Who takes care of whom? Surprising new evidence

There has been much recent discussion in the press of the plight of the so-called "sandwich generation," that is, adults who are responsible for the care of children as well as aging parents. The need for simultaneous childcare and eldercare is a reality that can limit families'—particularly women's—opportunities for paying work.

A new study by social scientists Emilio Zagheni and Denys Dukhovnov for the first time drills down into US statistics about who is providing this care, and who is receiving it. The study found that in 2012, adults in the United States provided more than a billion hours of unpaid caregiving every week—equal to the work of 30.5 million full-time caregivers. The researchers project a rise in the need for such care, reveal some surprises about who is providing care, and provide some reassurances about the future. The study appears in the June 2015 issue of Population and Development Review, a quarterly, peer-reviewed journal published by the Population Council.

Zagheni, an assistant professor of sociology at the University of Washington, and Dukhovnov, a graduate research associate at the CUNY Institute for Demographic Research in New York, used data from the American Time Use Survey (ATUS) to document unpaid caregiving by age and sex. The data were collected from about 36,000 people in the United States between 2011 and 2013. Unlike most other investigations of unpaid caregiving, the researchers examined data from the survey's time-use diaries as well as the survey's Eldercare Roster, providing much more detailed information than previously available about who is caring for whom.

For the purposes of this study, Zagheni and Dukhovnov defined "sandwich" caregivers as those who, during the course of a single day, provide unpaid care for at least one child and one adult, regardless of their relationship to the person receiving the care and regardless of living arrangements. A child receiving care may be a grandchild, an adult receiving care may be a spouse, and the people giving and receiving care may or may not live together.

The researchers found that about one-third of the US population provides unpaid care to another person. About 3 percent of the US population qualifies as sandwich caregivers by the researchers' definition, a smaller proportion than they anticipated.

Women provide more care than men, 137 minutes a day versus 110 minutes a day, respectively. Similarly, women who are sandwich caregivers provide 181 minutes of care a day, compared to 157 minutes a day for male sandwich caregivers.

The researchers noted other gender differences: grandmothers spend substantially more time with very young children, from birth to age 4, whereas grandfathers spend more of their caregiving time with children between the ages of 5 and 14.

Zagheni and Dukhovnov were surprised to discover that 20 percent of the caregiving time given to elderly persons (about 15 minutes per day) was given by other elderly people, perhaps spouses, rather than by adult children. "From the time-use perspective," write Zagheni and Dukhovnov, "people who provide simultaneous care to spouses and children or grandchildren are under greater pressure than those who have responsibilities toward their parents and their children or grandchildren."

In 2012, the value of unpaid care in the United States stood at $691 billion; the researchers project that with population aging, by 2050 (if people continue to produce the same amount of time for caregiving per capita), the value of unpaid care will rise to $839 billion. About 1.3 million additional providers will be needed in 2050 in order for beneficiaries to receive the same amount of care. However, write Zagheni and Dukhovnov, "considering that it would be spread over several decades, the size of the adjustment appears to be quite manageable for the United States."

Policy changes could make it easier for caregivers to stay in the work force and avoid career setbacks, suggest Zagheni and Dukhovnov. For example, "extra support to parents of in the form of community programs for , tax breaks, and subsidies might allow parents to pay for childcare services that they would otherwise have to provide themselves."


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Study reveals surprising truths about caregivers

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Jul 06, 2015
I know first-hand just how devastating this disease can be for an individual and their family. I cared for my mother-in-law for 10 years as she drifted down through the stages of dementia. But somehow in the midst of all this sadness I was able hare joy and peace with her. I write of my experience in my book 'Creating Joy & Meaning for the Dementia Patient'. It was a true labor of love, a vow I made to myself to do everything in my power to help other caregivers. I also share my insights on my blog TheDementiaConnection.wordpress.com.

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