Proprietary and Confidential The Economic Downturn and its Impact on Family Caregiving ASA/NCOA National Alliance for Caregiving Coalition Meeting Monday, March 15, 2010 Presented by: Sherri Snelling – Evercare, UnitedHealthcare

2 About Evercare Part of UnitedHealth Group serving 70 million individuals 1 in 5 Medicare beneficiaries choose UnitedHealthcare Evercare serves special needs populations: –Older Americans (nursing home, ASF) –Hospice –Family Caregivers One of the largest and most honored care coordination programs –Reduce hospitalizations (45%) and Emergency Room visits (50%) for nursing home residents –98% family satisfaction in independent survey on nursing home care –Recognized as innovative care coordination model Robert Wood Johnson Foundation national study Institute of Medicine report “Retooling for an Aging America” American Geriatrics Society Foundation for Health in Aging (FHA) Impact Award

3 Caregiving in the U.S. Snapshot 65.7 million family caregivers 43.5 million caring for loved one age % of family caregivers are working full or part- time 29% of caregivers live with their care recipient Typical Profile: 48- to 50-year-old Baby Boomer woman who is working and caring for her 77-year-old mother All statistics: 2009 NAC/MetLife/AARP Study “Caregiving in the U.S.”

4 Caregiver Health Risks Stress is #1 problem 91% reported suffering from depression Extreme fatigue, poor eating and exercise habits 72% ignore their own doctor appointments 85% of “caregivers in decline” are women All statistics: 2006 Evercare/NAC Study of “Caregivers in Decline”

Look at the Cost of Caregiving 50% of those caring for someone over age 50 spend on average 10% of their annual income ($5,531 annually) Heavier burden on low-income families 38% stopped saving 34% used current savings to cover costs 23% gave up their own health care needs and related costs All statistics: 2007 Evercare/NAC Study of “Family Caregivers – What They Spend, What They Sacrifice”

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Survey Objectives Impact to Job Situation Impact on Care-related Spending Impact on Living Situation Impact on Caregivers’ Emotional State Impact on Quality and Quantity of Care

8 Survey Methodology LOS ANGELES HOUSTON MIAMI Telephone Omnibus Survey 12 questions 1,005 respondents February 25 – March 19, 2009 Screening qualifying questions: 1.Had to provide care for loved one age 18 or over in last 12 months 2.Had to perform at least one ADL

9 Respondent Profile 54% female and 46% male Average age was 44.6 years 61% perform at least 1 ADL 39% performed IADLs only 38% had at least 1 child in the household; 60% had no children living at home 59% employed full or part time 45% had less than a $50,000 household income 66% White Non-Hispanic; 13% Black Non-Hispanic; 16% Hispanic; 5% Other or Refused

10 Key Findings Job Situation

11 Key Findings Spending and Sacrificing

12 Key Findings Living Situation –21% reported moving into the same household as their care recipient in the last 12 months –10% reported not being able to place loved one in nursing home as planned –9% have had trouble selling their care recipient’s home as planned

13 Key Findings Emotional Impact –Half of all respondents reported more stress about their caregiving situation since the recession began –Caregivers under age 65 were much more likely than older caregivers to report more stress since the economic downturn (54% v 31%)

14 Key Findings Quality and Quantity of Care –2 out of 10 report decline in quality of care they are able to provide –14% report they have had to decrease their caregiving hours –1 in 3 caregivers (36%) report that government agencies or non- profits are less able to provide services since economy has declined –1 in 4 report that services or outside help with their loved one has been cut back

15 For more information about Evercare: For more information about the National Alliance for Caregiving: ©2009 United HealthCare Services, Inc.