The Many Faces Of Caregivers: A Close-Up Look At .

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The Many Faces of Caregivers:A Close-Up Look at Caregiving and Its ImpactsTransamerica Institute’s Inaugural Study of CaregiversSeptember 2017 Transamerica InstituteSM, 2016 2017, Transamerica Institute

Table of ContentsIntroductionAbout the AuthorsAbout Transamerica Institute About the Inaugural Caregivers 568The Many Faces of Family Caregivers: A Close-Up Look at Caregiving and Its ImplicationsExecutive SummaryPage9A Portrait of Today’s Caregivers Key HighlightsA Portrait of Today’s CaregiversInsights About Care Recipients and Their NeedsThe Diverse Duties, Daily Lives, and Dedication of CaregiversThe Employment Situation of CaregiversThe Personal Financial Implications of Being a CaregiverPagePagePagePagePagePage172942495668 The Health Effects of Being a CaregiverPage81 Ways to Help Caregivers with Their ResponsibilitiesDemographic Perspectives Voluntary Status Employment Status Generations Gender Household IncomePage85PagePagePagePagePage90123156191225 Race/EthnicityAppendix: Caregiver and Care Recipient DemographicsAcknowledgementsPagePagePage2582922972

About the AuthorsCatherine Collinson serves as CEO and president of Transamerica Institute and Transamerica Center forRetirement Studies , and is a retirement and market trends expert and champion for Americans who are atrisk of not achieving a financially secure retirement. Catherine oversees all research, publications andoutreach initiatives, including the Annual Transamerica Retirement Survey. She also serves as executivedirector of the Aegon Center for Longevity and Retirement.With two decades of retirement services experience, Catherine has become a nationally recognized voice onretirement trends for the industry. She has testified before Congress on matters related to employersponsored retirement plans among small business, which featured the need to raise awareness of theSaver’s Credit among those who would benefit most from the important tax credit. Catherine serves on theAdvisory Board of the Milken Institute’s Center for the Future of Aging. In 2016, she was honored with a HeroAward from the Women’s Institute for a Secure Retirement (WISER) for her tireless efforts in helping improveretirement security among women.Hector De La Torre is the executive director of the Transamerica Center for Health Studies , which isfocused on empowering consumers and employers to achieve the best value and protection from their healthcoverage, as well as the best outcomes in their personal health and wellness. Hector served as a StateAssemblymember for California’s 50th District from 2004-2010. Among his accomplishments as an electedofficial were expanding access to doctors in underserved communities, consumer protections againstretroactive cancellation of health insurance, and supporting facilities improvements at Children’s Hospitals.Prior to that, he was Mayor and Councilmember in his hometown of South Gate.Hector serves on the board of L.A. Care, the largest public health plan in the United States, a member of theBoard of Trustees at Occidental College (his alma mater) in Los Angeles, and is a member of the CaliforniaAir Resources Board (CARB) as a gubernatorial appointee.3

About Transamerica Institute Transamerica Institute (TI) is a nonprofit, private foundation dedicated to identifying, researching andeducating the public about retirement, health coverage, and other relevant financial issues facingAmericans today. It is comprised of two research centers: Transamerica Center for Retirement Studies (TCRS) and Transamerica Center for Health Studies (TCHS). Its mission is to help educate and empowerpeople to make informed decisions about important matters that can improve their health and wealth. TI is funded by contributions from Transamerica Life Insurance Company and its affiliates and mayreceive funds from unaffiliated third parties. TI and its representatives cannot give ERISA, tax, investment or legal advice. This material is provided forinformational purposes only and should not be construed as ERISA, tax, investment or legal advice.Interested parties must consult and rely solely upon their own independent advisors regarding theirparticular situation and the concepts presented here. Although care has been taken in preparing this material and presenting it accurately, TI disclaims anyexpress or implied warranty as to the accuracy of any material contained herein and any liability withrespect to it.4

About the Inaugural Caregivers Survey The Many Faces of Caregivers is a comprehensive examination of the state of unpaid caregiving inAmerica. Unpaid caregivers face a host of financial and health-related challenges – both for themselvesand those they care for. A large proportion of the population is entering the age range where the need for them to becomecaregivers becomes more likely. At the same time, many find themselves financially unprepared forretirement and need to stay in the workforce longer. These factors, coupled with a healthcare systemthat is often difficult to navigate, result in an environment that is challenging for all concerned. The analysis contained in this report, The Many Faces of Caregivers: A Close-Up Look at Caregiving andIts Impacts, was prepared internally by the research team at Transamerica Institute. The survey uncovers the various challenges caregivers are facing as well as insight into their health,both physical and financial, and the support they desire.5

Methodology The national online survey was conducted by Harris Poll between March 13 - April 21, 2017 among 3,074 non-professionalcaregivers. A comprehensive demographic profile of the target population of interest of all U.S. non-professional caregivers is notavailable. Therefore, in order to ensure that this sample is properly representative, U.S. adults age 18 who were notcaregivers were also screened and asked certain demographic questions. However, the full survey was only administeredto non-professional caregivers. The combined data for non-professional U.S. caregivers plus all other age 18 respondents were weighted to make themrepresentative of the general U.S. age 18 population.— Data were weighted by race/ethnic groups [Hispanic, Black/African American (not Hispanic), Asian (not Hispanic),All Other (not Hispanic)] to each group's U.S. Census Bureau population distributions of U.S. adults age 18 forgender, education, household income, household size, marital status, and employment status.—The weighting also adjusts for attitudinal and behavioral differences between those who are online versus thosewho are not, those who join online panels versus those who do not, and those who responded to this survey versusthose who did not.The caregiver respondents were then analyzed as a representative subgroup of the general population age 18 . Caregivers for this survey met the following criteria:——— U.S. residents, age 18 or olderNon-professional caregivers (who may or may not receive compensation for caregiver role)Provided care for a relative or friend with an episodic, permanent, or temporary condition who needs help takingcare of themselves at any time in the preceding 12 months. The care recipient could be an adult or a child.The average survey length was 32 minutes. Respondents were given the option to complete the survey in Spanish, and199 respondents did so, including 79 percent Hispanics and 21 percent non-Hispanics. Percentages are rounded to the nearest whole percent. Differences in the sums of combined categories/answers are dueto rounding. Main sub-sample:——Primary caregivers 2,137Non-Primary caregivers 8296

Methodology (continued)Sample Sizes for Demographic BreakoutsCaregiver StatusPrimary CaregiversNon-Primary CaregiversNot SureN N 629584993655132N Voluntary StatusN Less than 25,000 25,000 to 49,999 50,000 to 99,999 100,000 or moreDecline To AnswerVolunteeredDid Not VolunteerNot Sure2,590331166Employment StatusGenderWomenMenTransgenderDecline To AnswerNeitherGenerationMillennialsGeneration XBaby BoomersMatures2,137829105Total Household IncomeN 1,7791,278993N 1,0716881,113202Full-timePart-timeSelf-EmployedNot EmployedNone1,1833912271,26512Race/EthnicityN WhiteHispanicAfrican-AmericanAsian/Pacific IslanderOtherDecline To AnswerMix2,1294663001328294Note: Subsample sizes do not add to full sample size due to other, non-responses, don’t knows, and declined to answer.7

TerminologyThis report uses the following terminology:Care Recipient: person for whom the caregiver provides careCaregiver and Voluntary Status Caregiver: 18 year old living in the U.S. who has provided care for a relative or friend at any time in the past 12months Primary Caregivers: caregivers who self-identify as the primary caregiver Non-Primary Caregivers: caregivers who do not self-identify as the primary caregiver Voluntary: caregivers who self-identify as voluntarily becoming a caregiver Non-Voluntary: caregivers who do not self-identify as voluntarily becoming a caregiverEmployment Status Employed full-time Employed part-time Self-employed including full-time and part-time self-employed Not employed including retired, stay-at-home spouse or partner, student, not employed but looking for work, notemployed and not looking for work, not employed due to the caregiver’s own disability or illness, and on leave ofabsence from employerGeneration Millennial: born 1979 – 2000 Generation X: born 1965 – 1978 Baby Boomer: born 1946 – 1964 Mature: born prior to 19468

The Many Faces of Family Caregivers:A Close-Up Look at Caregiving and Its Implications Executive SummaryA Portrait of Today’s Caregivers Key Highlights A Portrait of Today’s Caregivers Insights About Care Recipients and Their Needs The Diverse Duties, Daily Lives, and Dedication of Caregivers The Employment Situation of Caregivers The Personal Financial Implications of Being a Caregiver The Health Effects of Being a Caregiver Ways to Help Caregivers with Their ResponsibilitiesDemographic PerspectivesAppendix: Caregiver and Care Recipient DemographicsAcknowledgements9

Executive SummaryCaregiving for a loved one often transcends fulfilling the tasks and duties laid out daily. Nine out of 10 non-professional familycaregivers feel that it’s important to provide a good quality of life for the person they care for, like helping, and enjoy spending time withthe care recipient. However, many caregivers are providing care at their own risk. Fifty-five percent say that their own health is taking aback seat to the health of their care recipient. Sixty-nine percent gave little or no consideration to their own financial situation whendeciding to become a caregiver. These findings are part of The Many Faces of Caregivers: A Close-Up Look at Caregiving and ItsImpacts, a report by nonprofit Transamerica Institute (TI), a collaboration between its Center for Retirement Studies (TCRS) and Centerfor Health Studies (TCHS).“Millions of Americans are serving as unpaid caregivers for relatives or friends who need help taking care of themselves. With peopleliving longer, the high cost of long-term care, and the aging of the Baby Boomer generation, the number of unpaid caregivers is likely toincrease,” said Catherine Collinson, CEO and president of TI and TCRS. “It’s time to raise awareness of the challenges faced bycaregivers so that they can simultaneously care for their loved ones and protect their own long-term health and financial well-being.”Transamerica Institute’s national survey of 3,000 non-professional caregivers examines their duties and the impact caregiving has ontheir personal health and well-being, employment, finances and retirement preparations. It offers an in-depth analysis and demographicportraits of caregivers by employment status, gender, generation, household income, race/ethnicity, and whether they are the primarycaregiver and became a caregiver voluntarily or not. The report also offers detailed findings about care recipients, including their healthstatus and financial situation.A Portrait of Today’s Caregivers“Caregivers are a highly diverse population that includes men and women of all ages, ethnicities, income levels and employment status.Amidst this diversity, caregivers share much in common in terms of their motivations for being a caregiver and the types of duties theyperform,” said Hector De La Torre, executive director of TCHS. To illustrate the diversity of the caregiver population, the survey finds: Fifty-three percent are women and 47 percent are men; Thirty-four percent are Millennials (born 1979-2000), 22 percent are Generation X (born 1965-1978), 37 percent are BabyBoomers (born 1946-1964), and 7 percent are Matures (born before 1946); Thirty-nine percent are employed full-time, 13 percent are employed part-time, 8 percent are self-employed, and 40 percent arenot employed; and Eighteen percent had a household income (HHI) of less than 25k in 2016, 17 percent had an HHI between 25k and 49k,30 percent had an HHI between 50k and 99k, 28 percent had an HHI of 100k or more, and 7 percent declined to answer.10

Executive SummaryNotably, most caregivers provide care out of love for their care recipient. When asked how they became a caregiver, the mostfrequently cited reasons include a desire to care for their loved one (63 percent) and having a close relationship with the carerecipient (58 percent). Some caregivers indicate they have the time and capacity to do so (43 percent) and live in close proximityto the care recipient (36 percent).While the vast majority of caregivers (87 percent) are caring for a family member, the family relationship varies by generation: Generation X (42 percent) and Baby Boomers (42 percent) are more likely to be caring for a parent, compared toMillennials (24 percent) and Matures (8 percent); Matures (57 percent) are more likely than Baby Boomers (24 percent), Millennials (12 percent) a