By Carolyn Crist

(Reuters Health) – Nearly one in five caregivers who support ill family members or friends describe their own health as fair or poor, according to a new U.S. study.

Almost 18 million people are informal caregivers, and they play such an important role in the U.S. healthcare system that policymakers, nonprofits and healthcare organizations should find ways to take care of them, the study authors write in a Centers for Disease Control and Prevention (CDC) journal.

“Caregivers serve as such an important backdrop to our formal healthcare system, and knowing more about them is extremely important for those who make policies and oversee the parts of health care where caregivers are critical,” said coauthor Valerie Edwards of the Alzheimer’s Disease and Healthy Aging Program at the CDC in Atlanta.

Although caregiving can be beneficial for both the caregiver and the care recipient, caregivers may face emotional and physical strain, as well as depression, poor health and low quality of life, Edwards and colleagues write in CDC’s Morbidity and Mortality Weekly Report.

“We know that people are stretched thin when having to work and also take care of others,” Edwards told Reuters Health by phone. “We hope this data will encourage other researchers to examine this topic as well.”

Edwards’ team analyzed data from yearly surveys of U.S. adults in 2015-2017 that covered 44 states, the District of Columbia and Puerto Rico.

Overall, about one in five participants had provided care to a family member or friend in the previous 30 days, and another 17% expected to become caregivers in the next two years.

Among current caregivers, 58% were women. Most were non-Hispanic white, had some college education and were married or living with a partner.

Nearly half of unpaid caregivers were under age 45.

Across all the states, 19% of caregivers reported being in fair or poor health. This varied widely by state, though, ranging from 12% in Minnesota to 34% in Puerto Rico. In 19 states, including many southern states, more than 20% of caregivers reported fair or poor health, including one third of caregivers in Arkansas.

“This points out how common caregiving is in American family life, and it’s an incredibly helpful part of our lives,” Edwards said. “At the same time, caregivers need to take care of themselves so they can take care of others as well.”

“Caregivers are the ‘backbone’ of the long-term care system, providing most of the long-term care in the community, usually without any formally provided helpers in the home,” said Courtney H. Van Houtven of the Durham Veterans Affairs Health Care System in North Carolina, who wasn’t involved in the study.

A major next step, she said, is to include caregivers in electronic health records for patients, which would allow agencies and healthcare systems to identify caregivers and offer services. Veterans Affairs will begin to do this in 2020, she said.

In addition, families should discuss caregiving and what the preferences and expectations are, as well as state-level resources for paid home care.

“We all either have been caregivers, are caregivers or will be caregivers,” Van Houtven told Reuters Health by email. “It is important to know that it may not be possible to juggle work and caregiving, and that many caregivers experience negative health effects . . . as much as possible, planning for this juggle is incredibly important as everyone fares better when they have more choice.”

SOURCE: MMWR, online February 21, 2020.