I've been a gerontologist for 30 years, and the staying power of some misperceptions, or myths, of aging continue to amaze me. Among these is the myth that families in the United States don't take care of their elders.

The myth says that we dump our elders into nursing homes and abdicate their care and its costs to the government in the form of such programs as Medicare, Social Security and Medicaid. Nothing could be further from the truth.

Only 5 percent of seniors are being cared for in nursing homes, and, of course, in many cases families and friends continue to provide some care.

The vast majority of the care provided to seniors is provided by informal caregivers. These folks are unpaid and are usually family members or friends of the person being cared for.

The number of people involved is substantial. One-fourth of all households in the United States provide care for an elderly person.

Eighty percent of adults who receive long-term care at home get their care exclusively from unpaid family, friends and volunteers. Of those who have paid caregivers, two-thirds also get some regular assistance from family or friends.

In addition to these millions of caregivers who provide hands-on care, nearly 7 million Americans are long-distance caregivers.

Overall, 85 percent of all home care for seniors is provided by more than 23 million family and friends.

Who are these caregivers?

The average age of a caregiver is 57. One in 10 is 75 or older. Most are women. Twenty-three percent are wives, 13 percent are husbands, 29 percent are daughters and 9 percent are sons.

The personal investment of caregivers is substantial. One way to measure involvement is in terms of hours spent caregiving. Households involved in caregiving invest an average of 20 hours a week. That includes time spent traveling back and forth, activities such as shopping, as well as hands-on care.
In addition to time, caregivers also frequently provide some financial support. In fact, 40 percent of caregivers incur additional financial costs associated with their caregiving role.

Caregiving takes a heavy toll not only because of the actual care provided, but also because of the impact of caregiving on other aspects of the caregiver's life.
The time commitment of caregiving often affects the caregiver's other relationships. Work roles of the caregivers may be dramatically changed. One-third of caregivers unexpectedly lose time at work. Just over 40 percent have permanently reduced the number of hours they work, and 12 percent have given up working completely.

The extremely high levels of stress also lead to physical and mental health breakdowns. Six out of 10 caregivers report declines in their own physical health. The stress of caregiving makes caregivers more prone to frequent headaches, anxiety and depression. Caregivers use prescription drugs for depression and anxiety at three times the rate of the rest of the population.
It's obvious that families and friends provide the largest share of the care. Only 10 percent to 20 percent of care comes from the formal services provided by public agencies.

That's not to say that public programs such as Medicare, Social Security and Medicaid are not important. Without the support of these programs, most caregivers would find their difficult jobs virtually impossible.

Hanns Pieper is professor of sociology and gerontology at the University of Evansville. If you have questions about aging, send them by e-mail to dp5@evansville.edu, or write to him in care of Family, Evansville Courier & Press, P.O. Box 268, Evansville, Ind. 47702.