Submitted by Cassie Deacon, MSW Candidate, San Diego State University.

With over 64.8 million Americans over the age of 65, and the strain on existing systems such as health care, Social Security and local, state and federal resources, a push is occurring to transfer caregiving responsibilities from medical professionals to family members and friends in the home.  In 2016, it is estimated that over 17.7 million Americans act as primary caregiver for someone over the age of 65 experiencing a significant impairment.  Care provided within the home has an estimated economic value of over $470 billion per year, comparable to the annual spending on Medicare.

In addition, a drastic increase in cost for residential care is leading aging adults to look to family, friends and community members to fill the gap to obtain assistance with basic activities of daily living.  In California, residential care (assisted living, skilled nursing facilities, and memory care) can range from $2,800 to over $8,500 per month and in-home care providers cost on average $20-$25 per hour, often out of reach for many families.  Financially, caregivers are often required to reduce the number of hours at work or leave the workforce resulting in over $300,000 in lost wages and benefits over their lifetime.

This plight has created what is known as the “sandwich-generation”, individuals caring for multiple generations at one time, making this subset of individuals a highly at-risk population within the United States.  Research has begun to highlight the strains both physically, mentally, socially and financially on caregivers functioning in a system which lacks respite services, education on proper cares and emotional support.  Caregivers experience an alarming rate of depression, chronic health issues and increased mortality when compared to their non-caregiver counterparts.

A report by the National Academies of Sciences, Engineering and Medicine highlighted recommendations to address the health, economic and social issues of family caregivers for older adults. The report raised a call to action for policy makers to develop strategies within federal legislation to support the essential role of family caregivers to ensure the health, social and economic well-being of the family system. Such actions would require adapting America’s healthcare system, long-term care services and supports to partner with family caregivers.

As policy makers and community-based organizations engage, encourage and collaborate with family caregivers, families can take a much more active role to create, inform and sustain a person/family centered approach to the design and delivery of long-term care. Family caregivers are finding their voice, but are policy makers listening?


Schulz, R., Aranda, M., Beane, S., Czaja, S., Duke, B., Feder, J., … & Hinton, L. (2016). Families Caring for an Aging America. Washington, DC: Committee on Family Caregiving for Older Adults, National Academies of Sciences, Engineering, and Medicine.

Khulla, D. (2017, January 16). Who Will Care for the Caregivers? New York Times. Retrieved February 15, 2017, from

Reinhard, S. C., Feinberg, L. F., Choula, R., & Houser, A. (2015). Valuing the Invaluable: 2015 update. Insight on the Issues104.

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