LTC Bullet: Caregiving Crisis Continues

Wednesday, August 18, 2004

Washington, DC--

LTC Comment: Two new studies target the growing challenge of long-term caregiving and point to the need for better financing alternatives. More after the ***news.***

*** LTCi CONFERENCE. The 2004 National LTCi Producers Summit (November 7-9, 2004, San Francisco) program is now available online: This annual event, organized by Jesse Slome of Sales Creators sold-out to 700 attendees last year. This year's 3-day program is targeted toward LTCi agents but would be a valuable learning experience for anyone who cares about long-term care service delivery and financing. For more details, visit the Summit website or call Sales Creators for a brochure (888) 599-5997. Save $75 when registering: simply write "Center LTC" in the Discount Code box on the online registration form. Then deduct $75 from the cost. ***

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LTC Comment: Long-term caregiving, especially long-distance caregiving, is already a big problem. The MetLife Mature Market Institute shed new light on that subject recently in another of its excellent reports on long-term care service delivery and financing. Read on for the executive summary of that report and a link to the full text.

Despite the welcome news in many other studies that disability rates among the elderly are declining, the challenge of long-term caregiving will increase dramatically in the future. That's the conclusion of a new report by Robert B. Friedland, Director of the Center on an Aging Society, written for the Georgetown University Long-Term Care Financing Project. Read on for an excerpt from and a link to that article.

Why the focus on caregiving? Because that's where the rubber hits the road in long-term care. Literally, in the case of long-distance caregiving. Nothing stresses the importance of fixing America's dysfunctional long-term care system more than the tragedy of inadequate care.

Heavy reliance on public financing for long-term care has not solved the problem and has arguably made it worse, as we've explained many times in this space. Access to quality care by qualified, well-paid caregivers is the key to persuading the public to save, invest, insure and pay privately for long-term care. The more people know about this problem and heed the warning, the better able public programs will be to help those most in need.


MetLife Mature Market Institute, "Miles Away: The MetLife Study of Long-Distance Caregiving, Findings from a National Study by the National Alliance for Caregiving with Zogby International," July 2004, .

"Executive Summary

"Family care from a distance is a fact of life for millions of Americans. Living at a distance from an aging parent or grandparent can make care provision a complex and difficult challenge. And, for many of those who are caring at a distance, these challenges affect not only the personal activities of the care providers, but their work and career as well. In 2004, the MetLife Mature Market Institute and the National Alliance for Caregiving undertook a survey of long-distance caregivers to examine these challenges. A sample of 1,130 long distance care providers participated in an on-line survey conducted by Zogby International, an international polling and market research firm.


"The Caregiving Situation

o Despite an average distance of 450 miles and 7.23 hours of travel time one-way, long-distance caregivers reported substantial regular personal contact with the person they were helping; 51% reported visiting at least a few times a month.

o Nearly one-fourth (23%) of the long-distance caregivers reported they were the only or primary care provider.

o Nearly three-quarters of the respondents were helping their loved one with instrumental activities like transportation, shopping, managing finances or cooking and were spending 22 hours a month on this help.

o Almost half reported that they were managing needed services and spending the equivalent of nearly one full day a week doing so.

o Long-distance caregivers most often depend upon a sibling who lives near the care recipient. Nearly 80% of these care providers were working either full or part-time.

"Effect on Work

o More than four in ten had to rearrange their work schedules in order to take care of their caregiving responsibilities, more than a third (36%) reported missing days of work, and 12% took a leave of absence.

o Both men and women were equally likely to have rearranged their work schedules, left early or came in late to work, taken an unpaid leave, or to have considered changing employers.

o Women were more likely than men to report that they missed days of work and/or moved from full-time work to part-time work.

"Financial Contribution

o Long-distance caregivers spend an average of $392 per month on travel and total out-of-pocket expenses.

o Distance is a factor in the total out-of-pocket expenses reported by respondents. Those who live between 1 and 3 hours away from the care recipient spent an average of $386 per month on travel and direct expenses for items needed by the care recipient; those who live more than 3 hours away spent an average of $674 per month.

o For the relatively small group of respondents (nearly 10%) who also paid for services the care recipient needed, women reported spending on average $751 a month compared to men who spend an average of $490 a month."

Note: Sue Shellenbarger's "Work & Family" column in the Wall Street Journal on July 29, 2004 titled "When Elderly Loved Ones Live Far Away: The Challenge of Long-Distance Care" at,,SB109104958668776812,00.html highlighted the MetLife study and provided the following list of related websites. You'll need a subscription to WSJ Online to access the full article, but here are some useful links cited in it.

"Hyperlinks in this Article:

(9) "


Robert B. Friedland, "Caregivers and Long-Term Care Needs in the 21st century: Will Public Policy Meet the Challenge?," Georgetown University Long-Term Care Financing Project Issue Brief, July 2004, .

Excerpt (footnotes omitted):

"Over the next 15 years the number of people who need long-term care is expected to increase by 30 percent. Soon thereafter, the number of people likely to need long-term care is expected to increase even more dramatically. Estimates of the long-term care population suggest that the number of people with long-term care needs will more than double between 2000 and 2050. Government estimates suggest that the number of people using paid long-term care services-in a nursing facility, alternative residential care (such as assisted living) facility, or at home-could nearly double, increasing from 15 million in 2000 to 27 million in 2050.

"Given the sizable increase in the number of people who may need long-term care in the future, it is important to ask: will there be enough paid caregivers and family caregivers to meet projected long-term care needs? Currently, many persons who need long-term care have a number of family members available to provide care or have a significant pool of caregivers available for hire. However, as this paper will show, after 2015 the number of people likely to need long-term care will increase substantially faster than the number of people available either as family or as paid caregivers. Families will need more support to supplement their efforts and more paid caregivers will be necessary to provide this support.

"If the market does not respond to meet these needs soon, policy makers, working with payers and providers of long-term care services, may need to find ways to encourage workers to remain in the long-term care labor force, encourage a larger share of the labor force to seek employment in the long-term care sector, and enhance how long-term care providers work with families to expand the capacity of family caregivers. Family caregivers need all the help they can get to provide care, including purchasing modifications to the home, purchasing labor-enhancing and labor-saving technologies, and figuring out how best to integrate paid caregivers into their homes. Paid caregivers will also be necessary for those who do not have any family available to provide care. Since 2015 is slightly more than a decade away, it is not too soon to start working towards fundamentally improving the efficiency and effectiveness of how care is delivered.

"This paper reviews trends and identifies public policy issues that must be addressed to meet the demand for long-term care in the future. The next section examines the anticipated growth in the demand for long-term care. This is followed by an overview of recent trends in the supply of long-term care. The last section of the paper articulates the kinds of changes necessary to ensure an adequate supply of paid and family caregivers to meet the demand for assistance." (pps. 1-2)