Blog September 28, 2016

The Inextricable Link between the Eldercare Workforce and Family Caregiving

By Terry Fulmer, PhD, RN, FAAN
President, The John A. Hartford Foundation

Are you a caregiver? Sooner or later, caregiving touches us all.

According to a new report by the National Academies of Sciences, Engineering, and Medicine, Families Caring for an Aging America, nearly 18 million individuals currently provide care to an older family member, spouse, or friend. Millions more anticipate serving in a caregiving role in the future. Most of us, as we age, will eventually become care recipients.


For individuals and for society as a whole, the preparation of our nation’s workforce to address caregivers’ needs should be of paramount concern.

Family caregivers are a large and absolutely critical component of our health care workforce. They are the primary providers of care for our nation’s older adults, yet they remain almost invisible. While they perform a host of vitally important activities, from meal preparation and house cleaning to complex medical tasks like wound care, they often do so with no training, limited support, and little recognition.

As the Academies’ report documents, our fragmented health care system and the demands it places on families often result in physical, emotional, and financial challenges for these heroic caregivers, which puts their loved ones at risk. This is unsustainable, dangerous, and wrong.

The good news is that health and social service professionals, as well as direct care workers such as home health aides and nursing assistants, are in a unique position to support family caregivers. To make that possible, we must work to create a health care system that is not just person-centered, but also family-centered, as called for in the report. The entire care workforce needs to be equipped with training and systems that support this transformative approach.

One key initiative is the Health Resources and Services Administration’s Geriatrics Workforce Enhancement Program (GWEP), which The John A. Hartford Foundation is proud to be a partner of through support for a national coordinating center. This important federal program is integrating geriatrics into primary care through 44 academic-community partnerships across the country. Through the GWEP sites, various members of the health care team are trained alongside family caregivers. This is a critical step to developing an inter-professional workforce that includes these caregivers.

kissing-forehead_000010309449mediumUnfortunately, as the report notes, the GWEP program does not have adequate funding to meet the range of training needs, or the proper geographic distribution to affect true systemic change. To fully support family caregivers and properly train the entire eldercare workforce, both paid and unpaid, programs such as the GWEP need to be valued and expanded.

In my own work as a geriatric nurse, and among my friends and family, I have seen the enormous strain on caregivers. I have seen how our system too often excludes them from important decision-making, yet assumes they are willing and able to do this very difficult job. I am so pleased the Academies have committed to shining a light on this often overlooked constituency and am optimistic that the report’s recommendations will catalyze change.

This report, and the work of organizations like the Eldercare Workforce Alliance, which we also proudly support, have the potential to move family caregivers into the forefront of health system reform and policy discussions. We owe it to family caregivers to prepare them to be full partners in the health care system, and to build that system so it can do more to care for the families caring for our aging America.