Family Caregiving:

1
Myers-JDC-Brookdale Institute Center for Research
on Aging
Family Caregiving Needs and Program Initiatives
in Israel
Aging Subcommittee Meeting October 10, 2005
-

2
Why is there an Increasing Interest in Family
Caregivers?

• Family caregivers provide bulk of assistance to
  disabled persons
• Concern about implications of social changes on
  availability of family care
• Interest in enabling family caregivers to
  sustain their roles and maintain elderly in
  community
• Interest in making care more effective and
  efficient
• Prevent exhaustion and elderly abuse
• Growing evidence/recognition of negative effects
  of burden on family caregivers

3
Trends in Parent Support Ratio
ages 80/ages 50-64
4
Primary Caregivers of Disabled Elderly in Israel

• Most are women (about 2/3)
• Most are spouses or a child
• Most live with elderly or in geographical
  proximity
• Average age is mid-50's, however a significant
  proportion are 65
• Primary caregivers provide wide range of
  activities (e.g. personal care, homemaking,
  errands, emotional support)
• Significant proportion report difficulties,
  feelings of burden and stress

5
Percentage of Caregivers Reporting Burden, by
Level of Disability of Elderly in Care
Level of Disability
Total 75
Total 75
Total 96
6
The Effect of Caregiving on the Caregiver's
Employment (in )
7
Two Main Strategies to Assist the Elderly and
their Family Caregivers
Elderly person is the direct recipient of
care. (formal home care and day care)
Caregiver is direct recipient of care. (financial
and emotional support)
impact
If help is provided to the elderly, it alleviates
burden on caregiver. Support to caregivers
translates into meeting needs of elderly more
effectively.
8
Policy Towards Caregivers, Until Recently

• Status of caregivers has been ambiguous and has
  not until recently been officially recognized
  as clients of health and social service
  systems.
• Services to caregivers have been based more on
  the characteristics of the care-recipient than on
  evaluation of the caregiver's situation and
  needs.

9
Changing Policy Towards Caregivers

• Increasing recognition of caregivers' unmet
  needs
• Realization that needs should be addressed
  specifically
• Moving beyond "burden" with more emphasis on
• multiple dimensions of care-giving
• positive aspects of care-giving
• strengths-and-skills perspective building
  capacities and confidence

10
Types of Programs and Interventions

• Information and referral
• Case management
• Skills building, education and training
• Counseling and emotional support
• Breaks from caring (respite)
• Financial support (e.g. care allowances, tax
  benefits, pension credits)
• Business initiatives (to help caregivers
  reconcile employment and family life)

11
Policy Towards Family Caregivers
in Israel

• Among handful of countries that established
  legal commitment of children's responsibility
  towards care of their parents (alimony law)
  especially in the case of financial
  contribution to institutional care
• Families as representatives of elderly
  (informal ways of representation or legal
  guardianship)

12
Policy Towards Family Caregivers in Israel
(cont.)

• Services developed to address needs of elderly
  are also aimed at helping family caregivers
  (home and day care)
• Benefits for those caring for disabled
  spouses/parents
• Paid work leave (6 days)
• Entitlement to severance pay (if main reason for
  leaving the job is the need to care)
• Tax credit (if contributing to institutional
  care)
• Entitlement to income supplement from social
  security without usually required employment test

13
Non-Financial Direct Support to Caregivers in
Israel

• New initiatives in the area of information and
  referral
• In other areas (counseling, emotional support,
  breaks from caring) there are local
  initiatives but not broad programs

14
Selected Issues Requiring Attention

• Financial Benefits
• Caregiver awareness of available benefits
• Only caregivers of very severely disabled
  elderly are entitled to benefits
• In most cases, benefits are provided only to
  spouses and children, not including other
  informal caregivers
• Other kinds of support
• No broad national policy for direct support of
  caregivers
• Much can be learned from initiatives for
  caregiver support in other countries