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Family members have long provided physical, emotional, and financial assistance to relatives in need of support because of frailty, dementia, disability, and other conditions common in late life. As our country faces an enormous increase in the number of older Americans, the role of family caregivers will become increasingly important. Health care professionals, especially primary care physicians, should identify people in the caregiving role and screen for caregiving stress or burden. It is likewise important to screen for health effects including depression, anxiety, and substance abuse. Informal caregivers—friends and family members—often care for chronically ill older adults, including those who have a diagnosis of dementia. Caregiver stress can cause health issues for caregivers; clinicians are encouraged to use available tools to screen for stress and to link caregivers to local and online resources.
The extraordinary projected growth in the elderly population has prompted concern both about their care and about the impact the provision of that care will have on society. In 1900 only 4.1% of the population was 65 and older and only 0.2% was 85 and older. By 2050 an estimated 20.7% will be at least 65 years old and 5.0% at least 85. Thus, the population aged 65 or older increased from approximately 3 million in 1900 to nearly 35 million in 2000 and is projected to reach nearly 90 million in the year 2060.
Families are the most important providers of care for elderly people, with primary caregivers most likely to be immediate family. In fact, 78% of adults receiving care at home rely exclusively on care from family members. It is estimated that 9.4 million people in the United States are providing care to a relative or friend with a chronic health problem. The importance of the family support system on the well-being of patients has been recognized for almost 4 decades. The families who provide such care have been called one of society's great assets.
Seventy three percent of caregivers are spouses or children. Adult daughters make up 29% of caregivers and wives another 23%. Thus, the overwhelming majority of family caregivers are women. Because most elderly men are married and most elderly women are not, men tend to have a spouse for assistance whereas women do not. Thus, husbands constitute only 13% of caregivers.
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