Research Highlights Family Caregivers’ Central Role in Successful Aging.

The H.E.A.R. Institute’s research commentary, published in The Gerontologist, calls for the full integration of caregivers to best support successful aging. 

About 48 million people in the U.S. provide unpaid care to an adult, helping with personal services, social support, and household tasks. These family, friends, and neighbors are the backbone of how millions of older adults access and manage their healthcare. 

MedStar Health Research Institute’s Health Economics and Aging Research (H.E.A.R.) Institute studies care that supports the dignity and well-being of older adults. Our research commentary on Successful Aging, published in The Gerontologist, argues that respect for the role and perspective of family caregivers must be a central part of healthcare research and delivery.  

Successful Aging is a multi-faceted concept that describes ways to help older people stay active, healthy, and lively later in life. What started as a biomedical approach now includes a broader set of principles, such as:
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• Health and activities of daily living

• Physical function

• Cognitive function (thinking)

• Emotional health

• Active engagement in life

Family caregivers can focus on these elements at home to help a person age in a healthy, active, and productive way. However, without family caregivers, achieving the goals of successful aging in the U.S. population will be very difficult. Experts calculate that almost 25% of the U.S. population, or nearly 100 million people, will be 65 or older by 2060. 

Along with increased age comes the risk of chronic diseases such as dementia, cancer, and heart disease, as well as complications from infections such as the flu. For the best results, family caregivers should be seen as equal contributors to their loved one’s healthcare team, researchers, and healthcare providers. For the best results, family caregivers should be seen as equal contributors to their loved one’s healthcare team, researchers, and healthcare providers.

Family caregivers are central to successful aging. 

Family caregivers aren’t just family. They’re friends, neighbors, and community members who provide unpaid foundational care and support, from attending doctor visits and paying bills to cooking meals, assisting with bathing, and giving social connections that bring each new day to life.

The most recent report from AARP and the National Alliance for Caregiving paints a picture of the diverse and growing nature of caregiving in the U.S.:
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• Almost 1 in 5 people provide unpaid care to at least one adult with health or functional needs

• Family caregivers come from all generations, and 61% are working another job while providing care

• About 23% of people say caregiving has worsened their health, up from 17% in 2015.

Caregiving impacts the people who do it in both positive and negative ways. Research has demonstrated great things about caregiving, primarily when their friends and family support the person providing care. Caregivers often:
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• Build their self-confidence by helping someone else, recognizing their inner strengths, and learning new skills

• Develop a stronger relationship with the person for whom they’re providing care

• Get motivated to start new relationships with healthcare providers, other caregivers, and people in the care recipient’s social circle.

However, caregiving can also take a toll on those who provide it. Caregivers may:
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• They have less time for their own social lives, so their relationships can suffer

• Experience lower quality social lives that can link to worse mental health outcomes

• Develop a worsened relationship with the care receiver, which can make health outcomes worse for both

• Have more stress, which can lead to worse physical health and depression

• They struggle financially due to having to leave their job or reduce their work hours.

Caregivers who are healthy and supported have more capacity to help and provide consistent care, improving outcomes for aging adults by identifying issues early, communicating with providers, and fostering an environment of health. 

Related reading: Research Examines Quality, Outcomes From Subacute at Home Program.

Age-Friendly Health Systems: Adopting the 4Ms.

To help support Successful Aging and the caregivers crucial to its success, researchers and clinicians have developed methods to focus informal and formal caregiving on ways to make getting older better.

The Age-Friendly Health System movement includes more than 4,000 care sites such as hospitals, health systems, and long-term care facilities that follow the research-backed 4Ms Framework:
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• What Matters: Understanding each older adult’s specific health goals across all settings

• Medications: When necessary, using drugs that do not interfere with what matters, mentation, and mobility

• Mentation: Preventing—or identifying, treating, and managing—dementia, depression, and delirium in all settings

• Mobility: Making sure older adults move safely each day to maintain function and do what matters

The 4Ms are to be used with every adult, during every interaction, in all care settings. They can help family caregivers by supporting shared decision-making, improving communication, addressing cognitive issues, and promoting safe mobility. All of these also enhance the quality of life for caregivers and care recipients.

While the Age-Friendly Health System movement is one way many institutions adapt to support an aging population and its caregivers, our research urges national-level action to improve getting older for everyone.

Researchers must collaborate with policymakers and health system administrators to build lasting change. We identified five goals intending to improve outcomes that should be considered at the policy level. These include:
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• Increasing awareness and outreach to caregivers

• Advancing partnerships and engagement with family caregivers

• Strengthening services and supports

• Ensuring financial and workplace security

• Expanding data, research, and evidence-based practices to support family caregivers

Related reading: Diagnostic Safety Research Improves Communication Tool for Older Adults and Primary Care Providers.

Collaborating to support caregivers and patients.

The H.E.A.R. Institute is uniquely positioned to help initiate change. Because we’re a part of MedStar Health and MedStar Health Research Institute, every research study we conduct collaborates with leading clinicians and often patients and providers. 

This allows us to ensure that our work goes beyond mere ideas. Approximately 26%  of caregivers report having difficulty coordinating care, so we are committed to making a real difference for patients and caregivers.

MedStar Health’s commitment to advancing community health through research means our leaders don’t hesitate to make changes when we know it will help our patients or providers. As our nation ages, this spirit of nimble innovation will be necessary to support caregivers and care recipients in Successful Aging.