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Caregivers in America


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Published on Nov 20, 2020

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Helping people live safely at home

Family and paid caregivers provide life-saving and life-changing services for older Americans and people living with disabilities every day. Due to their dedication, millions of Americans can live where they choose, instead of facility-based care. Caregivers have long been a critical component of the American health care system, and they are more essential than ever during the COVID-19 crisis.

Across the country, 4.5 million direct care workers provide care for people in homes, residential care homes, nursing homes, and hospitals. By 2028, the need for paid direct care workforce is expected to grow by 1.1 million new jobs due to the growing number of older adults and increased longevity. In addition to new positions created, it will be necessary to fill in millions of positions as workers leave the field due to low pay, lack of benefits, and limited opportunity for promotion. 1 The direct care workforce has provided significant services while taking personal risk during COVID-19. The National Association for Home Care and Hospice estimated that 64% of home health and home care workers were caring for an individual diagnosed with COVID-19 as of May 2020.2

Approximately 48 million Americans care for a friend or family member over the age of 18.3 Unpaid family caregivers provided approximately 34 billion hours of care in 2017, a value of over $470 billion, according to AARP. Following the closure of adult day programs and families choosing to care for their loved ones at home instead of utilizing facility-based care, the value of care provided by families in 2020 has likely jumped. Family and friends have answered the call to provide increased care to loved ones due to COVID-19.

Many states leveraged their Medicaid programs to increase access to services due to COVID-19, including 37 states who either added or expanded paid family caregiver limits.4

People receiving care at home are some of the most at-risk for contracting COVID-19 and experience significant challenges that can put caregivers in a difficult position. Access to personal protective equipment (PPE), for example, has been limited at times across the spectrum of health care because of COVID-19. Caregivers could either without appropriate PPE or skip work. Health insurance plans immediately sought to help in a variety of ways, including buying PPE or donating funds to buy PPE—all of which were distributed to caregivers.5 Health insurance plans also created access to respite options to provide caregivers with a well deserved break and developed back up service plans to ensure continuity of care when a primary caregiver was unavailable.

AHIP and our health insurance provider members have supported legislation aimed at providing direct assistance to caregivers—through the delivery of necessary PPE,6 including caregivers in the definition of essential employees, and increasing funding for home and community-based services.

Caregivers are an essential part of our health care system and always deserve our gratitude. During National Family Caregivers month this November, we offer our thanks especially to the caregivers who have continued to care for older Americans and people living with disabilities throughout the COVID-19 crisis.