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The Hidden Cost of Caregiving

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Time Spent on Caregiving

The Stages of Caregiving

Don\'t Wait for a Crisis to Act

Caregiver Stress

Long Distance Caregiving

A Caregiver\'s Bill of Rights


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Caregiving is no longer predominantly a women\'s issue. 

Men now make up 44% of the caregiving population.

Source: National Family Caregivers Association  Summer 2000.


"We can\'t thank you enough for all you\'ve done for our family. You were so sweet to meet with us, and help dad explore his needs and options. This was such a complex and emotional process, that we couldn\'t have done without you.

I\'m pleased to say that dad loves his new friends at the assisted living facility, and is back playing poker which he loves."

The Becket Family

Boston, MA












Employee Assistance Professional Association





Society for Human

Resource Management 






"How do I know I am doing everything I can to care for my dad?"

"Will I be able to handle my family obligations without them interfering with my job responsibilities?"

"I love my mother, and want to help, so why am I always so angry?"

"I\'m really worried about my parents, but is it normal for me to call them several times a day, to make sure they\'re OK?"

"I\'ve been taking care of my husband for eight years, and I\'m not well myself. Who is going to take care of me?"

These are some of the common questions, that we hear from elder caregivers, as they struggle to come to terms with their caregiving responsibilities.


The Cost of Caregiving

A University of Michigan study predicts that caring for older Americans with dementia, costs more than $18 billion a year, in additional time spent by family and friends. This help includes assistance with basic daily activities such as bathing, dressing, eating, and fixing meals, and with less frequent activities including grocery shopping and managing money.

"We found that the care-giving burden on family members increased substantially as cognitive impairment worsened," says Kenneth M. Langa, M.D., Ph.D., lead author of the study. "Those with mild dementia received 8.5 more hours of care per week than elders with normal cognitive function, who received only 4.6 hours of help per week. And those with severe dementia received 41.5 more hours of help per week than elders with normal cognition."

A second University of Michigan study that was conducted in 2004, revealed that depression among senior citizens carries a huge unrecognized cost: many extra hours of unpaid help with everyday activities, delivered by the depressed seniors, spouses, adult children and friends.

Even moderately depressed seniors, the University of Michigan study finds, require far more hours of care than those without any symptoms of depression, regardless of other health problems they may have.

If depressed seniors\' "informal" caregivers were paid the wages of a home health aide, the cost to society would be $9 billion a year, the researchers estimate. That puts depression second only to dementia in the national annual cost for informal caregiving, based on previous studies of the same data. And the findings illustrate the major impact of depression on both seniors and their loved ones.

Source: University of Michigan Health System

The Hidden Cost of Caregiving

A 2010 MetLife study, reported that the average working caregiver is subject to a loss of more than $659,000 over their lifetime, as a result of their caregiving responsibilities:

  - $567,000 in lost wages
  - $ 67,000 in retirement contributions
  - $ 25,000 in social security benefits

Other affects experienced include:

  - Sadness & grief
  - Fear & anxiety
  - Anger & guilt
  - Fatigue
  - Isolation
  - Disruption of the workday
  - Relationship stress - with children
  - Relationship stress - with their spouse or significant other  

Elder Caregiving

Caregiving often involves one or more persons (family, friends or paid professionals), who provide assistance to the elder in one or more of the following areas:

  housekeeping & home repair
  transportation ( e.g. doctor appointment, leisure activity)
  meal preparation
  supervision of medication
  providing ADLs (activities of daily living such as bathing, dressing)
  supervising others who provide direct care

Taking care of an elderly loved one is a real challenge, which currently involves 1 out of every 4 U.S. households. This number is expected to double by the year 2011, when 5 million baby boomers turn 65.

The US Department of Labor estimates that 30% of the work force is currently involved in caring for an aging parent or relative. These working caregivers are paying a heavy price as they struggle to balance their personal and work responsibilities. By 2010, it is expected that this caregiver workforce figure will jump to 54%.

Time Spent on Caregiving

  - 80% of caregivers provide unpaid assistance 7 days a week.

Stone, R., Cafferata, G.L., & Sangl, J. (1987). Caregivers of the Frail Elderly; A National Profile. The Gerontologist, 27(5): 616626

  - On average, caregivers provide personal care assistance and household maintenance chores for 12 hours per week. In addition 28% give care for 8 hours or less, 36% provide help for 21 hours or more, while 11% provide "constant" care.

American Association of Retired Persons (AARP) and The Travelers Foundation (1988). A National Study of Caregivers: Final Report. Washington, DC: American Association of Retired Persons

  - Caregivers of persons living in residential care facilities provide on average 36 hours per month (8.5 hours per week) of care, while caregivers of elders living in the community provide on average of 286 hours per month (66.5 hours per week) of care.

Rice, D.P., Fox, P.J., Max, W., Webber, P.A., Lindeman, D.A., Hauck, W.W., & Segura, E. (1993). The Economic Burden of Alzheimer\'s Disease Care. Health Affairs, 12(2):164176

  - The amount of time spent providing care varies based on the elder\'s type of impairment. A study of family caregivers found that caregivers of cognitively impaired elders spent an average of 13 hours per day providing care; more hours than spent in most full-time jobs.

Friss, L.R. & Whitlach, C.J. (1991). "Who\'s Taking Care: A Statewide Study of Family Caregivers," American Journal of Alzheimer\'s Care and Related Disorders and Research, 6:1626

The Stages of Caregiving

It is important to keep in mind that as human beings, we are all different, and as such we each have our own unique set of experiences. Research and experience however has shown that there are some similar themes and patterns experienced by the majority of caregivers. In order to create a working framework from which to discuss the spectrum of elder caregiving, we will outline seven stages of caregiving. It is important to note that this is a conceptual model, and based on the individual situation, not all caregivers will experience all seven stages.

Stage One - Basic Caregiving

The first stage, occurs when a loved one becomes concerned, that an elder is having difficulty performing what was once routine activities. At this stage a loved one begins to feel that they are "helping out", as they offer assistance in areas such as banking, bill paying, shopping, or transportation.

Stage Two - Self Identification as a Caregiver

This stage begins when the loved one sees that their helping out, has shifted to a self-identified "responsibility", which is now necessary for the elder\'s day to day functioning.

Stage Three - Providing Personal Care

This stage is marked, when a loved one begins to provide assistance for the elder, in the area of personal hygiene. Depending on the level of care needed, and the relationship between the elder and the caregiver, this may create an uncomfortable situation. It is often at this point that the caregiver begins to explore other options, such as hiring a professional to provide care in the home, or alternative housing such as assisted living.

It is important to note that caregiving is a demanding responsibility, and if the loved one continues to provide all care without outside assistance, the end result may be stress, physical illness, or exhaustion. All too often a loved one, believes it is their obligation to provide the care themselves, and might feel too guilty or embarrassed to seek outside help. It may be helpful to look at this from another perspective - we have a responsibility to see that our elder loved ones receive the care they need, but that doesn\'t mean that we must provide the care ourselves.

Stage Four - Seeking assistance

This stage begins when the loved one actively seeks out assistance may come in the form of support services (e.g. respite care, education programs, in-home services, alternative housing). One of the advantages of contracting with professional providers, is that it frees up some of the loved one\'s time and energy, thus allowing them to focus on quality time with the elder.

Stage Five - Exploring Placement in a Facility

The loved one usually reaches this stage, when they realize that the elder is in need of more services, than can be provided within the home. At this stage the loved one begins to explore alternative living arrangements. All too often, loved ones wait until there is a crisis before they look at alternative housing, often with the end result being that they feel guilty about "forcing" the elder into a facility.

Stage Six- Institutionalization

The sixth stage, involves placement of the elder in some form of care facility (e.g. nursing home, hospice). Once an elder is living in an appropriate facility; the loved one can now offer their assistance as an advocate or care manager, ensuring that the elder is receiving needed services.

Stage Seven - The Passing of the Elder

The final stage of caregiving occurs when the elder passes away. This begins a period of mourning and healing for the loved ones. It is important to mention, that all too often at this stage, loved ones begin to second guess themselves saying:

"I wonder if I made the right choice."

"If only I had done..., they may still be alive."

"Maybe I should have done ..."

Be careful not to do this to yourself! It is important to seek out professional assistance and support for yourself, while the elder is still alive, to take a pro-active approach to ensure that you and the elder are receiving the care that you need and desire.

Don\'t Wait for a Crisis to Act

All too often, we receive a frantic call from an individual who is in the midst of a crisis situation, following an elder being involved in an accident, or experiencing a sudden illness. These individuals feel unprepared to respond to the situation, because they often lack basic knowledge regarding the elder\'s medical history, medications, insurance coverage, financial matters, or what the elder\'s wishes would be in the given situation. In addition, they don\'t understand what the issues are, where to turn for help, or what kinds of questions to ask.

To ensure the highest quality of life for the longest time possible, it is crucial that elders and their loved ones, begin a dialogue to discuss the topic of aging. This process needs to focus on the elder\'s hopes and desires, short and long term goals, and their abilities and needs; while at the same time establishing a spectrum of resources that will address the elder\'s evolving needs.

For information about eldercare planning click on Advanced Care Planning

Caregiver Stress

Taking care of an elder can be a challenging responsibility that requires time, energy, and patience. In order to be effective in caring for another person, you must first take care of yourself.

One of the first steps in caring for yourself, is understanding and recognizing the signs of caregiver stress. Once you are aware of the stressors in your life, and your body\'s warning signs; the next step is to incorporate effective stress reduction techniques into your day.

Common Signs of Caregiver Stress

Physical headache, muscle aches, sleeping and eating problems, frequent illness
Emotional guilt, anger, loneliness, depression, and anxiety
Mental forgetfulness, difficulty making decisions, attention wandering
Interpersonal   withdrawal, blaming, irritability, impatience, and sensitivity to criticism
Spiritual feelings of alienation, and loss of hope, purpose, or meaning

Possible Ways to Reduce Caregiver Stress

  Identify community resources and support
  Obtain information on aging, the elder\'s condition, and caregiving
  Request assistance from family, friends, and community resources
  Practice stress reduction techniques (e.g. exercise, visualization, yoga)
  Eat well and get rest
  Set realistic goals and expectations - What can and can\'t you change?
  Look at long term planning (e.g. healthcare, financial, legal)
  Set realistic goals and expectations
  Do something nice for yourself (e.g. take a bubble bath, buy a new book, take a walk)
  Acknowledge the sacrifice that you are making out of love

Long Distance Caregiving

More than 14 million employees are juggling work, raising a family, and providing caregiving tasks. While caregiving can be challenging and stressful, the situation can be complicated even further, when the elder lives in a different community or State.

A Survey by The National Council on Aging

  - 3.3 million adults provide long distance caregiving
  - The average travel distance is 304 miles (4 hours)
  - Primary caregivers average 35 hours/month
  - Distance caregiving costs 15 million workdays/year

Questions to ask before committing yourself:

  - How independent is the elder?
  - What are the elder\'s wants and desires (e.g. remain in the home)?
  - What types of assistance does the elder require (e.g. meal preparation)?
  - Has the elder had a geriatric assessment?
  - What resources are within the elder\'s community (e.g. volunteer and fee based)?
  - Would the elder consider moving?
  - How much time do you have to commit to caregiving?
  - Does your job allow for caregiver travel?
  - Can you handle the travel fatigue?
  - How will your caregiving impact on the rest of your family?
  - How will your decision affect your work/career?
  - Are you emotionally prepared for the challenge?
  - Are there any other people who can help (e.g. friends, neighbors, clergy)?
  - Would you consider consulting an elder care manager?

A Caregiver\'s Bill of Rights

I have the right to:

  - take care of myself. This is not an act of selfishness. It will give me the ability to take better care of my loved one.
  - seek help from others even though my loved one may object. I recognize the limits of my own endurance and strength.
  - maintain facets of my own life that do not include the person I care for just as I would if he or she were healthy.
  - know that I do everything that I reasonably can do for this person and I have the right to do some things just for myself.
  - get angry, be depressed, and express difficult feelings occasionally.
  - reject any attempt by my loved one (either conscious or unconscious) to manipulate me through guilt or anger.
  - receive considerations, affection, forgiveness, and acceptance for what I do for my loved one as I offer these attributes in return.
  - take pride in what I am accomplishing and to applaud the courage it has taken to meet the needs of my loved one.
  - protect my individuality and my right to make a life for myself that will sustain me in times when my loved one no longer needs my full-time help.
  - expect and demand that as new strides are made in finding resources to aid physically and mentally impaired older persons in our country, similar strides will be made toward aiding and supporting caregivers.  

To obtain more information or to request a consultation click on Contact Us


About Our Company

Employee Assistance Professionals, Inc. has over 32 years of experience providing services for individuals, couples, families, and organizations.  Our mission is to provide a broad range of high quality counseling, outreach, and consultation services to help clients assess their needs, evaluate their relationships, define their goals, and design action plans that includes specific and practical steps to achieve those goals.

Our organizational goals are to:

  - provide services regardless of race, color, ethnicity, sexual orientation, or religion
  - respect our clients\' beliefs
  - support our clients\' individuality, diversity, and unique needs
  - preserve our clients\' independence, dignity, and confidentiality
  - offer services to individuals, couples, and families
  - consult with professionals, businesses, and other organizations
  - design and run effective Employee Assistance Programs (EAPs)
  - conduct quality educational programs


The Caregiver Resource Center is a division of Employee Assistance Professionals, Inc.  Our mission is to assist seniors, people with special needs and their families; in understanding the aging process, facilitating open communication; and providing information, support and guidance through the caregiving process.

Our goals are to:

  - offer services that will help preserve an elder\'s health, safety and quality of life; while at the same time allowing them to maintain their independence and dignity.
  - provide support, understanding, and guidance to all person\'s who are directly or indirectly responsible for the well-being of an elder; in an effort to improve the quality of their lives.


In addition to working with seniors, people with special needs and their families; The Caregiver Resource Center also provides a spectrum of services for businesses and their employees.

Our services help maximize employee productivity, sustain supervisors\' focus on operations, and equips senior management with an effective cost management tool.

We are available to provide services on a case-by-case basis, or as a full service company program.


The Caregiver Resource Center
a division of
Employee Assistance Professionals, Inc.
PO Box 122
Cos Cob (Greenwich), CT 06807-0122

For more information or to request a consultation, please contact:
Linda A. Ziac,

(203) 861-9833
Contact Us





Employee Assistance Professionals, Inc. and The Caregiver Resource Center have a company policy that the company\'s website does not display advertisements, nor do we host or receive funding from advertising, or from the display of commercial content.  

Any reproduction of the content of this website site is strictly prohibited, without prior written permission from Employee Assistance Professionals, Inc. and The Caregiver Resource Center.

Updated 3/1/2023

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