Last week, Governor Andrew Cuomo signed the CARE (Caregiver, Advise, Record, Enable) Act into law in New York State. The law, which passed unanimously in the State Senate back in June, mandates training for the fastest growing labor force in the State: caregivers.

This is only a first step in protecting caregivers, 90 percent of which are unpaid. The State government is going to have to find some way to subsidize this labor as well as provide insurance for caregivers.

The new law requires that a physician inform an officially designated caregiver, almost always a family member, of the entire discharge plan when a senior citizen is released from the hospital. Right now, the majority of caregivers perform health related tasks, and most people who need care will never see a health-care professional, the caregivers take on all of that slack. The law goes into effect immediately.

However, these are family members that are burning out, losing their jobs and getting sick themselves. They throw the deficit in care spending into startling relief. These are 2.6 million caregivers who provide an estimated $32 billion in unpaid labor annually. They are also supplementing the income of a poor senior population, over 75 percent of which have no access to a retirement plan.

“There needs to be more resources for respite care, more resources for case management and people who can advise caregivers on how to be more efficient,” Bill Ferris, State Legislative Representative for the AARP said. “This is an issue for all levels of income. They have to go to work. Everyone has loved ones and people that they care about.”

New York State is the 18th State to adopt the CARE Act. The major opposition to the Bill came from the Greater New York Hospital Association who said that this law was unrealistic. The caregiver is not always present at the time the patient is released. The law it is up to the doctor to locate and inform a family member who may be difficult to reach or identify.

However, empowering the caregiver has been proven to be an important first step in cutting down on the rate of recidivism, according to Ferris. He said that a lot of the time, without proper care at home, people return to the hospital within 30 days of their discharge. This creates a huge financial burden as hospitals are penalized if they show readmissions.

Ferris said that caregivers are picking up State slack. By keeping people out of the costly nursing home system they are not only performing free labor, they are saving taxpayers money.

One way that the state could subsidize caregiving is by putting more money into case management. Case managers connect an elderly person with services, help them pay their bills and assess their needs. This, in itself is a full-time job and often falls squarely on the backs of the caregivers.

There is currently a waiting list of over 2,000 seniors looking for case managers in New York City. Over the past five years, the number of case managers has been steadily declining, a spokesperson for the DFTA said recently that their over $44 million budgetary increase was going to be spent largely on reversing that trend.

For Assemblymember Linda Rosenthal, who cosponsored the Bill, the issue goes beyond informing the caregiver, the next step is protecting them. The average caregiver is said to be a 60 year old woman caring for an 82 year old parent.

“I think the primary issue is ensuring that they don’t burn out and that they are not on duty 24/7,” Rosenthal said.

Rosenthal would like to see caregivers given paid leave when they are looking after a sick loved one.  Right now the AARP is advocating for a Family Leave Insurance Bill in New York State so that caregivers would granted time off and insurance in case something happens to them while they are occupied with care. They are also looking to possibly extend the limits of disability leave to include care as well. That Bill did not pass the New York State Senate.

For Assemblymember Rosenthal, there is an even bigger issue at hand. Looking after caregivers is a worthy cause, even worthier is making sure there is someone there to give care at all. Seniors are the fastest growing population the reserve people aged 45-65 is stagnating. In 2010, there were 6.6 people 45-65 for every person over 80 who might need care. That number is expected to shrink to 4.8 by 2030 and 3.5 by 2050. Unless more people become employed to help, as the senior population ages, our reserve of caregivers will be cut almost fully in half.

“We are going to reach a critical point where we run out of caregivers,” Rosenthal said. “People are getting older, with illness, but they are surviving.”




  1. Caregivers perform $32 Billion worth of unpaid labor a year.

  2. They provide 80 percent of long-term care for the elderly. This includes treating people with diseases like Alzheimer’s and Dementia.

  3. Research shows that caregivers have increased instances of high blood pressure and dementia. Caregivers have 23 percent higher stress hormones and 15 percent less antibodies.

  4. Caregivers with a history of chronic disease have a 63 percent higher mortality rate than non-caregivers.

  5. The average caregiver is a 65 year old woman looking after an 82 year old mother.

  6. 43% of caregivers show signs of clinical depression.

  7. The amount of money that family caregiving accounted for nationally ($470 billion) in 2013, was equal to $1,500 per each person in the United States.

  8. 60 percent of caregivers are also fully employed, causing a huge stress on both their job and their ability to care for a loved one.

  9. Companies lose $25 billion annually due to absent caregivers.

  10. 1 in 5 people leave the workforce early to care for a loved one.