Caregivers Pay the Cost with Their Own Health Issues

Care for the caregiver is desperately needed.

The National Alliance for Caregiving released their latest study on family caregivers of people with Alzheimer's Disease (AD). Caregiving Costs: Declining Health in the Alzheimer's Caregiver as Dementia Increases in the Care Recipient shows a significant decrease in family caregiver health over time and increased personal healthcare costs, as their care recipient's dementia increases. The study was conducted by examining the use of formal health services in a large sample of Alzheimer's disease caregivers.

The findings suggest that the strain of caring for someone with AD can cause family caregivers to use health care services at higher rates than non-caregivers of the same age. Caregivers showed a 25% increase in the utilization of all types of services combined over the 18-month time period of the study. The estimated $4,766 more annually in health care services for caregivers whose average age is 61 could become a substantial cost to Medicare when the caregiver turns 65. Compounding the problem is the fact that caregivers do not always self-identify. And with more care moving into the home, I would guess caregivers hold out until the last minute to avail themselves of home health care too.

The results suggest that caregiver assessments would be valuable in identifying those at risk of having their own health decline. These assessments look at the caregiver's health, ability and willingness to do what tasks may be required as well as the caregiver's need for support. The assessment should be done at the same time as an initial diagnosis of dementia is confirmed for the care recipient.

The report also suggests that primary care doctors should be sensitive to whether their middle-aged and older patients are family caregivers. They should be asking "Are you caring for a relative or friend?" as a potential risk factor that may cause stress or even physical strain. The doctor can also refer the caregiver to the local Alzheimer's Association chapter or the local area agency on aging for community resources. This is a big issue because as primary care physicians assume more of a role in a person's health through medical homes, it is imperative that they start to employ geriatricians in the practice.

To date, health care utilization studies have focused on the care recipient rather than the caregiver. These new findings, according to the Alliance, suggest we need to expand the focus to the family caregiver to obtain a more comprehensive picture of the overall effect of caregiving from both a personal and a societal perspective.

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Clarissa Leahy