Caregiving and Women’s Jobs: The Most Overlooked Election Issue

How voters view health care and women’s jobs will have a major impact on the outcome of the presidential election. I say this, not because I’m a pundit or a pollster, but because of what I see in my job as a doctor.

As a hospital physician, I’m often faced with patients who can no longer live independently due to worsening illness or a new disability. They need help to take care of their daily needs like bathing, cooking, and dressing. Some patients have families who seem to move mountains to provide 24-hour care for their loved ones at home – rearranging work schedules, having their family members move in with them, or perhaps hiring outside help –while other patients whose families understandably may not be able to provide this level of care at home may enter a nursing home.

Neither is an easy decision. For patients, losing their independence can be devastating. For family members who assume the role of caregiver, it is equally life-changing. But, it’s common. Researchers estimate that about 70 percent of 65-year-olds will require long-term care at some point. But, here’s a recipe for disaster: With the number of elderly in the US ballooning (In 2000, about 1 in 8 Americans were 65 and older; by 2030, it will be 1 in 5) the need for caregiving will increase tremendously. Add in the draconian cuts to Medicaid proposed by Romney-like health care plans, estimated at $1.7 trillion; financial assistance for nursing home care will become scarce. The ones who will carry those increased economic caregiving burdens will be largely middle and lower class women.

No one plans or hopes to ever require long-term care, but chronic illnesses like cancer or dementia may result in the inability of some people to take care of themselves. Most of the long-term care needs of older Americans are provided by friends and family; of this, the majority is provided by women. The value of the informal care provided by women caregivers is estimated to be $148 to $188 billion annually. Caregivers allow people with long-term care needs to stay at home versus entering a nursing home, an option that can cost upwards of $70,000 a year and largely supported by Medicaid dollars. In 2003, nearly half of the nation’s nursing home bill was paid for by Medicaid. While caregiving can be rewarding, it can also be incredibly draining – physically, mentally, and financially. An estimated 25% of the entire US workforce provided informal care in 1996.

The average American caregiver is 46, female, and working outside the home with an annual income of $35,000/year. One study revealed that nearly half of Baby Boomer women caregivers suffered from financial hardships due to the costs of caregiving. For working women caregivers, their caregiving role is associated with decreased hours working, being passed up for a job promotion, training, or assignment, taking a leave of absence, switching from full-time to part-time employment, quitting their jobs entirely, or retiring early. It has been estimated that financial impact for businesses of replacing employees or absenteeism due to caregiving totals $7.7 billion. While men also provide caregiving, female caregivers generally spend more time providing care, up to 50% more, than their male counterparts. Caregiving is also associated with depression, anxiety, and other physical problems in middle to older-aged women.

The need for long-term caregiving in the US will only grow. We need to be thoughtful about how we can support the backbone of long-term care in the US, women caregivers. Blind cuts to Medicaid without an alternative solution to supporting long-term care for our most vulnerable hurts lower and middle class women preferentially. Of note, the Affordable Care Act recognizes the importance of caregiver support, establishing special centers to help train caregivers in chronic disease management, dementia and mental health.

Who do we care for as a country? Next week’s election will be telling.

Katherine Chretien is an associate professor of medicine at George Washington University.

Image via iStockphoto/mandygodbehar

  • What worries me also is that women will have to pay for this medicare. Either way, the population differential between Baby Boomers and those who came after will potentially have an enormous financial, emotional and physical strain.

  • I was really nice to see with this kind of information, Thank you for sharing this…

Why I Wrote “Trumping And Drinking”
Get Over Yourselves. We’re All Rory Gilmore
Hillary Clinton, Shake It Off, Taylor Swift, Hillary Clinton Campaign song
Six Reasons “Shake It Off” Should Be Hillary Clinton’s Campaign Theme Song
Nancy Reagan dies, Just Say No, Ronald Reagan
A Not-So-Positive Ode to Nancy Reagan’s Frothy “Just Say No” Campaign
I Married for Health Insurance
Why I Wrote “Trumping And Drinking”
A Case of Nixonian Deja Vu
Post-Election Munchies: What is Your Grief Snack of Choice?
Why I Wrote “Trumping And Drinking”
A Case of Nixonian Deja Vu
Trump Reality Check, Now with Actual Facts!
Fascism Facts
I Married for Health Insurance
Get Over Yourselves. We’re All Rory Gilmore
Post-Election Munchies: What is Your Grief Snack of Choice?
Women’s Elections Rights in Saudi Arabia: A Token Drop in an Abysmal Bucket & the Plight of Women Under Sharia Law
Maybe It Wasn’t Rape: Emerging Matriarchy and the Altering of Women’s Past Sexual Narratives
Paris attacks, Paris terrorism
Is Paris Burning?
Chinese government and women's reproductive rights, adopting Chinese girls, international adoption
Dear Xi Jinping, I Am Writing to You as an American Mom of a 19-Year-Old Chinese Daughter
The Vital Voice of Hillary Clinton: Part 1
Maybe It Wasn’t Rape: Emerging Matriarchy and the Altering of Women’s Past Sexual Narratives
The Eyes Have It!
Ashley Madison, Jared Fogle, sex, rape, sexual affairs
Ashley Madison vs. Jared Fogle: Rape, Sex and Hacking in America
women's viagra, Viagra, Flibanserin, sexual arousal, women's desire, sex after menopause
That “Little Pink Pill” Isn’t All It’s Cracked Up to Be

Get our new weekly email
Broadly Speaking

featuring our best words for the week + an exclusive longread