Paul Kusuda’s column
Aging has its worries--Part 1 of 2
Paul H. Kusuda
the elderly.  That situation must be faced immediately.  Good geriatric care has a positive impact on provision of
independent living, amelioration of diseases, and longer lives of the older population.  Such provision will lead to an ever-
increasing number of frail and elderly persons, that is, those 85 and older.

As people age, their preference has increasingly been to “age in place.’’  That is, they clearly want to stay where they’ve lived
most of their lives, where they did things that have become their memories.  As widely known, aged people increase each
year and comprise a larger and larger proportion of total population.  That means the proportion of working-age-population
declines in counterpart proportions.  The major question that must be faced is “Who will be around to take care of the
aged?” Part of the answer must be that other aged who are capable of caregiving responsibilities must step up.  However,
that can only be a partial answer, one that inevitably weakens as age continues to exert its influence on capability.

The need for caregivers will increase each year.  According to an article in The Gerontologist, Volume 55, Issue 2 (2015),
“Informal Caregiving and Its Impact on Health…” by Roth, Fredman, and Haley:  “As the pool of traditional family caregivers
declines in coming years, a more balanced and updated portrayal of the health effects of caregiving is needed to encourage
more persons to take on caregiving roles…The defining characteristics of an informal caregiver typically include being a
person who provides some type of unpaid, ongoing assistance with activities of daily living…to a person with a chronic
illness or disability.  This is in contrast to formal caregivers, such as home health aides, who are paid for their professional
services.”  So, it appears that many facets must be considered, including who provides the caregiving, stress-effect on
caregivers, extent of conditions needing attention, financial costs, and training or education.

Population Reference Bureau’s Today’s Research on Aging, February 2016, had an article “Family Caregiving” that noted
“Almost half of U.S. adults age 65 and older report they either need help or are currently receiving help with routine daily
activities…Family members provide more than 95 percent of the informal care for older adults who do not live in nursing
homes…Nearly two out of three caregivers rated their caregiving experience as largely positive...Family members
represented nearly 90 percent of informal caregivers…One in five caregivers…were spouses.”  The data show the extent of
need for caregiving and that family members comprise the major source of help.

The AARP Public Policy Institute’s July 2015 report, “Valuing the Invaluable: 2015 Update,” provided much interesting
information about the topic.  It noted that caregiving is almost universal, affecting “...most people at some point in their lives.  
The need to support family caregivers will grow as our population ages…Without family-provided help, the economic cost to
the U.S. health and long-term care services and supports system would skyrocket.  The contributions of this invisible
workforce often go unnoticed.”   The report pointed out that U.S. family caregivers gave an estimated 37 billion hours of care
in 2013, equivalent worth of about $470 billion, about $20 billion more than in 2009.  The estimates “…were based on about
40 million caregivers providing an average of 18 hours of care per week to care recipients, at an average value of $12.51 per

When a caregiver must take time from work and thus lose income, provision should be made to compensate for that loss
without any requirement for demonstration of financial need.  If a caregiver must withdraw from full employment or become
part-time employee, both state and federal governments should enable income-tax offsets.  Other use of public funds
should also be considered, e.g., food stamps and food vouchers.

Families carry the brunt of the burden of caregiving, and that leads to many factors that should be considered in examining
its impact.  Although occurring on a willingness-to-help-out basis, it is often more demanding and stressful than
anticipated.  Consequences include feeling there’s too much to do and it takes up a lot of time ordinarily available for one's
By Paul H. Kusuda

A half-year ago, I wrote “We get old—so what’s to worry about?”  Well, lots.  What used to be the
present became the past; what will be the future will eventually become the present.  So, we live
between past and future.  Knowing the past and looking to the future, we have to act and
prepare during the present.  If we don’t, all kinds of not-so-pleasant events will happen, some
predictable and others not; life with all its baggage will inevitably move forward in time, and what
we consider our future will become our present.  We can affect some of what will happen even
though we can’t make an effect on all.  So, to optimize future happenings in some aspects, we
must plan ahead, if not for ourselves, at least for others in the current and generations to come.

For years, we’ve known about the growing shortage of physicians, dentists, nurses,
pharmacists.  Yet, response has been minimal in terms of meeting the need.  Much needs to
be done to increase the number of those professionals.  To exacerbate the situation, most
health-care professionals are not sufficiently equipped to deal with unique requirements of
self.  Caregivers might resent lack
of cooperation and assistance by
siblings or other members of the
family or kin.  They may feel “put-
upon” or “being taken for
granted.”  Emotional strength and
patience may be stretched as
feelings of exhaustion or
excessive demand on personal
time exceed initial expectations.  
Thus, plans to meet the to-be-
continually growing need for
caregiving services must include
considerations involving both care
recipients and caregivers.

Yup, there’s much to worry about.