Caring for the Elderly: A Job Deserving Recognition and Support

What would you expect if you were offered a job that requires a great deal of time and commitment, and which also requires specific technical skills, interpersonal skills, a bit of psychology, empathy, the ability to react to unforeseen events and, above all, a lot of patience? Surely, you would expect at least two things: a good level of remuneration and a technical preparation that allows you to perform the job in the best possible way.

You will be surprised to learn that there are around 13 million people in Latin America and the Caribbean (publication soon available) who perform such work, but without receiving any remuneration or training for the task. They are the family caregivers of the elderly.

A recent IDB survey , which studies the experiences of caregivers in 25 countries in the region, shows that eight out of ten family caregivers of older people have no training. The situation is not much better among paid caregivers: more than 30% work without any training, and only three out of ten have taken a course of 150 hours or more.

Why Is the Situation of Caregivers in the Region Important?

Caregivers, whether paid or unpaid, are the cornerstone of any care policy. Whether in an institutional setting or at home, they are the ones who give their time and support so that, day after day, those receiving care can carry out the activities that are essential to their lives and well-being.

In the survey, 78% of unpaid caregivers of older people said that the role of caregiving gives them satisfaction, and 60% said they provide care because it's their choice. Similarly, about 70% of paid caregivers said they like their work.

But there is another side to the coin. High levels of satisfaction are associated with high emotional and economic costs. About 25% of unpaid caregivers and 20% of paid caregivers experience symptoms of depression, figures that are high compared to the population average. In addition, about half of unpaid caregivers acknowledge that they have neglected their health due to caregiving responsibilities.

The results of this survey are in line with those reported by other research on paid caregivers working in institutions in Colombia, Costa Rica and Uruguay. In the sample, 42% report physical burnout, 36% report emotional burnout and 22% report both physical and emotional burnout.

In addition to the health cost, there is also an economic cost. Among unpaid caregivers, 48% had to stop working and 20% had to reduce their working hours due to caregiving responsibilities. Among those who are paid for their work, 70% earn just the minimum wage or less.

Evidence suggests that access to training mitigates the negative effects of caregiving on both the health and economic autonomy of caregivers. In our survey, caregivers who received training reported lower levels of stress and depression. The analysis also shows that training is associated with higher income and that this effect is greater the longer the course taken.

How Can We Care for Caregivers?

Based on the results analyzed, the answer to this question seems to be simple: One of the main ways we care for caregivers is by providing them with training.

Training allows also to improve the care of those receiving it. Especially that which considers a person-centered care approach, where the user becomes the protagonist of their own care and their tastes and preferences are taken into account. This approach aims to ensure that the person being cared for maintains their dignity and autonomy, keeps control over their life, pursues their life projects, and engages in meaningful and purposeful activities for as long as possible.

This is sometimes not easy. Although there is evidence about the benefits of the person-centered care approach, difficulties in its implementation are also recognized. Establishing routines, standardizing tasks, times, and procedures typical of the traditional health-focused care model is often simpler. For example, when an elderly person retains functional capacity to assist in the hygiene process, but the caregiver completes the procedure entirely, the task is quicker. However, from a person-centered care perspective, the caregiver should promote the autonomy of the person being cared for, supporting them to carry out the activity on their own.

To break away from old paradigms, it is essential to mainstream the person-centered care approach in training programs and provide both content and strategies that emphasize the importance and benefits of the person-centered care model.

Given the importance of training, the IDB is supporting several countries in the region, including Uruguay, the Dominican Republic, Mexico, El Salvador, Colombia, Costa Rica and Ecuador, in this public policy area. This support includes assessments of caregivers' situations and policies aimed at improving them, the development of curricula, and the training of thousands of trainers and caregivers.

To learn more about the situation of caregivers in the region, you can read the full report at Caregivers of the Elderly: Overburdened and Underpaid: Evidence from an Inter-American Development Bank Survey in Latin America and the Caribbean. If you care for an older person, or know someone who does, and want to make your voice heard, you can complete the online survey here.

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