Long-Term Care

Today, about six million older Americans living at home need help with day-to-day activities, such as eating, bathing, shopping, and house cleaning. Most disabled elderly get all their care informally, from family members and friends, mainly women. Greater geographic dispersion of families, small families, and more women working outside the home are straining the ability of informal caregiving. Some private and public-sector employers are now providing assistance known as "elder care" to alleviate work and caregiving conflicts. This assistance may include leave policies, alternative work schedules, and referral services to help employees care for their elderly relatives. Little is known nationwide about the extent and content of elder care generally--and even less is known about elder care in government, which employs 18 million people or 15 percent of the workforce. This report evaluates (1) the extent and nature of government practices facilitating elder care; (2) planned changes in these practices; and (3) their potential to further support informal caregivers.

GAO found that: (1) most disabled elderly people receive informal care from family members and friends, primarily women; (2) 12 percent of the federal work force have some elder care responsibilities; (3) the federal, state, and city governments studied offer flexible schedule options which include leave without pay, flex-time, compressed work schedules, and part-time employment with benefits; (4) the Office of Personnel Management, in collaboration with the Administration on Aging, is promoting a publicly available toll-free number to assist federal employees in locating home and community-based services for the elderly; (5) some state and city governments plan to expand the availability of existing elder care programs and promote flexible schedule options to help caregivers balance their work and family responsibilities; and (6) the effectiveness of federal elder care programs will depend on how well these initiatives are implemented and the extent that federal employees use them.