CAREGIVERS AS UNSUNG HEROES

Wednesday, March 14, 2007


In the financial planning world, as well as the realms of politics and economic policy, we see a major focus on the burning question, "What happens when all of the baby boomers retire?"

In a speech before the Economics Club of Washington, Federal Reserve Bank Chairman Ben Bernanke said, "Reform of our unsustainable entitlement programs" should be a priority. "The imperative to undertake reform earlier rather than later is great," he added.

The post-W.W. II baby boom was followed by a "birth dearth," a demographic imbalance that means more people needing social benefits and fewer people to pay the bills. The focus on boomers, however, overlooks another question: "What about the parents of boomers?"

As a keynote speaker at several meetings for financial planning professionals, in addressing future trends, I noted that "increasingly you will have clients whose children are on Medicare." As eyes widened, I suggested, "Do the math."

If clients are in their mid-to-late 80s, or in their 90s, they may have "children" age 65 or older. Conversely, if we define the "boomer wave" as the cohort born between 1946 and 1965, the oldest boomers hit age 61 in 2007, the youngest, age 42. Increasingly, the word "caregiver" is creeping into the boomer lexicon. Like anything else, when the boomers begin to focus on a problem or challenge, the topic enters the mainstream conversation.

In an effort to get ahead of the trend, The Coach attended the 6th Annual Caregiver Conference held in Atlanta on February 3, 2007. Sponsored by The Emory Center for Health in Aging, and others such as the Aging and Developmental Disabilities Coalition, the gathering was an eye-opening experience.

A "caregiver" is a person who is caring for a family member or someone else who needs help due to age-related loss of function, chronic health problems due to illness or accident, or a developmental disability.

If we assume on average that a child was born to a mother and father who were close in age and use age 25 as an average age for giving birth, the youngest boomers will have parents in the age 67 range. The oldest boomers will have parents in the age 86 range. Add or subtract a few years either way, and you can begin to grasp the size of the demographic phenomenon. Relative to those who either need care now, or who will need care in the future, those thrust into the role of primary caregiver represent huge and growing numbers!

Gail Hunt, Executive Director of the National Alliance for Caregiving, the keynote speaker at the Atlanta conference, said that approximately 44.4 million people in the U.S. in 2004 were involved in "family caregiving." Ms. Hunt estimated that there are approximately 844,000 family caregivers in Georgia. If we use 2005 Census Bureau figures for adults age 18 or older, approximately 20% of the adult population nationwide is engaged in some aspect of family caregiving.

"Family caregiving" is not the same as "professional caregiving," since we are talking about unpaid work. Author Beth Witrogen McLeod, a double Pulitzer Prize nominee, has written extensively on the issue of caregiving. Her mid-life rite of passage occurred when she had to deal with simultaneously terminally ill parents who were 1200 miles away. Her father battled a rare form of cancer while her mother suffered from Lou Gehrig's disease and dementia.

Ms. McLeod's experience reflects growing reality. Most caregivers are women, many of whom juggle some combination of work, family and marital demands at home, including child care, while trying to meet the needs of aging and impaired parents or other loved ones.

Increasing numbers of women in their late 40s, and 50s are caught in a "Sandwich Generation" squeeze. Many are dealing with "grown children" who have "issues," aging parents with increasing health and/or financial problems, and perhaps, health concerns of their own. For whatever reason, in any family there seems to be one sibling who is more responsible or caring than the others, or who is geographically closer, upon whom burdens fall disproportionately. Often, that person is female

There are growing concerns over the health of the caregiver. Recent surveys show that 87% of caregivers report a decline in energy and increased sleep deprivation; 70% worry about stress; 60% report higher levels of pain and aches (lifting and moving impaired adults is a factor); and, 52% show signs of serious depression. According to McLeod, depression rates are higher, up to 76%, for intense caregivers supervising those with maladies such as Alzheimer's disease, Parkinson's disease, Lewy body dementia, or other forms of dementia, or neuropathic and peripheral nerve diseases.

Dr. Kathy Scott, R.N., representing Programs Assisting Community Elderly (PACE) in Roswell, GA, touched on the fact of "unpredictability" in caregiving. Often decisions are forced in a crisis atmosphere; "very little planning goes into it." The situation, "It's out of control!" is a common complaint.

Dr. Scott's advice: "Plan now!" Her counsel parallels advice that increasingly mirrors planning matters for retired clients and their adult "children." A series of in-depth conversations need to be had concerning big picture expectations and possibilities relative to life cycle transitions. Dan Taylor, author of "The Parent Care Conversation", has outlined a series of dialogues that children need to have with parents, and that parents need to have with children-before trouble arises, and while everyone is lucid, unemotional, realistic, and creative. What would you want done about your home, your money and key assets, your "stuff" and prized possessions, your car and driving skills, your health care, management of affairs and basics like bill paying, and ultimately, your estate and your legacy?

If you are growing older and are caring for a disabled child or adult offspring, who will care for him or her when you can't? Have you addressed trust planning and funding issues?

Who will care for beloved pets?

Do you have legal authority to take charge of the health care for a parent or other loved one? Do you know what resources exist relative to legal, financial, and health matters? Who pays for what? What if you have to drop out of work to provide care? What will that do relative to your finances and retirement plans or education costs for your own children?

So many questions! There are answers but few simplicities. Your future care, and that of loved ones, should be part of all holistic planning. Don't wait for a crisis.