When the Elderly Need Help, Who is Their “Natural Caregiver?”

Maybe you know of one living nearby. An elderly senior, someone you see around town, at the grocery store or your favorite local diner. You immediately feel bad, because it seems like this person is lonely. Sadly, it’s likely this person’s reality. These days more older adults are aging without a spouse or children, and that’s creating unique problems.

The number of women not having children is growing. It’s already increased from one in nine in a generation not having kids to one in five. This begs the question: when these people eventually need assistance to live, who will be their “natural caregiver,” the person naturally responsible for their care?

In a 2015 AARP Public Policy report, Valuing the Invaluable, experts estimated the ratio of potential family caregivers available to adults ages 80 and older. In 2010, it was a healthy 7.2-to-1; however, in 2030 — just a little over a decade away — that number is likely to drop to 4-to-1, and by 2050, they estimate it will reach 3-to-1.

The number of “elder orphans,” a term describing those who are aging alone with no family to address their caregiving needs, is growing — and not just in the above-80 demographic. Per the research conducted by Maria Torroella Carney, chief of geriatric and palliative medicine at Northwell Health of Great Neck, NY, more than one in five Americans ages 65 and up are, or are at risk of becoming, elder orphans.

When There’s No Obvious Answer

More people beyond relatives are likely to step into a caregiving role, and many have already done so, meeting caregiving needs for a neighbor, a close friend or a friend’s aging parents.

While 85 percent of caregivers for older adults are relatives, 15 percent of caregivers today are caring for a friend, neighbor, or another non-relative, and seven percent care for a parent-in-law, per Caregiving in the US, a 2015 survey from the Alliance for Caregiving and AARP.

Even those with children may have trouble finding care, especially when so many move away and have started their own families. So the 15 percent caring for a non-relative are vital. A neighbor, a friend from the VA – these are solutions that sometimes work themselves out. And while it can feel reassuring to know someone is stepping in as a good Samaritan for this person, the uncertainty of what’s next can still keep you up at night if thinking about your own mom or dad living alone, far away from you. Because no matter which of Mom or Dad’s friends is helping, that person still has her own life, her own responsibilities. Should her situation change at any time, your loved one will suddenly be without a dedicated caregiver.

If the above scenario sounds like the situation of someone you know, call the Area Agency on Aging that’s local to the individual who needs assistance. You can at least inquire about any available resources. Moreover, if it’s your own parent you’re calling about, you may already be thinking about changing Mom or Dad’s living situation to better meet current and future needs.

Preparing for Changing and Unexpected Needs

If you do find yourself leaning on help from others around Mom, it’s wise to understand the weight of responsibility this good Samaritan has willingly put on her shoulders, and what you should expect should your parent’s responsibility ever fall on you.

These stats from a 2011 Gallup-Healthways study show just how much caregivers are contributing, on a monthly average, to the support of an older adult:

• 13 days on tasks like food prep, shopping, laundry and general housekeeping, transportation, administering meds
• 6 days on dressing, feeding, walking, grooming, and personal care like bathing and assistance toileting
• 13 hours researching care services or information on a condition or disease, coordinating physician visits or managing financial matters

Further statistics show that caregivers perform nearly two of the six activities of daily living (or ADLs, such as bathing, getting in and out of chairs, and feeding) and four of the seven instrumental activities of daily living (or IADLs, like shopping, housework, and transportation), per the aforementioned AARP & National Alliance for Caregiving survey.

Caregiving takes a village. In most cases, many people who step in to provide care. No one person may be the natural caregiver, but rather, a combination of support from friends, family, neighbors, and other good Samaritans.

Why You Can’t Rely on the Idea of a “Natural Caregiver”

If you are the child of an elderly senior, and you’re the oldest, you may feel like the responsibility is naturally yours. But many adult children live far away from their parent, or simply have too may responsibilities to take on anything additional. Don’t think that you must be your parent’s primary caregiver — or feel guilty if you simply cannot fill the role because of your own circumstances. Instead, start thinking about the people who have been there for your dad over the years, or the social networks your mom’s been part of since you were growing up. Think about who might be the natural caregiver among those people. From this starting point, you can advocate for your loved one’s best caregiving arrangement. And of course, you can always consider professional assistance.

Working Together in Caregiving

 Caregiving is more than the daily hands-on tasks we often think of — and there are always many moving parts. Your best role may be as care coordinator: keeping track of Mom’s finances and healthcare records, keeping tabs on the people checking in on her, making sure she has enough groceries, clean laundry and more. When you solve for Mom’s caregiver village, your role in communicating with these people about Mom’s preferences, personality, and background is critical. You are still part of your parent’s caregiver team.

Caregiving is a team effort, and by bringing in that support early on, you’re taking active steps to prevent caregiver burnout. You’re also creating a plan B: if there is a care crisis, it doesn’t all fall on you.

How Home Care Fills in the Gaps

As your parent’s condition advances, a caring neighbor or devoted co-worker may not be the best fit anymore. You may find the “natural caregiver” at this point is someone who can be in your parent’s home on a regular basis. Consider partnering with a professional caregiver through a trusted home care provider. That professional caregiver can be the eyes, ears, hands, and heart your aging parent needs — be it for a few hours a week or several hours every day.

Make a list of the things that you and your Mom’s neighbor have been doing over the past few months. Find out what Mom’s neighbor or best friend is still willing to do, and determine what support you can still reasonably provide as you balance your own family’s priorities. From there, you’ll have a better idea of how a professional caregiver can fill in the gaps for your older loved one.

The reality is, the natural caregiver is a myth. No situation is the same. Maybe your parent has a network of people who can help. But if that’s not the reality, then you may feel like it’s your responsibility. And you may not be prepared – or physically able – to take on this challenge. Maybe it’s time to move on from the idea of a “natural caregiver,” and instead consider a real, professional caregiver.