Relatives who care for elderly frequently miss work, deserve public help, SFVAMC study says

November 19, 2001

People who care for their frail elderly relatives instead of putting them in nursing homes frequently miss work or leave their jobs entirely, according to research from San Francisco VA Medical Center (SFVAMC). Latino, African American and female caregivers are especially likely to make these sacrifices, the study found.

The researchers argue that family caregivers deserve public aid or tax breaks because they save the government billions in Medicare expenses by keeping these elderly out of nursing homes. The study was published in the November issue of the Journals of Gerontology.

"These caregivers are the backbone of our system of caring for the elderly. We found that a lot of them are making significant sacrifices, including missing time at work or quitting their jobs altogether," said the study's lead author Kenneth Covinsky, MD, MPH, UCSF assistant professor of medicine and SFVAMC staff physician.

Two-thirds of elderly people who are eligible to live in a nursing home get their care at home instead, usually from members of their extended family. Researchers have estimated the value of this care at $196 billion dollars a year.

To determine the factors that made caregivers most likely to miss work, Covinsky and his colleagues surveyed more than 2,800 elderly people who were eligible for, but not living, in a nursing home and their caregivers.

Twenty-two percent of these patients had a caregiver who had cut back their working hours or quit their job to provide care, the study found.

Hispanics, African Americans and women were more likely than others to have limited their work schedule, Covinsky said. Hispanics were nearly twice as likely as others to make this sacrifice.

The ethnic disparity may be due either to cultural differences or access to care, Covinsky said. "There's some evidence that, in general, African Americans and Hispanics believe more strongly that family members are responsible for taking care of younger and older generations. Another possibility is simply that there is less access to nursing home services in these communities," he said.

"These caregivers are saving the public health system a lot of money because, for almost all the patients in our sample, if they didn't get care at home they would be drawing on the Medicaid system," Covinsky said.

"We need to find ways to minimize the sacrifice of these caregivers, perhaps through tax breaks for caregiving, or other ways of assisting caregivers so that they don't need to take time off from work," he said.
Co-authors on the study included: Kristine Yaffe, MD, SFVAMC chief of geriatric psychiatry, and UCSF assistant professor of psychiatry, neurology and epidemiology; Li-Yung Lui, MS, UCSF statistician; Laura Sands, PhD, UCSF/SFVAMC assistant professor of medicine; Louise Walter, MD UCSF/SFVAMC geriatrics fellow; Catherine Eng, MD, medical director at On Lok Senior Services; Ashwini Sehgal, MD, Case Western Reserve University; and Darryl Wieland, PhD, and G. Paul Eleazer, MD, both from University of South Carolina School of Medicine.

The study was funded by the American Federation for Aging Research Paul Beeson Faculty Scholars Program.

University of California - San Francisco

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