Informal Caregiving
The majority of long-term care in
Minnesota is provided informally at no expense to public coffers. Family
members, friends and neighbors provide most of the assistance to
individuals who want to remain in their homes but need help with daily
activities because of chronic illness or disability. The importance of
these caregivers will increase as the population ages over the coming
decades and the number of seniors at risk of requiring help with daily
functional tasks rapidly grows. At the same time however, increasing
numbers of women in the workforce, changing family patterns and greater
geographic dispersion of family members have put additional strain on
family caregivers and contribute to a decline in their availability.
Recognizing and supporting family caregivers will become a central
component in Minnesota’s long-term care system.
How Many Seniors Have Informal
Caregivers?
Seniors age 60 and over were
asked if they had someone to help them if they became sick or disabled.
Most older people (seven out of eight) report that would have someone to
take care of them. In fact, slightly more seniors report they have a
caregiver available now than they did 13 years ago (88%, 2001 vs. 86%,
1988). There are subpopulations however, who are less likely to have a
caregiver. Older people who live alone are much less likely to have
caregivers than those living with others, as are those 75 years and older
and those with annual incomes less than $12,000.
Figure
1 Percent of Older Minnesotans Who Report That They Would Have Someone to
Provide Long-Term Care for Them Should They Need It
Most seniors say they would rely
on a spouse (54%) or adult child (37%) for caregiving. The proportion
relying on children however, is higher for seniors age 85 or older (52%)
and for seniors living alone (50%).
Table 70 Who Helps Seniors When Sick or
Disabled?
Elderly Rates of Disability in
the State are Decreasing
Reports that national rates of
disability among the elderly are decreasing (Manton, et al, 19971)
are verified here in Minnesota as well. The percent of seniors age 60 and
older with functional limitations has significantly decreased since 1988.
Having difficulty shopping for groceries or doing heavy housework.
Table 71 Functional Status of Minnesota
Seniors
1
Difficulty doing a functional activity because of health or physical
problems.
2 Heavy
housework includes scrubbing floors, mowing the grass, or washing windows.
3
Light housework includes doing dishes, straightening up, or light
cleaning.
4
Personal care includes bathing, dressing, washing hair, or showering.
Fewer Seniors Are Getting Help
With Daily Functioning
Except for heavy and light housekeeping,
the proportion of older Minnesotans receiving help with functional
activity limitations has dramatically decreased from 1988 to 2001. In 1988
for example, 84 percent of seniors needing help to prepare their meals
said someone helped them; in 2001, 67 percent said they were getting
assistance in preparing their meals. Similar decreases in assistance were
also indicated for grocery shopping, managing money, getting outside the
home and personal care. So, although more people reported that there was a
caregiver who could help them if needed, fewer people who need help were
actually getting help.
Figure
2 Someone Helps with Daily Functioning
Who Provides Assistance With
Functional Activities?
Table 3 shows the persons who actually
provided assistance with various activities of daily living in both 1988
and 2001. Informal caregivers, especially spouses and children are still
the main sources of assistance for seniors with functional limitations.
Table 72 Who Helps Seniors with
Functional Activities?
However, Indications that the present
informal network may be stretched beyond capacity are evident:
- There is a significant decrease in the
number of older person who mentioned spouses, other relatives, friends
or neighbors as providers of personal care or assistance with getting
outside from 1988 to 2001.
- At the same time significantly fewer
agencies are providing assistance in preparing meals, heavy housework,
personal care and getting outside.
- The number of persons purchasing
services available for hire such as heavy housework, light housework,
and personal care has dramatically increased in the last 12 years.
- Except for light and heavy housework,
the percent of respondents with functional limitations who are not
receiving any assistance with these limitations has significantly
increased.
- The percent of seniors living alone has
also slightly increased (from 26 percent to 28 percent).
How Many Seniors are Providing
Informal Care Today?
The number of seniors who describe
themselves as caregivers is growing. In 2001, about 13 percent of seniors
said they were currently providing care for or giving assistance to
someone because of their injury, disability, medical condition or
inability to care for themselves up from about 10 percent in1988. They are
equally likely to be males or females, to be working or not and represent
all age groups, income and educational levels. Married seniors are
however, more likely to provide caregiving than those not married (15
Percent vs. 9 percent). Seniors living alone are less likely to be
caregivers than those who live with others (15 percent vs. 8 percent).
Who Are They Caring For?
Six percent of all married seniors are
currently providing care for their spouse. Forty percent of married
seniors who identified themselves as caregivers are spouse-caregivers. Men
and women are equally likely to find themselves in the role of spousal
caregiver.
Looking at all caregivers, spouses are
still the predominant care recipients (see Figure 3) although the
percentage of spouse-caregivers has dropped significantly since 1988.
Older caregivers are more likely to provide care to parents, friends or
neighbors and less likely to care for spouses, parents-in-law or brothers
and sisters in 2001 than they were in 1988.
Over half of the sons and daughters cared
for by seniors in 2001 are developmentally disabled. While only 5 percent
of the respondents report that they are caring for grandchildren, these
children are overwhelmingly young (under 19 years of age). None of their
caretakers however have legal custody nor did any want to get legal
custody.
Figure
3 For Whom Are Older Minnesotans Providing Care?
How Many Hours of Care Do They
Provide In a Typical Week?
The average senior caregiver in Minnesota
provides care for 18 hours a week. Number of hours range from less than
one hour up to "constant care "of 168 hours per week. About one
in ten provides 40 or more hours of care per week. Female caregivers spend
more time on average than male caregivers (21 hours compared to 11 hours
per week).
Figure
4 Weekly Hours of Caregiving Provided to Family/Friends
ABOUT THE SURVEY
The data presented in this report are
based on the 2001 Survey of Older Minnesotans conducted by the Minnesota
Center for Survey Research under contract with the Minnesota Department of
Human Services. A randomly selected statewide representative sample of
2,011 adults ages 60 or older were interviewed by phone between April 16
and August 6, 2001. The margin of sampling error is +/- 2.2 percentage
points. For results based on subgroups of respondents the margin of error
is higher.
Significant differences (P< .01)
between subgroups of seniors are indicated by an *. Continuous variables
were compared using 1-way analysis of variance and categorical variables
were analyzed using the c 2 test.
Results from the 2001 Survey of Older
Minnesotans were compared with survey results reported for 1988.
Significant population differences between 1988 and 2001 are also
indicated by an *. For a complete description of the 1988 study see:
Fischer, L.R., Mueller, D.P., Cooper, P.W., and Chase, R.A.; Older
Minnesotans: What Do They Need? How Do They Contribute? St. Paul
Minnesota: Amherst H. Wilder Foundation, 1989.
1Manton, K. Corder, L. and Stallard, E. (1997) Chronic
Disability Trends in Elderly. United States Populations:1982-1994.
Proceedings of the National Academy of Science. 94:2593-2598.
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