WUNRN
Family Caregiver Alliance – USA National Center on Caregiving
https://www.caregiver.org/women-and-caregiving-facts-and-figures
WOMEN & CAREGIVING: FACTS & FIGURES
Who Are the Caregivers?
Most older persons with long-term care needs—65%—rely exclusively on family
and friends to provide assistance.1 Another 30% will supplement
family care with assistance from paid providers.2 Care provided by
family and friends can determine whether older persons can remain at home. In
fact, 50% of the elderly who have a long-term care need but no family available
to care for them are in nursing homes, while only 7% who have a family
caregiver are in institutional settings.3
Within our complex system of long-term care, women’s caregiving is
essential in providing a backbone of support. In fact, the value of the
informal care that women provide ranges from $148 billion to $188 billion
annually.4 Women provide the majority of informal care to spouses,
parents, parents-in-law, friends and neighbors, and they play many roles while
caregiving—hands-on health provider, care manager, friend, companion, surrogate
decision-maker and advocate.5
Many studies have looked at the role of women and family caregiving.
Although not all have addressed gender issues and caregiving specifically, the
results are still generalizable to women because they are the majority of
informal care providers in this country. Consider:
· An estimated 66% of caregivers are female. [Updated February 2015] 6,
7
· The average caregiver is a 49 year old woman, caring for her 60 year
old mother who does not live with her. She is married and employed. [Updated
Februrary 2015] 8
· Although men also provide assistance, female caregivers may spend as much
as 50% more time providing care than male caregivers.9
Women’s Long-Term Care Needs
Women are the major providers of long-term care in this country, but they
also have long-term care needs of their own. Women live longer than men, tend
to outlive their spouses, and have less access to retirement savings such as
pensions. In 2010, almost eight percent of all women were age 65 or older10 [Updated February 2015]. A common scenario is an older woman who cares for her husband and who
discovers that there are few resources—financial or otherwise—to meet her own
needs for assistance. For example:
· Women who were 65 in the year 2014 can expect to live another 24 years
to age 86.11 [Updated February 2015]
· In 2005, almost half (48%) of women age 75+ were living alone;
compared to less than one quarter (22%) of men.12 [Updated
February 2015]
· In 2005, one in nine older women aged 75+ and one in five aged
85 or older, needed assistance with daily activities.13 [Updated
February 2015]
Women, Work and Caregiving
The number of working women age 55 and older is projected to increase by
52% between 2000 and 2010, from 6.4 million to 10.1 million.14 As
workforce participation increases, caregiving could pose even greater financial
challenges for many women workers, due mostly to lost wages from reduced work
hours, time out of the workforce, family leave or early retirement.
This time out of the workforce for caregiving may compound the impact of
earlier leave taken to care for a child. Further, caregiving is expensive in
and of itself. Whether it’s paying for prescription medications, installing a
ramp for a wheelchair-bound care recipient, or purchasing consumable supplies,
caregiving has a significant economic impact on a family. Women who are family
caregivers are 2.5 times more likely to than non-caregivers to live in poverty
and five times more liekly to recieve Supplemental Security Income (SSI).15
[Updated February 2015]. Furthermore, a 2011 study by MetLife
found that 23% of non-working and 20%of working female caregivers are providing
financial assistance to parents that they are caring for.16[Updated
February 2015]
While the costs of providing care are high, the demands on caregivers’ time
are also substantial. Estimates indicate that some 20 percent of all female
workers in the United States are family caregivers.17 [Updated
February 2015]. But women don’t abandon their caregiving responsibilities
because of employment. Instead, they cope—to the best of their abilities—with
the combined pressures of caring for a loved one, their need for income,
reliance on often inadequate public programs and fewer employment-related
benefits.18 Unmarried women caregivers may have even fewer options
for balancing work and caregiving.19
One national study on women and caregiving highlighted the conflicting
demands of work and eldercare. The study found that:20
· 33% of working women decreased work hours
· 29% passed up a job promotion, training or assignment
· 22% took a leave of absence
· 20% switched from full-time to part-time employment
· 16% quit their jobs
· 13% retired early
Other research paints a similar picture. For example:
· The negative impact on a caregivers retirement fund is approximately
$40,000 more for women than it is for men.21 [Updated
Februrary 2015]
· More intense caregiver responsibilities tend to have a greater impact on
the odds of retiring. Women who provide assistance to multiple family members
or friends have 50% higher odds of retiring than non-caregiving women.22
· Caregiving reduces paid work hours for middle aged women by about 41
percent. 23 [Updated Februrary 2015]
· In total, the cost impact of caregiving on the individual female caregiver
in terms of lost wages and Social Security benefits equals $324,044. 24
[Updated Februrary 2015]
Caregiving places a further strain on the precarious nature of many women’s
retirement income, particularly since time out of the workforce does not only have
short-term financial consequences. For most women, fewer contributions to
pensions, Social Security and other retirement savings vehicles are the result
of reduced hours on the job or fewer years in the workforce. Women caregivers
are:25
· Significantly less likely to receive a pension and, when they do, the
pension is about half as much as those that men receive.
· Likely to spend an average of 12 years out of the workforce raising
children and caring for an older relative or friend.26
Complicating the picture, researchers have found that women who reduced
their work hours while caregiving did not increase work hours once caregiving
had stopped.27 Additionally, caregivers who return to full-time
employment after caregiving are more likely to: 28
· Earn lower wages
· Have a “benefit-poor” job
· Receive reduced retirement benefits.
Caregiving also has a substantial impact on business. Absenteeism,
replacing employees who quit in order to provide care and other
caregiving-related activities can have serious financial consequences to
employers. For instance:29
· The cost to businesses to replace women caregivers who quit their jobs
because of their caregiving responsibilities has been estimated at $3.3
billion.
· Absenteeism among women caregivers due to caregiving responsibilities costs
businesses almost $270 million.
· The cost to businesses because of partial absenteeism (e. g., extended
lunch breaks, leaving work early or arriving late) due to women’s caregiving has
been estimated at $327 million. Caregiving-related workday interruptions add
another $3.8 billion to the burden borne by businesses.
Health Consequences of Women’s Caregiving
The toll that caregiving takes is not just financial. Higher levels of
depression, anxiety, and other mental health challenges are common among women
who care for an older relative or friend. Studies find that men respond to
caregiving responsibilities in a fundamentally different way. Women tend to
stay home to provide time-consuming care to one or more ill or disabled friends
or family members, while men respond to loved one’s needs for support by
delaying retirement, in part to shoulder the financial burden associated with
long-term care.30 The impact of the women’s intensive caregiving can
be substantial.
One four-year study found that middle-aged and older women who provided
care for an ill or disabled spouse were almost six times as likely to
suffer depressive or anxious symptoms as were those who had no caregiving
responsibilities.31 It’s not only care for a spouse that can affect
mental health, however. The same study found that women who cared for ill
parents were twice as likely to suffer from depressive or anxious symptoms as
noncaregivers.32
One in five female caregivers age 18 to 39 said that stress was nearly
always present in their lives; nearly twice as many as those who were not
caregivers and for male caregivers. 33 [Updated February
2015] The negative impact on carers' relationships and social networks due
to their reduced ability to participate in activities outside their caring role
can lead to carers' experiencing social isolation, which in turn can impact on
their psychological wellbeing. Studies have demonstarted that women are more
vulnerable than men to the effect of reduced social support. 34
[Updated February 2015]
A particularly strong factor in determining the mental health impact of
providing care is the amount of care per week that a woman provides. One study
found a marked increase in risk among women who provided 36 or more hours per
week of care to a spouse. Researchers concluded that there may be a threshold
of time involvement beyond which the likelihood of mental health consequences
rapidly escalates.35
The incidence of symptoms or experiences are not limited to depression.
Various studies have identified other common hallmarks of women’s caregiving
experience:
· A higher level of hostility and a greater decline in happiness for
caregivers of a family member.36
· Greater increases in symptoms of depression, less “personal mastery” and
less self-acceptance.37
· High caregiving-related stress.38
Compounding this picture, physical ailments are not uncommon. Researchers
found that more than one-third of caregivers provide intense and
continuing care to others while suffering from poor health themselves.39
Additionally, a 1999 study indicated that as compared to noncaregivers, women
caregivers were twice as likely not to fill a prescription because of the cost
(26% vs. 13%).40 Elderly women caring for a loved one who has
dementia may be particularly susceptible to the negative health effects of
caregiving because they receive significantly less help from family members for
their own disabilities.41 To highlight this, a 2003 study found that
over one in four (26%) of female caregivers reported fair to poor health
compared to 12% of women generally.42 [Updated February
2015]
The physical impact of providing care can lead to long-term care needs for
the caregiver. For example:
· A national survey found that 21% of female carers' had mammograms
less often. 43 [Updated February 2015]
· As many as two out of three older women do not take advantage of preventive
health services due to lack of information and high out-of-pocket costs.44
· 25% of women caregivers have health problems as a result of their
caregiving activities.45
· Coronary heart disease (CHD) is one physical risk factor of caregiving.
Women who spend nine or more hours a week caring for an ill or disabled spouse
increase their CHD risk twofold.46
· Other health effects include elevated blood pressure and increased risk of
developing hypertension; lower perceived health status; poorer immune function;
slower wound healing; and an increased risk of mortality.47
Despite the physical and emotional tolls of caregiving and risk factors for
disease, women caregivers are less likely to have their own health needs met.
One study found that women providing care to an ill/disabled spouse were more
likely to report a personal history of hypertension, diabetes and
hypercholesterolemia. These same caregivers were also slightly more likely to
smoke and consume more saturated fat.48 Additionally, compared to
non-caregiving women: 49
· 25% (vs. 17%) rated their own health as fair or poor
· 54% (vs. 41%) had one or more chronic health conditions
· 51% (vs. 38%) exhibited depressive symptoms
· 16% (vs. 8%) were twice as likely in the past year not to get needed
medical care
· 25% (vs. 16%) had difficulty getting medical care
It is clear that caregiving can have negative health effects. It is
important to note, however, that although caregiving can exact physical,
emotional and financial tolls, it can also be rewarding. Some women
caregivers:
· Reported a caregiver “gain”: more purpose in life than their noncaregiving
women peers.50
· Reported beneficial effects including more autonomy, more personal growth
and more self-acceptance when caring for friends.51
Minority and Low-Income Caregivers
Minority and low-income caregivers may face additional challenges. The
poverty rate for single African American women over the age of 65 is 30.7%, for
single Hispanic women it is 40.8% .52 [Updated February
2015] For these caregivers, accessing paid sources of care may be
particularly difficult. In fact, lower-income caregivers are half as likely
as higher-income caregivers to have paid home health care or assistance
available to provide support for and relief from their caregiving functions.53
· One study concluded that the caregiving time burden falls most heavily on
lower-income women: 52% of women caregivers with incomes at or below the
national median of $35,000 spend 20+ hours each week providing care.54
Support Systems for Women Caregivers
Because of the multi-faceted role that family and informal caregivers play,
they need a range of support services to remain healthy, improve their
caregiving skills and remain in their caregiving role. Caregiver support
services include information, assistance, counseling, respite, home
modifications or assistive devices, support groups and family counseling. While
many services are available through local government agencies, service
organizations, or faith-based organizations, employers are beginning to
implement workplace support programs as one way to mitigate the impact that
caregiving can have on workers.
Frequently, support services can make a real difference in the day-to-day
lives of caregivers. Research has shown, for example, that counseling and
support groups, in combination with respite and other services, have positive
direct effects on health behavior practices 55[Updated
February 2015] and assist caregivers in remaining in their caregiving role
longer, with less stress and greater satisfaction. In fact, women are more than
twice as likely as men to say that they would benefit from talking to
someone about their caregiving experience.56 Further, some studies
have shown that actual linkages to services in lieu of information-only
programs are more beneficial to caregivers.57Because women’s labor
force participation continues to grow, employer-sponsored programs will become
an increasingly vital resource for women who both work and provide care to a
loved one.