On The Next Big Thing in Health, hosts Laura Evans and AHIP President and CEO Matt Eyles sat down with Susan Reinhard, Director of AARP’s Public Policy Institute, to discuss how the caregiving industry is evolving and what steps lawkmakers and regulators can take to support America’s caregivers.

Listen to the full interview on iTunes, Spotify, Soundcloud, and Stitcher.

Laura Evans: I know there are millions of Americans who are falling into the role of caregiver. In fact, a 2015 AARP study shows that about 17% of adults ages 18 or older – or about 39.8 million adults in the United States – were caring for an adult loved one.

Susan Reinhard: We’ll do another study next year to update that data. But we expect there actually could be fewer caregivers because families are shrinking, and what that means is even fewer caregivers doing even more. We’re anxious to see what the data will show us, but we don’t expect that it will be dramatically smaller.

But it’s millions of people of all ages, and I think that’s really important – that 1 in 4 is a millennial. In that 2015 study, we really looked at ages and I was blown away … Now, we have even more data about millennials, and people of all generations.

We’re trying to really unpack this idea of the “average caregiver.” Which, when you do that, is a typically a 48-year-old woman – typically a white woman – caring for her white mother. That is the average, but that’s changing so much with the aging of the population and the growing need for family caregivers of all ages. We see multicultural aspects, we see millennials, and 40% are men – this is not just a women’s issue.

And they are doing so many things. They are doing financial aspects of care, they are dealing with so many different doctors, nurses, and therapists. Care coordination becomes incredibly difficult.

Laura Evans: Why is family caregiving today so different than it was in the past? What is this new normal?

Susan Reinhard: Well, people are living with multiple chronic conditions which changes … I think families have always cared for ill family members. They have for centuries. That’s part of a normal expectation for families.

What’s different now is that there’s more technology. There are so many more medications. You don’t just take one pill – you take 10 pills. And you get injections on top of that. You might get an intravenous injection – eyedrops, eardrops, patches. All new things – I mean, it was only in the 40s that we got penicillin.

If you really think about it, this is all new. It’s good news, we have more solutions, more ways of helping people manage their chronic conditions and live longer.

Laura Evans: As a caretaker, it makes your head spin.

Susan: Exactly, and it doesn’t come with a nurse who is going to be doing this. Or a doctor, or a physical therapist.

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Laura Evans: Matt, I know you’ve had experience both inside and outside of the government. Are there policies or is there legislation that we should be looking at or thinking about to support these caregivers?

Matt Eyles: Absolutely. The flexibility that we’ve seen recently in Medicare Advantage from the federal government to really enable and empower Medicare Advantage plans to offer these types of support services – like respite care and other types of innovative programs – that you wouldn’t traditionally associate with a health insurance provider.

You might think about that kind of care with respect to social services support or other government agencies. But I think the federal government has recognized the importance of getting into the home where people receive care, and that the types of flexibility in that system have the potential to be profoundly helpful going forward.