Last week, we discussed National Caregivers Day, honoring the people who provide physical and emotional support to those who need it most. Our focus was on unpaid family caregivers, who might be a spouse, partner, daughter or son. This week, we continue that focus and conversation.

More than 1 in 5 American adults — a total of 53 million — are unpaid family caregivers, according to a report from AARP and the National Alliance for Caregiving. Shorter hospital stays, limited discharge planning and expansion of home care technology have placed greater responsibility on family caregivers. Given the convergence of these changes plus increased longevity, it seems timely to address their impact.

Impact on health: When comparing noncaregivers to caregivers, the latter have more of everything. Anywhere from 40% to 70% suffer from depression. This group is more likely to experience anxiety disorders, substance abuse or dependence, and chronic disease. We know family caregivers experience a high level of stress. Consequently, they are at greater risk for high blood pressure and heart disease. And with chronic stress, they may be at greater risk for cognitive decline, including loss of short-term memory. Caregivers have more physical ailments than noncaregivers such as acid reflux, headaches and pain, and have an increased tendency to develop serious illness. Obesity often becomes a problem. Unfortunately, caregivers often ignore their own medical checkups; 1 in 5 female caregivers surveyed had mammograms less often. In general, when it comes to physical health, women do worse than their male counterparts. Furthermore, caregivers often have diminished immune response, which leads to frequent infections and increased risk of cancer. Despite poor health, more than one-third of family caregivers continue to provide intense care to others, putting their own health in danger.

Impact on finances: On average, the uncompensated expense of family caregiving is more than $7,000 a year. These expenses include costs of housing, health care and transportation. Almost half of these caregivers indicated they had to withdraw money from saving accounts or their retirement nest eggs; take on debt; or lessen their retirement contributions, according to the Family Caregiver Alliance. These actions can have a severe impact on lifetime earnings, savings, Social Security benefits and retirement readiness. According to a study by TIAA and the University of Pennsylvania School of Nursing, caregivers tend to have fewer financial assets and more debt than those who don’t care for loved ones. One in 4 caregivers have less than $1,000 in savings and investments; for noncaregivers, it’s closer to 1 in 7. And again, family caregiving costs interfere with self-care. Women caregivers are twice as likely to avoid filling a prescription because of the cost than noncaregivers.

Impact on employers: Caregiving affects employers. Almost three-quarters of the 53 million caregivers continue to work. Since caregiving responsibilities often occur during business hours, employees frequently find they need to set up appointments, consult with doctors, deal with emergencies and coordinate care as well as serve as an advocate — all while working. As a result, over half go in late, leave early or take time off. Others have to reduce their hours, take a leave of absence, turn down promotions, give up work or retire early. These distractions may lead to less engaged employees, affecting the quality of their work. Caregiving can cost employers $6,410 per employee yearly in productivity loss. Furthermore, unhealthy caregivers increase employers’ health care expenses.

All is not lost: A Harvard report noted that employers who offered caregiver benefits through a “care concierge” service that connects caregivers to planning, administrative and support services reap the benefits. These employers reduced absenteeism up to 50% and achieved a return on their investment of up to 72%.

The upside: Again, all is not lost. A survey by the National Opinion Research Center found that 83% viewed their caregiving experience as positive. Benefits include the opportunity to deepen and strengthen relationships with loved ones. Caregivers felt good about themselves, knowing they were needed and that their role gave meaning to their lives. Other benefits to the caregiver included increased companionship, love and affection as well as experiencing a sense of pride and purpose. Note: Positive and negative experiences can occur simultaneously.

At some point for most people, columns on caregiving are likely to become personal. To quote Rosalynn Carter: “There are only four kinds of people in the world: those who have been caregivers, those who are currently caregivers, those who will be caregivers and those who will need caregivers.”

Stay well, everyone, and, of course, be kind.

Helen Dennis is a nationally recognized leader on issues of aging and retirement, with academic, corporate and nonprofit experience. Contact Helen with your questions and comments at Helendenn@gmail.com.