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National paid leave could change the American caregiving experience

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Many older Americans reported depression, anxiety and trouble sleeping during the pandemic.

As the country continues to fight its way through the COVID-19 pandemic and a rapidly changing economy, Congress is debating priorities to include in the upcoming legislative package. While Americans have heard the most about the “hard infrastructure” components such as job-creating roads, bridges and broadband, the Biden administration’s proposal includes robust “soft infrastructure” such as caregiving and paid family and medical leave. Despite the media and political labels, the truth is there’s nothing soft about the caregiving crisis in which America finds itself, and there’s nothing harder for working and retired Americans, and those people caring for older parents, spouses and other loved ones, than balancing caregiving needs with basic financial stability. 

Every day, thousands of Americans in every city, county and state are forced to make impossible decisions. How do they choose between a family-sustaining paycheck and caring for an older relative, a new child, or even themselves when they are sick or injured? All of us — regardless of our political party, socioeconomic status, race, gender or geography — will need to give or receive care at some point (and typically, many points) in our lives. Being able to take compensated time away from work makes these big responsibilities and challenges a little bit easier.

Consider, for example, Arizona, a state with rapid growth and diversity. Its population is rich in older Americans, young families seeking opportunities, veterans and military members, and Latino and Native families. The absence of a national paid leave policy is a major issue for these groups. More than 36 percent of Arizonans are over age 50, and one in five are over 65. The average monthly cost for a home health aide in Arizona is $4,004, and nursing home care can cost up to $10,000 per month, whereas the average monthly pay in Arizona is $4,758. The math just doesn’t add up. For families who may not be able to choose paid caregivers — and for many families who would prefer to provide care for their loved ones at home — paid leave is a must to ensure everyone can age with dignity and comfort according to their preferences.  

For Sonia Pizano from Phoenix, there never was a question that she would care for her mother when she became ill. With little time to plan, Pizano managed her mother’s care until she passed, but it wasn’t easy. Like millions of families who struggle with being able to care for their aging relatives — a growing population that is projected to nearly double from 52 million in 2018 to 95 million by 2060 — it is nearly impossible to juggle work, caregiving and financial responsibilities. “This was a time I should have been able to focus on my mom’s care,” Pizano told us. “Instead, I was juggling my work schedule. All families deserve to be there for one another in these moments. We don’t get to have this time back.” This story repeats itself over and over in many locales. 

When Consuelo Hernandez was in high school, her father was severely injured on the job. Her family struggled to make ends meet and provide the care her father would need for the rest of his life. With COVID-19, her family took on new challenges, managing her father’s long-term injury, new health issues for her mother, and a global pandemic. Hernandez is the hub of her family, coordinating schedules with her siblings, caregiving for her parents, all while balancing her job and trying to stay afloat to make it all work. “I may someday worry about losing my job if I need to take extended time to care for my family,” she told us. “It’s a struggle I see played out not only in my own family, but with those in my community. No one can afford to go without a paycheck.”

Veterans and military members are another community who would particularly benefit from a national paid leave policy. David Lucier, head of the Arizona Veterans and Military Leadership Alliance, told us: “A service member’s deployment is often disruptive to their family’s emotional and economic stability. It requires enormous sacrifice by spouses, friends and other loved ones to cope with the challenges of deployment. Inevitably, employed military spouses shoulder the weight of preparing for and managing daily life, including juggling household tasks, finances and child care. And when a service member returns from deployment wounded, physically or mentally injured, or ill, family members often take on the role of caregiver … navigating their loved one’s recovery, rehabilitation and reintegration without adequate support systems.”

Pizano, Hernandez and Lucier are Arizonans, but the stories they related to us are not unique to that state. Across America, millions of families — 1 in 6 Americans — struggle to provide care for an older relative, and this population is projected to double over the next 20 years. With millions of Americans in the so-called “Sandwich Generation,” struggling to provide care and financial support to both children and parents, the absence of a national paid leave policy makes the balancing act that much more challenging. With a paid leave policy, these 15 percent of Americans who are financially supporting both a parent and a child — and currently undertaking 2.5 hours of unpaid care a day — would not have to choose between providing care or possibly enduring financial ruin should illness or injury strike.  

As we continue to navigate the pandemic and aim to rebuild our country and economy when it abates, we are faced with some hard truths: a rapidly aging society, rising health care costs, and a growing shortage of caregivers, paid and unpaid. As a result, Americans increasingly will rely on a smaller pool of family and friends, many of whom are working full- or part-time jobs, to care for them as they age. 

We cannot accommodate these changes without changing how we view caregiving itself — as a part of the American family experience, in good times and bad — and provide the tools that caregivers need, including an equitable and accessible national paid family and medical leave policy.

Nancy LeaMond is the chief advocacy and engagement officer for AARP. Molly Day is the executive director of Paid Leave for the US (PL+US).

Tags Caregiver stress Caregiving Health care paid leave

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