes can cost around $7,000-$8,000 a month, and they’re expected to continue to climb by as much as a third over the next decade. Similarly, in-home care costs could rise as well. Hiring a home care aide typically costs over $4,700 a month today. Given the rising costs of professional care, many people may have no choice but to be the sole caregivers for their aging family members.
While many people see caring for older or ill family members as an honor, caregiving can still cause emotional, physical, and psychological strain. This is a growing issue, and was especially pronounced during the height of the Covid-19 pandemic. Our research confirms that caregivers are more likely than others to say they have anxiety, depression, or insomnia.
Compared to non-caregivers in our study, people who assist older adult family members are much more likely to experience near-constant anxiety, depression, or insomnia. By a similar margin, they report “often or always” feeling overwhelmed by all the tasks they need to accomplish in a day.
Taking care of an aging or ill family member can strain one’s mental health for several reasons. It can be emotionally challenging to see a loved one in pain or to see their physical or cognitive condition worsen over time. Caregiving can also lead to burnout, as many family caregivers are balancing both family and professional responsibilities with little rest.
When asked about the specific difficulties they’ve experienced in providing care for an older loved one, family caregivers frequently signaled signs of burnout — feeling stressed, overworked, tired, and depressed.
Seven in 10 caregivers in our study said they feel emotional stress, and nearly two in three had trouble balancing their caregiving responsibilities with other demands or desires in their lives. About 40 percent struggled with sleep and setting boundaries on their time, while nearly as many reported financial strain due to caregiving. We also discovered that female caregivers were more likely than men to experience emotional stress and other difficulties.
Nearly 40 percent also said they are experiencing financial strain as a result of their caregiving duties. An AARP study found that about eight in 10 family caregivers spend money not reimbursed by insurance or Medicare on expenses for their loved ones, including household expenses, home modifications, medical costs, and more.
Many of these issues, such as lack of sleep and financial strain, put caregivers at increased risk of developing mental health issues.
For many caregivers, looking after a loved one is nearly as time-consuming as a full-time job. Over the course of several years, caregivers spend an average of 25 hours per week looking after their loved ones who need care in addition to 35-hour workweeks. As they balance their caregiving commitments with work and childcare, caretakers often don’t get enough restorative rest, which is essential for mental health.
Caregivers’ hours are often filled with duties such as transportation to doctor visits, grocery shopping, or cooking and cleaning. But in the case of older adults who require help from another person to get to the shower or the toilet, it can also mean heavy lifting. With all these factors at play, it’s easy to see why caring for a loved one can be physically and emotionally demanding.
While most caregivers reported similar difficulties, not all reported negative mental health symptoms. Being new to caregiving, having little health and support, and living with the person they help were all significant risk factors for poor mental health.
Caring for a loved one often requires hours of care each day for several years. Because of this, caregivers need to have a community of support and help, though our research revealed this is not the case for many caregivers.
Nearly 40 percent of the caretakers in our study were the sole caretakers for family members aged 50 or older. These people are at heightened risk of poor mental health because all the physical and emotional caregiving tasks fall to them alone. We know that sole caregivers put in more hours than the average caregiver – 32 hours per week compared to 25 hours for all caregivers. Sole caregivers are likelier than those with help to lose their temper with others, feel pervasive anxiety, and experience depression.
According to AARP research, the percentage of older adults who need care and live with their caregivers has risen steadily over the past few years. This is likely due in part to the rising costs of residential care and the increasing costs of housing in many cities.
Living with a family member can reduce costs for the care recipient and be very convenient for the caregiver. It also guarantees plenty of quality time together. However, this situation also has unique challenges, including:
These difficulties can have an impact on emotional health and wellbeing. Even when they have assistance from others, people who live with the person they care for experience unhappiness and anger at higher rates than those who live separately.
They also have higher rates of feeling overwhelmed and have trouble engaging with friends or family members. Caregivers who live with the family member they care for are also more likely than those who live apart to feel listless doing activities that once brought joy and relaxation, which is a primary symptom of depression.
Although caregiving is a very time-intensive role, just 55 percent of caregivers in our study received outside support such as financial support, help in getting access to services, support from loved ones’ physicians, respite care, and more. This lack of support is likely a risk factor for poor mental health.
The most common support caregivers receive is communication from their loved one’s physicians. Another 16 percent say they get help accessing community or government services, and just 14 percent receive financial support.
What do family caregivers need that they aren’t getting? Financial support. Forty-nine percent of family caregivers said financial aid would be the most desired of the services they don’t currently receive. For example, extra financial resources could enable family caregivers to pay for respite care or take time off work, reducing stress.
Financial support is available for some people caring for older family members through Medicaid. If eligible, they can receive a monthly payment for providing care. Veterans and their spouses are also often eligible to receive caregiver benefits, but navigating the red tape of government benefits can be difficult. In fact, more than a quarter of caregivers who do not receive help accessing benefits said that is the type of support they need most.
Some older people might already be eligible for caregiver benefits from their health insurance providers, which can reduce the amount of day-to-day work that falls onto solo family caregivers.
“Caregivers should take a close look at their loved one’s specific health plan benefits. If you need help getting your loved one to a doctor’s office, for example, their health plan may offer a transportation benefit with rides to medical appointments and pharmacies,” said Christopher Ciano, President of Aetna Medicare. “Health plans can also offer access to more convenient care choices, like telehealth and in-home care, or prescription delivery options.”
Balancing caregiving with work, childcare, and other life responsibilities can be very challenging, and it’s not unusual for caregivers to experience a decline in their mental health. Our research revealed it’s more common for those who care for an aging family member to experience symptoms of anxiety, depression, and other mental health issues than the general population.
For family caregivers who struggle to maintain their mental health and balance their needs with their loved ones, it’s easy to assume you’re on your own. But it’s important to remember that mentally healthy caregivers can provide better care to their loved ones.
While many more resources are needed to support the growing needs of caregivers fully, here are a few starting places for those who are looking for more help now:
A service of the U.S. Administration on Aging, the Eldercare Locator lets you type in your ZIP code or city and state and find dozens of organizations that provide support for older Americans and their caregivers, such as their local Area Agency on Aging.
A nonprofit grassroots organization, Caregiver Action Network offers online support tools, chat, and news about family caregiving.
In some cases, family caregivers may be able to get financial support from Medicare/Medicaid via self-directed services. Eligibility depends on the state, and enrollment may be a challenge. But for families that can participate, the cost savings could be significant. Those with Medicare Advantage plans are also eligible for additional caregiver benefits.
For family caregivers of U.S. military veterans, many benefits are available. For those who qualify, caregivers can receive education and training, mental health counseling, and financial assistance when traveling with the veteran to receive care. Monthly stipends and respite care are also available.
Whether online or in-person, support groups can provide caregivers with a community of others who understand their needs and concerns. Groups are typically free to join and run in various formats. Some groups are oriented around conditions like Alzheimer’s or geared toward younger caregivers.
The Senior List conducted an online survey of 1,951 U.S. adults aged 18 or older. 1,431 participants provided care for a loved one or family member over the age of 65 at the time of our survey. Mental health quality was self-reported by participants and was not based on a professional evaluation.