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27 Things You May not Know about Women and Caregiving

By Sean Coffey, MPA, Policy Specialist, National Center on Caregiving at Family Caregiver Alliance

In honor of International Women’s Day 2012, we want to highlight some of the most interesting data related to women and caregiving from 2011. This data is a sneak preview of our “2011 Year in Review: Family Caregiving” that will be released later this month at our session at the American Society on Aging conference, though you can view our 2010 Year in Review now.

According to most research in 2011, the majority of caregivers continue to be women, though an analysis of employed caregivers by Gallup  found much higher numbers of men caregivers than past research. This data may be different than other research because it was looking at employed caregivers. The Gallup analysis found: “Women are also slightly more likely than men to be caregivers — 20% versus 16%, respectively.”

Research on Women and Caregiving in 2011

1. The majority of caregivers are female (65%), and more than 80% are caring for a relative or friend who is age 50 or older. AARP Public Policy Institute: “Valuing the Invaluable.

2. In a study by the National Alliance for Caregiving of 583 family caregivers taking part in the REACH 1 project,  82.8% of the caregivers were female. The average age of the caregivers was 61.7 years, 58% were white, 23% were African American, and 18% were Hispanic/Latino. The average amount of care provided was 7.9 hours per day.

3. Of the 2.6 million family caregivers in Australia in 2009, 68% were women (Australian Government data)

4. Twenty-nine percent of Australian caregivers identified themselves as the primary caregiver, defined as the person providing the most assistance, and women were about twice as likely to fill this role (5% women, compared to 2% for men). Of the 98,300 primary caregivers who reported a need for respite care, only 36% had ever used it. Forty percent of primary caregivers providing 40 hours or more of care (per week) were likely to frequently feel worried or depressed, as compared to 27% for caregivers who provide 20 hours or less of care. Twenty-five percent of primary caregivers reported losing touch with their existing friends, while 61% of caregivers with a spouse or partner (who isn’t the care recipient) reported that the relationship had been affected. (Australian Government Data)

5. In France, not only are women more likely to be caregivers, they also devote about two hours more per day for caregiving as compared to men.  See: Elder care and dependence: no longer just a women’s concern?

6. Even in states where a family caregiver can be compensated, it’s rare that the hours authorized match the hours actually spent providing care. In a report on California’s In Home Supportive Services, the authors note that the program paid for, on average, 21.4 hours of week in 2008, while the national average of care provided (both paid and unpaid) is 31.4 hours a week.

7. A report published in August 2011 suggested that policymakers should begin to address the “feminization of aging” based on the disproportionate dementia burden that women bear.
Women are more vulnerable to prolonged inequality because of lower levels of education and a greater risk of poverty, and, because caregivers are more likely to be women, they are also exposed to increased health and financial risks associated with caregiving. The authors recommend incorporating a gender dimension to health policy and programs; including gender as a key health determinant in prevention of dementia; disaggregating dementia research by gender and age; equal representation by men and women for policy decision-making roles; and more interdisciplinary research that incorporates the biological and social models of health for men and women.

8. An analysis by Bowling Green State University found that female and adult-child caregivers generally reported having more negative experiences than male and spouse caregivers, with wife caregivers least likely to report positive experiences. The Care recipient’s problem behavior was the most important risk factor for wife caregivers having a negative experience, whereas positive experience was correlated with reciprocal help from care recipients, suggesting that caregivers need recognition and care from their care recipients.

Working and Caregiving

9. While 71% of caregivers report that their employer is aware of their caregiving role, only about a quarter of employees have access to employer programs that would support them, for example support groups, ask-a-nurse services, financial/legal advisors, and assisted living counselors. (Gallup: Caregiving Costs U.S. Economy $25.2 Billion in Lost Productivity)

Caregiving’s Negative Impact on Women’s Financial Health

10. Researchers from Demos and the Institute on Assets & Social Policy found:  “Close to half (47%) of single female seniors are economically insecure, while more than half of all seniors of color do not have the resources required to support themselves over the remainder of their lives.”

11. According to a Census analysis and estimate of earnings for 2009 and 2010, for “female householder, no husband present,” the median income for 2010 was $32,031, a 3.3% decrease from 2009, and $17,686 less than the median income for “male householder, no wife present” in 2010, which was $49,178.

12. A December 2011 report from AARP’s Public Policy Institute finds that male-headed households had higher incomes than female-headed households, with a median income for widows that was only 75% of the median income for widowers.

13. An analysis by the Met Life Mature Market Institute find that the average 50-year old woman who stops work to be a caregiver will have lost wages of $142,693; lost Social Security benefits of $131,351; and lost pension benefits of $50,000. In total, she will forego $324,044. In comparison, the average 50-year old male would forego $283,716.

14. A September 2011 report from the MetLife Mature Market Institute and Scripps Gerontology Center finds that women are more likely than men to be widowed, divorced, or otherwise live alone. Women (71%) are more likely than men (63%) to report being either very or somewhat concerned about providing for their own or their spouse’s long-term care needs. Women are also more likely to need long-term care, with an average bill of $124,000 vs. $44,000 for men. Income (from all sources) during retirement for men aged 65 and older is $37,509, while women’s income is only 57% of that amount: $21,509.

15.  In 2008, in the United States, 11.9% of women lived below the poverty line as compared to 6.7% for men, and rates are even higher for nonmarried (16.9%), widowed (15.4%), and divorced (19.5%) women. A report by an analyst from the Social Security Administration examines caregiver credit components in retirement programs in France, Germany, and Sweden and provides recommendations for the US to consider if the policymakers implemented a caregiver tax credit in the US. The author of the report, John Jankowski, wrote a blog post about the report for FCA’s 30 Days of Caregiving.

16.  A February 2011 report by Human Rights Watch found that the U.S. (other than New Jersey, California, and six cities) lags behind 178 other developed countries that have national laws guaranteeing paid maternity leave for mothers, while 50 countries also provide paid leave for new fathers. The U.S., Papua New Guinea, and Swaziland offer no legal guarantee of paid maternity leave, and only 11% of U.S. companies have opted to provide paid leave. While the Paid Family Leave Act does mandate the provision of unpaid, job-protected leave, it is only for eligible employees who have worked at least a year, have worked 1,250 hours, and who work for employers with 50 or more employees.

17.  According to the Telegraph, a widower in the United Kingdom, Ian Cockbrun, is suing the Department of Health because he receives £3,200 less ($5,200) annually in pension than a widow would in the same situation. His wife passed away in 2007, and Mr. Cockburn argues that his wife’s contributions to the pension system should be treated in the same manner as a man’s contributions. When the Department of Health calculates pensions, it discounts contributions made by deceased wives before April 6, 1988, whereas widows’ pensions are based on the full contributions by their husbands. This provision is in place because of women’s lower earning potential and child-care responsibilities placing them at an economic disadvantage. A number of studies have also found that caregivers are more likely to be women. However, in Mr. Cockburn’s case, he had stopped working to serve as his wife’s full-time caregiver while she battled cancer. If he is successful, the result could be the Department of Health paying an extra £1billion a year to widowers.

Women, Caregiving, and Health

18. A study of 6,376 post-menopausal women aged 65 to 79 years old found that the 508 women who had significant depressive symptoms had about twice the risk for developing mild cognitive impairment and probable dementia as women who weren’t depressed.

19. In a study of 7,163 post-menopausal women aged 65 to 80, researchers found that excess weight on belly or hips is a risk factor for cognitive impairment and probable dementia in normal-weight women. Dr. Diana Kerwin, one of the authors of the study, explained that every one point increase in a woman’s body mass index meant a decrease of one point in her cognitive test score.

20. According to the Center for Disease Control, Alzheimer’s was the fifth ranked disease for females in 2007, accounting for 4.3% of deaths, as compared to being the tenth ranked disease for males (accounting for 1.8% of deaths). Alzheimer’s was the sixth leading cause of death overall in 2007.

21. In a survey of Alzheimer’s caregivers by the National Alliance for caregiving, 67% of the caregivers were women and seven in ten were employed, with 51% working full time and 18% working part time. Women were more likely than men to remark on changes in mood and personality of a loved one (33% vs. 25%) and poor financial judgment (17% vs. 11%).

22. The Sacramento Bee reported that the number of Americans aged 65 and older who cohabitate has tripled from 193,000 in 2000 to 575,000 in 2010. The increase is tied to several issues, including greater societal acceptance of cohabitation without marriage, financial concerns, and a desire to not re-work legal documents like wills. Dr. Susan Brown, a professor who studies the topic, cites the example of a widow who currently receives her late husband’s pension and/or health care coverage and who would be forced to forfeit that income if she were to remarry.

23.  According to Center for Disease Control research, of people aged 80 and older, women were more likely than men to need assistance with personal care activities (14.8% vs. 10.2%). Of these activities, women were more likely than men to need assistance with bathing/showering (12.1% vs. 8.1%), dressing (9.1% vs. 7%), and eating (3.9% vs. 2.4%). The estimates are based on household interviews from a sample of the non-institutionalized U.S. population, and therefore excludes adults living in assisted living facilities, nursing homes for the elderly, hospitals for the chronically ill, or correctional facilities.

24.  An article in the Sydney Morning Herald  highlighted a trend of elderly Australians entering nursing homes later in life and with greater care needs. The median stay in nursing homes is about two years for women and one year for men, and an expert suggests that about 60% of patients also have some level of dementia.

Women and Caregiving in the News in 2011:

25.  Minnesota’s Long-Term Care Ombudsman, Deb Holtz, was profiled in the Star Tribune for her stay at a nursing home after shoulder surgery. While she was scheduled to stay for a week, she left after 25 hours. Holtz explains that other than somebody offering her dinner, she sat alone for five hours after being admitted, without an admissions meeting.

Right before bed time, a nurse entered her room to perform a skin check (to prevent bed sores), and despite Holtz explaining she didn’t need the check because she was mobile, the nurse proceeded to check her exposed areas like her feet. The nurse stopped when Holtz told her to write on her chart that she had declined treatment, something she knew she had the legal right to request. Holtz was awakened the next morning by an aide turning on bright lights and telling her to stand up so she could be weighed. She ended her stay that day and explains that she felt a loss of dignity and that she felt more like a “check-mark on a to-do list.”

26. The Bangor Daily News  highlighted Kara Janes, a graduate student in social work in Maine, who participated in a program called “Learning by Living,” and through it, Janes spent ten days at a nursing home. As part of the program, Janes had a “diagnosis” of a stroke that disabled her right hand side as well as pneumonia because of an impaired ability to swallow. She fully embraced her diagnosis by being fed a pureed diet, being assisted with toileting, bathing in a whirlpool tub, and not having any visitors during her stay.

    An administrator from the facility explains, “There’s no place like home, but a busy in-house social calendar, regular shopping excursions and other “field trips” along with a cadre of dedicated volunteers help make Lakewood more livable.” Janes is the first non-doctor to participate in the program, which has had 26 participants to date.

    27. Jeff Danielson, a firefighter in Iowa, who is also a state senator, followed Kelly Stokes, a Certified Nursing Assistant during a PHI “Come Care With Me Day.”  Despite being a firefighter, Senator Danielson expressed surprise at the physical toll of the direct care work. He explained that he thinks the public may underestimate the importance of direct care workers, and suggested that direct care workers need to be paid well and receive health care benefits.

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