Latina woman caregiver comforting her father

Expanding services for caregivers during the pandemic and beyond

UC Davis Health focuses on ‘unseen’ group as they cope with increased stress and anxiety


Stress. Depression. Substance abuse. All increased during the COVID-19 pandemic for ‘unseen workers’ — those who care for a family member or friend.

A recent report published by the Centers for Disease Control and Prevention (CDC) states that, among over 10,000 US adults surveyed during the pandemic, parents, unpaid caregivers of parents or other adults had significantly worse mental health than adults not in these roles. Their valuable role is recognized each November during  National Family Caregivers month.

Family caregivers had three times the odds for adverse mental health symptoms stemming from caregiving-related family disagreements or resentments regarding their caregiving responsibilities.

Nancy Pennebaker, who cares for her 84-year-old husband challenged by cognitive decline, knows the pressure all too well.

“No one knows how to be a caregiver. You just jump in and start doing and making mistakes. You feel scared and guilty and stressed,” Pennebaker said.

Pennebaker’s stress eased once she tapped into new services — caregiver consultations and a specialty clinic for people 65 and older — at UC Davis Health. And the support can’t come soon enough. A June report from the CDC concluded that at least 43% of U.S. adults are unpaid caregivers right now—more than double pre-pandemic figures.

“Caregiving is hard work. It’s physically demanding, mentally draining and isolating for those providing care,” explained Terri Harvath, director for the Family Caregiving Institute at the Betty Irene Moore School of Nursing at UC Davis. “Their mental and physical struggle is a public health crisis that costs us all.”

Working two jobs

Providing care to a family member or friend tells only part of the story. More than one in six caregivers are also employed outside that role. In fact, more than half of employed caregivers work 40 or more hours each week. It’s a phenomenon that not only affects the working caregivers but also their employers.

Alexandra Drane, CEO of Archangels, an organization working to raise awareness about unpaid caregivers, examines the impact caregiving has on individuals, organizations and communities. 

“Employers, health systems and payers are a key access point for recognizing and supporting unpaid caregivers who are able to work or who have access to care and coverage,” Drane said in a recent interview with McKinsey & Company. “It’s hard to do two jobs at once—for any of us—and for the most at risk and underserved in our nation, it can be that much harder.”

A 2019 AARP study showed the economic value of caregivers’ unpaid contributions was approximately $470 billion, now higher with the pandemic.

The CDC study authors concluded that family caregivers might benefit from mental health support and services tailored to their roles.

Stepping up to support

UC Davis Health CEO David Lubarsky recognizes this unprecedented need. When mapping out the Healthy Aging Initiative vision focused on serving the over-65 generation, he leveraged the strengths of the Family Caregiving Institute to include caregivers in the mix.

“When an older adult with cognitive or physical challenges seeks care, we know their caregivers have valuable information about the condition and the medications the patient is taking,” Lubarsky explained. “Caregivers are often a critical part of the patient’s treatment plan.  In fact, we see them as an important member of the patient’s health care team.”

Caregivers aren’t just team members. They also benefit from consultations at the new Healthy Aging Clinic. Opened in January to serve UC Davis Health patients who have cognitive and aging challenges, close to 200 caregivers have met with Harvath and a team of geriatric nurse practitioners with expertise in caregiving support.

“One of the things I often tell caregivers is to put your own oxygen mask on first before helping others because we know that caregiving gets more difficult over time. If they’re going to be around for the long haul, they have to treat it like a marathon and not a sprint,” she said.

“After meeting with Terri, I don’t feel so alone anymore,” Pennebaker added. “She’s suggested things that need to change and shows me how to do that. I’m growing as a result. I kind of like who I’m becoming because I’m learning a lot.”

Benefitting patients and employees

Pennebaker’s son, UC Davis Health Pharmacist Tim Cutler, appreciates the attention given to both his mother and stepfather. When they moved to Davis last year, he made sure they enrolled in UC Davis Health for their care. He considers this level of expertise one more reason why choosing UC Davis Health as a health care provider offers benefits far beyond illness.

“The ultimate test of how much you believe in a health system is if you send your family there. My entire family uses UC Davis Health,” he said. “It’s a huge source of pride knowing this institution is investing in this kind of care for patients and their caregivers.”

UC Davis Health employees benefit from both choosing a UC Davis Health plan and employee resources such as the Caregiver Education and Support Program from UC Davis WorkLife. Drane’s data indicates that among working caregivers with a risk for high intensity situations, feeling a strong degree of support from one’s employer reduces the likelihood of depression, anxiety or high stress by 19%.

A 2019 AARP study concluded that the estimated economic value of caregivers’ unpaid contributions was approximately $470 billion. Experts suggest the pandemic has driven that amount higher.

“Our employees give so much to their patients and students at work — and then some of them go home and assume a whole second job of caregiving.  These caregivers should know they are seen and valued,” Lubarsky added.  “We hope as their contributions to our society grow that our services can expand to meet their needs.”

Pharmacist Tim Cutler headshot
The ultimate test of how much you believe in a health system is if you send your family there. My entire family uses UC Davis Health.Tim Cutler, UC Davis Health pharmacist