Costs of 'informal' caregiving for heart disease to reach $128 billion by 2035

[April 11, 2018] By Lisa Rapaport

(Reuters Health) - As relatives and friends step in to provide increasingly complex care at home for heart attack and stroke survivors, the costs associated with such "informal" caregiving are expected to double to $128 billion by 2035, U.S. heart doctors say.

When this informal care is added to the tab for traditional medical services provided by doctors, nurses and other clinicians, the total price tag for treating cardiovascular disease in the U.S. will reach $1.2 trillion a year by 2035, according to a new report from the American Heart Association (AHA).

"Informal caregiving needs are escalating due to the aging of the U.S. population, the increased cardiovascular disease occurring at older ages, and the reduced availability and affordability of formal caregiving in the health care system," study leader Sandra Dunbar of Emory University School of Nursing in Atlanta said by email.

Dunbar and colleagues examined survey data collected in 2014 from 16,731 adults aged 54 and older.

Among other things, the survey asked about informal caregiving provided at home by family members or friends without any compensation. Researchers then calculated the dollar value of this care based on wages paid to home health workers in the U.S. as well as the added benefit of having someone available around the clock to assist with medical tasks and day-to-day activities like eating, dressing and bathing.

For stroke survivors alone, the annual cost of informal caregiving will reach $66 billion by 2035, accounting for almost half of the overall costs of all care friends and family provide to people with cardiovascular disease, researchers report in Circulation.

For African-Americans, who often experience stroke earlier in life and require more support from friends and family, the average annual cost of informal care is projected to surge from $7,200 in 2015 to $10,000 by 2035.

As a group, however, white patients have the highest total costs overall, with the annual tab for their informal caregiving projected to climb from $37.7 billion in 2015 to $70 billion by 2035. This is because they make up the largest segment of the population.

Costs for people 80 and older are projected to more than double, from $24 billion in 2015 to $53 billion in 2035, surpassing costs for people aged 65 to 79, the study also found.

The study wasn’t a controlled experiment designed to prove whether or how caregiving costs might arise for families and friends of people with heart disease. It’s also possible that a different mathematical model for projecting costs might yield different results.

Still, the AHA highlights a need for programs to provide economic assistance, education and training to informal caregivers and expand access to formal medical care for people who need complex ongoing care or support at the end of life.

As the population ages, the pool of potential family caregivers is also shrinking, noted Lynn Friss Feinberg of the AARP Public Policy Institute. By 2035, the population of adults 65 and older is expected to outnumber children for the first time in U.S. history.

"In previous generations, older people could often count on large, extended families for help with health and functional needs, but this is no longer the case with changes in family structures, including higher rates of childlessness, greater divorce, and more women in the workplace," Friss Feinberg said by email.

The report also expands the picture of family caregivers beyond the common perception that falls mostly on people helping a loved one with dementia, said Carol Levine, director of the Families and Health Care project for the United Hospital Fund in New York City.

"While these caregivers certainly need all the help they can get - and more - they are not the only caregivers facing long-term crushing financial and emotional burdens," Levine, who wasn’t involved in the study, said by email. "Cardiovascular disease in its many forms affects millions of people in profound ways, and, as the report makes clear, the problem will grow at an alarming rate in the next 20 or more years."

SOURCE: http://bit.ly/2JCw211 Circulation, online April 9, 2018.

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