The time spent caring for an older stroke survivor in the home totals about 22 hours a week, or more than $11,000 a year, a new study finds.
Paying bills, shopping and traveling to and from doctor’s visits adds up, say researchers who found the true cost of post-stroke home care services for American seniors is much higher than previously estimated. Stroke survivors received about 10 more hours of caregiving from family or friends compared to seniors who had not had a stroke, the study found.
Study author Dr. Lesli Skolarus said more than half of seniors living at home after a stroke have some kind of caregiver on hand.
“Our team found stroke survivors receive an average of about 22 hours of [caregiver] help per week,” she said, compared to about 12 hours a week for a comparable group of seniors with no stroke history.
“If all of this care was provided by a paid caregiver, the total cost would be huge,” said Skolarus, an assistant professor in the neurology stroke program at the University of Michigan. “This includes basic and instrumental activities of daily living along with health care, money matters and transportation activities.”
Skolarus said previous studies arrived at a 16-hour weekly tally, and pegged the national value of post-stroke home care services for at-home Medicare recipients at roughly $27 billion a year. But the true stroke caregiving bill approaches the $40 billion mark, her team concluded.
The study authors said prior analyses haven’t accounted for the full value of the care that informal providers — such as family and friends — typically offer beyond the basic daily living assistance given older adults not in post-stroke recovery.
Skolarus and her colleagues were to present their findings Wednesday in Los Angeles at the annual meeting of the American Stroke Association. Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.
The study team focused on nearly 900 stroke survivors included in the 2011 National Health and Aging Trends Study and compared them with a similar group of seniors with no prior stroke. All were Medicare recipients living at home.
The researchers first identified all caregiving involving self-care assistance or help with mobility and household upkeep. This included helping patients get to doctors’ visits, assistance with health insurance decisions, and help with transportation issues and financial logistics, such as opening and closing bank accounts.
Services were then quantified in terms of overall value (paid and unpaid) and total time required for caregiving.
The study helps to paint an accurate picture of what caregiving is really all about, said Matthew Neidell, an associate professor in the department of health policy and management at Columbia University’s Mailman School of Public Health in New York City.
“It’s a move in the right direction, because it is tracking the full or true costs, which are not limited to just paid expenses but also what we call classic ‘opportunity costs,’ ” he said. “Beyond just medical bills and supplies, there is the time and effort devoted to caring for somebody that a lot of family members are, of course, willing to do. But that can mean taking time off of work or changes in that caregiver’s lifestyle and leisure time.”
Because that care may not involve direct outlays of money, “that can make it hard when thinking about how to account for this outlay of time and effort in terms of designing policies that support the people involved,” Neidell said. But factors such as paid or unpaid work leave, flex time or a reduced workload have a value, he noted.
There’s more on stroke caregiving at the National Stroke Association.