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SAN FRANCISCO--Family Caregiver Alliance has released its most recent analysis of California's family caregivers of brain-impaired adults.

The research documents trends among families and friends who care for a loved one with a cognitive impairment (e.g., Alzheimer's, stroke, Parkinson's disease, Huntington's disease, traumatic brain injury) from all regions of California and who completed a comprehensive in-home assessment by one of the state's 11 Caregiver Resource Centers (CRCs).

The statewide database generates information on the need for and impact of caregiver support services; identifies trends and directions for service development; and assists in laying a foundation for new policy initiatives.

In comparing data collected in 1997 with data from 1992, researchers noted critical differences and emerging trends. For example:

• Family Caregivers Are:
• More likely to be caring for aging parents. Reflecting the aging of the baby boomers and the increasing numbers of children of aging parents, the proportion of adult child caregivers in California increased from 36% to 40% over the five-year period. In the San Francisco Bay Area, the number of adult child caregivers grew sharply from 29% of all caregivers in 1992 to 42% in 1997. Though still the largest kin group, the proportion of spouse caregivers statewide fell from 51% to 47%.
• More likely to be employed, juggling work and care. The proportion of working caregivers under the age of 65--those most likely to be in the labor force--increased from 47% in 1992 to over half (53%) in 1997. This trend is likely to grow as women continue to enter the labor force. Those who reduced their work hours to give care increased dramatically from 18% in 1992 to 43% in 1997.
• Slightly older. The mean age of caregivers increased slightly from 59 years to 60 years of age. Those caregivers who are 75 years of age and older grew from 16% to 21% of this caregiver population during the five-year period.
• Increasingly ethnically diverse. The number of non-white caregivers increased statewide from 14% in 1992 to 18% in 1997. In Los Angeles, 42% of caregivers served are African American, Asian or Pacific Islander, Hispanic/Latino or other ethnic groups. In the Bay Area, nearly one-third (31%) of the caregivers served are non-white.
• Less likely to receive adequate support from their own family and friends. In 1997, 44% of family caregivers said the help they get from their own family and friends in the care of their loved one is "far less than they need" compared to 28% who reported this in 1992.
• Increasingly at risk for physical health problems. Between 1992 and 1997 the proportion of family caregivers rating their own health as "fair" to "poor" grew from 43% to 50% statewide. Family caregivers with their own health problems often find it difficult to continue to provide ongoing care. This is an area of growing concern and suggests the need for more "preventative" caregiver support services.
• Continuing to experience depression. The proportion of family caregivers exhibiting clinical symptoms of depression fell from 66% to 58% between 1992-1997. The fact remains, however, that well over half of California caregivers seeking help and support from a CRC are suffering emotional strain from providing long-term care to a loved one with cognitive impairment. Mental health concerns remain a serious and pervasive problem.

• Adults with Brain Impairment Are:
• Increasingly older. The mean age of adults with brain impairment increased from 71 years to 75 years of age. The proportion of the affected population aged 85 and older increased from 14% to 19% over the five-year period.
• More likely to be enrolled in managed care. The proportion of adults with brain impairment who are enrolled in Health Maintenance Organizations (HMO) nearly doubled, from 21% in 1992 to 40% in 1997. In the Bay Area, the proportion of HMO enrollees increased dramatically from 28% to 50% in the five-year period.
• More likely to have prepared advance directives. The proportion of brain-impaired adults with a Durable Power of Attorney for managing assets increased from 38% to 59%; those with a Durable Power of Attorney for Health Care increased from 35% to 60% during the same period.

As the California population ages and becomes increasingly more diverse, changing patterns of family life are increasing the demands placed on family caregivers who provide long-term care to a loved one with cognitive impairment. The need for emotional support, respite care, and other home and community-based service options continues to grow dramatically.

The caregiving database is maintained by Family Caregiver Alliance in its role as Statewide Resources Consultant to the California Department of Mental Health. The study sample consists of 1,159 California caregivers who were assessed by one of the Caregiver Resource Centers between January and June, 1997. The comprehensive in-home assessment is conducted when a family client needs help beyond basic information and referral. A reassessment of the family situation is completed six months after the initial assessment and every six months thereafter if CRC services are being provided. CRC services include information, education, long-term care planning, legal/financial consultations and respite care assistance.

For more information, call Family Caregiver Alliance at (415) 434-3388.

Editors please note: National Family Caregivers Week will be celebrated this year November 22 to November 28, 1998; National Stroke Awareness Month is October, 1998; National Alzheimer's Month is November, 1998. For additional information on long term care please see the FCA website at www.caregiver.org or contact Bonnie Lawrence at (415) 434-3388, ext. 312.

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