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Family Caregiving is Global, Not Local

December 18, 2015
We often think of family caregiving as a local issue. As policymakers in the U.S. continue to put pressure on the healthcare and long-term care systems to cut costs, many believe that caring for an aging or disabled loved one is a personal issue. We ask the family caregiver to take on assistance with daily activities, medical and nursing tasks, financial management, and care coordination. Supports, where available, are typically provided through individual health plans, state programs, or federal programs available only to a small portion of America’s caregivers.

But the issues that family caregivers are grappling with on a local level add up to serious policy questions on the national and global front. In the aggregate, we’re talking about 44 million family caregivers in the U.S. alone. Worldwide, carers organizations estimate that there are as many as 434 million family carers. It’s time for global bodies, such as the United Nations and the World Health Organization, to pay attention to how caregiving is impacting our workforce, our healthcare systems, and our societies.

Multinational Momentum

The International Alliance of Carer Organizations (IACO), an umbrella organization of 12 member nations, comes together each year to share best practices in caring programs between countries. The third annual meeting of IACO, held this past September in Gothenburg, Sweden, addressed the issues facing families caring for someone with Heart Disease, Parkinson’s, children with special needs, and the role of caregiver assessments in providing services.

In addition to the IACO meeting, advocates participated in the 6th International Carers Conference, which featured more than 500 advocates from around the world to discuss the challenges facing family caregivers. The meeting sessions focused on creating different strategies to address the health and overall well-being of carers, reducing the burden caring has on the carer, and identifying the needs of the carer. Her Majesty Queen Silvia of Sweden joined the conference to share her personal experiences with family caring and to commit to taking action to support carers within her country.

Global programs and forums such as the Carers Conference and IACO provide opportunities to identify what programs might serve as models for other nations.  Of particular note, many countries provide supports to family caregivers that may serve as models for the U.S.:

  • In Australia, a government program called “Carer Payment” provides financial support to carers who are unable to work full-time because they provide daily care to someone with a disability or medical condition, or to someone who is frail.

  • Canada’s government offers the “Compassionate Care Benefit” (CCB) program to provide support to carers for loved ones at the end of life. This program allows carers to receive employment insurance benefits and job protection for up to six weeks to care for a loved one who is dying or managing a terminal illness.

  • Ireland’s government provides income support payments for low-income carers and social insurance for carers providing full-time caring to a loved one through “Carer’s Allowance” and “Carer’s Benefit” programs.

  • New Zealand’s Ministry of Health offers respite services for carers, allowing carers a short period of rest from caring.

While many countries are leading the way, others parts of the world such as Latin America, Africa, and South-East Asia, do not have any policies or programs in place to help carers. If services are available, they usually are limited to a certain segment of carers and often are not available nation-wide. This is despite the fact that most countries are seeing a rapid increase in their aging populations as younger generations bear less children. Lack of infrastructure creates challenges for governments that need ways to care for their older and disabled citizens. Only recently have some developing countries begun to develop legislation to help carers and the elderly, in places such as Argentina, Chile, Kenya, Philippines, and Uruguay.

Here in the United States, more can be done. Current programs offer some relief, such as the Family and Medical Leave Act, the Older Americans Act, and safety-nets such as Social Security Disability Insurance and Medicare. From a global perspective, however, it is evident that more needs to be done to better support our carers, the aging, and those managing long-term disability. Let’s continue the conversation.

Rick Greene, M.S.W., serves as Executive Advisor to the International Alliance of Carer Organizations, where he leads a coalition of 12 nations in building a global understanding and respect for the vital role of carers. Learn more at