12. Caregiving
While older people are often thought of as individuals who need care, it is often the older person who is the caregiver, either by choice or necessity. As an area of focus, caregiving means support for family members and others providing voluntary care and assistance. Caregivers provide much of the support to people who want to remain in their homes, but need help with daily activities such as bathing, dressing, taking medications, preparing meals, shopping, or transportation. Caregivers also provide resources such as time, money, and/or shared residential spaces that help older people age in place. Many older Texans find themselves fulfilling the role of caretaker either to other older persons or to children or grandchildren.
According to the 2008 survey, 17 percent of older Texans are currently providing care to a family member or friend over the age of 60, a child 18 years of age or younger, or both.
Table 12.1 Caregivers
| Do you provide care for a family member that is over the age of 60, a child 18 or younger… |
Percent of respondents 2004 |
Percent of respondents 2008 |
| Care for person over the age of 60 |
10% |
11% |
| Primary caregiver of relative child 18 or younger |
4% |
5% |
| Both |
1% |
2% |
| Not a caregiver |
84% |
83% |
| Total |
100% |
100% |
The majority of survey respondents rate themselves as being good caregivers.
Table 12.2 Caregiver's Self-Assessment
| Overall, do you feel that as a caregiver, you are |
Percent of respondents 2004 |
Percent of respondents 2008 |
| Excellent |
32% |
26% |
| Very good |
34% |
41% |
| Good |
27% |
26% |
| Fair |
6% |
7% |
| Poor |
1% |
0% |
| Total |
100% |
100% |
Family Caregivers
Family caregivers of a person over age 60 are defined as those who are providing unpaid care to a relative or friend to help them take care of themselves, which may include helping with personal needs, household chores, or finances. The care recipient does not always live with the caregiver.
Of the 11 percent who are caring for a person over the age of 60, more than 90 percent are family members.
Table 12.3 Relationship of Caregiver
| How is that person related to you? |
Percent of respondents 2004 |
Percent of respondents 2008 |
| Spouse |
39% |
39% |
| Family member |
55% |
57% |
| Friend |
5% |
2% |
| Other, specify |
2% |
1% |
| Total |
100% |
100% |
Some caregivers in Texas have only been providing care for a few years and 33 percent reported being a caregiver for more than 10 years.
Table 12.4 Length of Time as Caregiver to Adult
| How long have you been providing care for this person? |
Percent of respondents 2004 |
Percent of respondents 2008 |
| Less than 1 year |
15% |
6% |
| 1 to 5 years |
42% |
41% |
| 5 to 10 years |
17% |
20% |
| More than 10 years |
25% |
33% |
| Total |
100% |
100% |
More than one-third of caregivers are providing full-time care (more than 40 hours each week).
Table 12.5 Time Spent in Caregiving
| How much time each week do you spend providing care for this person? |
Percent of respondents 2004 |
Percent of respondents 2008 |
| 0-8 hours |
36% |
22% |
| 9-20 hours |
21% |
22% |
| 21-40 hours |
11% |
17% |
| 41 hours or more |
32% |
39% |
| Total |
100% |
100% |
Geographic proximity can be a primary barrier for many caregivers and care recipients. For the 43 percent of caregivers who provide care outside their home, more than 2/3 travel within 15 miles of their current residence.
Table 12.6 Distance to Provide Care
| How far do you have to travel to provide care for this person? |
Percent of respondents 2004 |
Percent of respondents 2008 |
| 0 to 15 miles |
73% |
69% |
| 16 to 50 miles |
21% |
8% |
| More than 50 miles |
5% |
22% |
| Total |
100% |
100% |
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Formal Supports
Among respondents who are responsible for caring for others, about 15 percent in both years used other paid supports. Of those, about half found the cost very affordable, while
20 percent in 2004 and 15 percent in 2008 found the costs somewhat to very unaffordable.
Informal Supports
In the 2008 survey, only six percent of Texas caregivers received payments for the care they provide. Unpaid caregiving constitutes a substantial contribution to the care of Texans with disabilities.
Factors such as education and awareness of available support influence the caregiver's utilization of supportive services. Approximately 55 percent of Texas caregivers reported being aware of free informational services provided through an Area Agency on Aging (AAA), such as information on respite care, referrals to doctors, nursing homes, support
groups, and other caregiving tips and advice. Twenty-four percent reported ever using caregiving resources offered through their Area Agency on Aging.
The most common reasons cited for not using available resources were not needing or wanting assistance, and not knowing where to find it.
Table 12.7 Reasons for not Using Caregiving Resources with Elders
| What is the primary reason you have not used any caregiver
resources? |
Percent of respondents 2004 |
Percent of respondents 2008 |
| Don't know how to find these caregiver resources |
15% |
20% |
| Service/support I need is not available in my community |
4% |
6% |
| I do not know what type of service I need |
7% |
7% |
| I am too busy-schedule not convenient |
3% |
2% |
| Not interested/embarrassed to get assistance |
14% |
19% |
| Not open to assistance from non-family, paid caregivers |
5% |
9% |
| Don't have a need for assistance |
49% |
27% |
| Other, specify |
4% |
9% |
| Total |
100% |
100% |
Grandparents Raising Grandchildren
A growing number of people over age 60 are becoming primary caregivers to grandchildren or other relative children. AARP has estimated that 448,439 children (7.6 percent of the children in Texas) live in grandparent-headed households. These family caregivers, often called “kinship caregivers,” become surrogate parents as a result of divorce, crime, child abuse and neglect, increased single-parent households, illness, or substance abuse among the middle generation.
Of the seven percent of older Texans who are caring for a relative child under the age of
18, the majority have no legal designation or custody other than relative status.
Table 12.8 Legal Status of Grandchildren
| Are you: |
Percent of respondents 2004 |
Percent of respondents 2008 |
| I am the Legal Guardian |
33% |
33% |
| I am a Custodial Designee |
7% |
15% |
| Relative/Grandparent with primary responsibility for child |
60% |
52% |
| Total |
100% |
100% |
Some kinship caregivers have been providing care for only a few years, while 44 percent reported in 2008 being a caregiver for more than 10 years. A smaller proportion had primary responsibility for a child in 2008 compared to 2004. More than twice of survey participants have a custodial designee in 2008 compared to 2004.
Table 12.9 Length of Time as Caregiver to Child
| How long have you been providing care for this person |
Percent of respondents 2004 |
Percent of respondents 2008 |
| Less than 1 year |
7% |
10% |
| 1 to 5 years |
40% |
34% |
| 5 to 10 years |
17% |
11% |
| More than 10 years |
37% |
44% |
| Total |
100% |
100% |
Among kinship caregivers, four percent pay someone else to help care for their relative child.
In 2008, 21 percent of kinship caregivers in Texas reported receiving payments for the care they provided. In 2004, 14 percent received payment for care.
Grandparents often lack information about the range of services, benefits, and policies available to support their caregiving role. Approximately 37 percent of kinship caregivers reported being aware of free informational services provided through the AAA for caregivers of relative children, such as information on education, healthcare, financial assistance, child care, support groups, and other caregiver tips and advice.
The most common reason kinship caregivers cited for not using available resources was that they did not know how to find caregiver resources in their community.
Table 12.10 Reasons for not Using Caregiving Resources with Children
| What is the primary reason you have not used any caregiver services? |
Percent of respondents 2004 |
Percent of respondents 2008 |
| Don't know how to find these caregiver
resources |
26% |
19% |
| Service/support I need is not available in
my community |
0% |
6% |
| I do not know what type of service I need |
9% |
8% |
| I am too busy-schedule not convenient |
7% |
6% |
| I am not interested/I am embarrassed to get
asst from others |
4% |
14% |
| I do not want assistance from non-family,
paid caregivers |
11% |
14% |
| Don't have a need for assistance |
35% |
20% |
| Other, specify |
7% |
13% |
| Total |
100% |
100% |
Employed Caregivers
Most caregivers responding to the survey were not employed, but in 2008, 29 percent worked part or full time.
Table 12.11 Employment Among Caregivers
| Are you employed full time or part time? |
Percent of respondents 2004 |
Percent of respondents 2008 |
| Yes, full time |
22% |
13% |
| Yes, part time |
11% |
16% |
| No, not employed |
64% |
71% |
| Total |
100% |
100% |
Employed caregivers have made adjustments to their job because of caregiving responsibilities.
Table 12.12 Impact of Caregiving on Employment
| Have you ever had to do any of the following...? (All that apply) |
Percent of respondents 2004 |
Percent of respondents 2008 |
| Give up work entirely or take early retirement |
10% |
13% |
| Give up work temporarily or take a leave of absence |
21% |
31% |
| Go from full-time to part-time work |
11% |
15% |
| Turn down a promotion |
7% |
6% |
| Make changes in daily work schedule |
43% |
55% |
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Updated:
April 11, 2012
