Addressing the Diverse Needs of Unpaid Caregivers Through New Health-Care Policy Opportunities.

Abstract

About 41 million spouses, children, and other relatives have provided unpaid care to a family member aged 50 years or older in the past 12 months (AARP, 2020). Population aging is increasing demand for these unpaid caregivers, who play a valuable role in allowing older adults to age in place. Longer lifespans have increased the number of Americans living with health conditions such as Alzheimer’s disease and dementia, which require extended periods of intensive care. Whereas care for aging Americans was traditionally shouldered by adult daughters, daughters-in-law, and wives, trends in family structure and employment and growing racial/ethnic diversity have altered who provides care, the type of care provided, and potentially their beliefs about caregiving. There has been some growth in policies and programs supporting family caregivers, but they have not kept up with the realities of caregiving for many Americans. Studies have reported on state and federal policies that address some previously unmet needs, such as paid and unpaid family leave and financial support to caregivers (Dawson et al., 2020); however, this patchwork of policies only addresses some groups of an increasingly diverse set of caregivers. For example, the Older American Act (OAA) of 1965, the first to bring social services to older persons living in the community, is a grant-based program with disparate access to services depending where one lives (Administration for Community Living, 2020). Despite the growing numbers of unpaid caregivers providing an array of care services with disparate support needs, they remain invisible in the health-care system that relies on them to provide this care. In this article, we first describe the caregiving landscape in the U.S. population today. Next, we highlight opportunities within the current health-care system: in particular, those with the potential to address some unmet needs of modern caregivers. Finally, we suggest avenues for future research to inform policy.