b'AGING IN THE 21ST CENTURYCaregiver Burden When dementia is accompa- and wives are most likely to be providing care As part of the in-homenied by other neuropsychiatricto husbands. Because of lower birthrates among ADAMS assessment,symptoms like depression andthose in the Baby Boom generation, the resulting informants who wereanxiety, the number of care- decline in available family caregivers (Ryan et present were asked togiving hours increases. Thisal. 2012) may lead to a caregiving perfect storm complete a question- is because these additionalseverely straining families and public programs as naire about their rolesymptoms increase the num- dementia cases grow.as a caregiver. Fisherber of functional limitations et al. (2011) report onthe person with dementiaEconomic Costsdata from caregiversexperiences. Okura et al.One way that dementia represents a substantial who report being a fam- (2010) show that the increasedeconomic burden is in out-of-pocket medical ily member with primaryfunctional impairment associated(OOPM) expenses. Delavande et al. (2013) show responsibility for providingwith neuropsychiatric symptoms, likethat OOPM costs for those with dementia are care to the person with dementiadepression and anxiety that are common$8,440 per year (in 2016 dollars) compared to or CIND. Caregivers are asked a wide range ofin dementia and CIND, translates into a higher$2,570 for those with normal cognition at similar questions about their experiences providing carenumber of caregiving hours. Caregiving for thoseages; increased expenses are mainly due to nurs-to their relative. Caregivers are most often femalewith dementia may itself be a risk for cognitiveing home care. Projecting this amount up to the children of the care recipient. Sixty-two percentdecline. Husbands and wives who are caregiversUS population over age 70 in 2009, which they of caregivers live with the care recipient. The re- for their spouse with dementia are themselvesestimate to be about 28 million based on census searchers compare the experiences of those caringmore likely to experience cognitive decline com- records, the excess cost of OOPM spending asso-for relatives with dementia and CIND.pared to caregivers of spouses with other diseasesciated with dementia was $22 billion in 2010.Those providing care to relatives with CIND(Dassel et al. 2015). report an average of 133.7 care hours per month.Women who are disabled from dementia are Care of a relative with dementia was twice asmuch less likely than men to receive informal hard, involving an average of 278 hours perhome care (Katz et al. 2000). Women are more month. Around 44% of those caring for a relativelikely to be living alone, but even among married with dementia report feeling depressed comparedcouples, wives receive less care than husbands. to 26% of those caring for someone with CIND.Among those receiving informal care, children Despite this, caregivers also reported on the re- are most likely to be providing care to mothers, ward of caring for their relative, including feeling closer to the person they were caring for and moreBecause of lower birthrates among those in the Baby Boom in control of their relatives well-being.generation, the resulting decline in available family caregivers may lead to a caregiving perfect storm severely straining families and public programs as dementia cases grow.46'