Family caregivers have become the backbone of long-term care services. But as the average life expectancy in developed countries rises by 2-3 years every ten calendar years, whereas the Total Fertility Rate has been halved in 60 years, we won’t have the capacity to meet the demand for caregivers. We are heading toward the caregiving cliff as the number of older individuals needing care will greatly exceeds the supply of caregivers.
In terms of projection, individuals 85 years and older are expected to reach 19.4 million by 2050, including 6.2 million individuals with severe or moderate memory impairment. While in 2010 we counted 7 caregivers (typically adult children ages 45 to 64) per adult older than 80, that ratio may drop to 3 to 1 by 2050.
With the intention to provoke a wider discussion about current alternatives to improve support for caregivers, the Robert Wood Johnson Foundation and the Institute for the Future (IFTF) have created a set of three scenarios that explore the future of caregiving in the year 2031. The scenarios have been turned into videos which can help us think about the future we want to happen and action plan to design this future.
- Neighbors care: In a world where social innovators, policy makers, and the financial industry have acted to develop new markets and models of caregiving, a generation in which childlessness is normal is redefining what “family” caregiving means. TimeBanks are already rising, so that seniors can get support for personal needs through exchanges of services with other members that focus on their interests and skills.
- Angels in the floorboards: Technology has a role to play in alleviating the burden of caregivers and improving the quality of caregiving. Caregivers, care recipients, policy makers, and technologists need to work together to navigate how big a role technologies play and anticipate the tradeoffs that may come with it. Home assistants start dealing with more complex tasks, as artificial intelligence helps detect falls in nursing homes or at home.
- Carer Act: In a future where caregiving is integrated into the formal health care system through a national Caregiver Advise, Record, Enable, and Reimburse (CARER) Act, respect and opportunities for caregivers come with increased demands for documentation and interaction. Note that the Caregiver Advise, Record, Enable (CARE) Act, passed in over 30 states, requiring hospitals to identify the family caregiver on their loved one’s medical record, inform caregivers of an upcoming discharge, and provide instruction for any medical tasks the caregiver will perform.
Initiatives to structure the caregiving system of the future are already on their way. In Europe, EIT Health has identified 6 of the most urgent healthcare challenges facing society:
- Extend care pathways to provide end-to-end care before the onset of disease through to end-of-life support.
- Improving healthcare systems to overcome fragmentation across healthcare delivery.
- Harnessing real-world data to provide early diagnosis, enhance treatment and inform how to lead healthier lives.
- Support healthcare delivery in the home and away from the hospital to give back autonomy to the individuals.
- Improve workplace health at every level through better education and awareness.
- Change lifestyle behaviors by creating the tools and incentives for patients to prevent early ageing and reduce disease and disability.
If there is an increasingly strong articulated wish of citizens to be in control of their health issues, the reality is that only little of that aspiration is successfully being implemented yet, as older people are missing the appropriate tools and services. However we can still encourage and celebrate initiatives aiming at preserving the autonomy of the elderly through independent living, such as inter-generational villages based on volunteering and reciprocity.