When relatives want to age at home, family caretakers struggle with two jobs. It's more difficult for rural residents.

A growing number of Americans are working two jobs: one to pay the bills and a second unpaid job caring for an aging family member. "The double shift can come at a career cost. Caregivers who are also working full-time report turning down promotions or seeking less-demanding assignments," reports Clare Ansberry of The Wall Street Journal. "Some switch companies or say they've had to choose care duties over their careers." Even if the older relative still lives independently, the juggling still can be taxing.

In rural communities, aging residents prefer to have family members care for them, but they have additional challenges. "Like older adults across the country, rural seniors tend to want to age in their communities, amid familiar people and places," report Martha Hostetter and Sarah Klein for The Commonwealth Fund. "But with fewer health care providers, fewer professional caregivers, and fewer young people than in urban areas, rural communities struggle to care for aging residents."

Both rural and urban families struggle to balance elderly care with life's other duties. "An estimated 29 million workers, from senior managers to retail clerks, work while also caring for an adult family member, according to research by AARP and the National Alliance for Caregiving," Ansberry writes. "Care demands on workers are growing because people are living longer with chronic illness. . . . A large share of people want to age at home but need lots of help from family members to do so."

Many companies don't offer eldercare options, so employees often have to sandwich in a loved one's medical appointments during breaks and use vacation time. "Some working caregivers have been called in to talk with their bosses about performance. Others say they haven't used a vacation day for an actual vacation in years," Ansberry reports. "Tensions can run high between employees and employers over caregiving."

Rural communities are working on ways to help residents get to appointments and social events without solely relying on family members. "St. John's United, a member of the Rural Aging Action Network, provides senior housing in and around Billings, Montana," Hostetter and Klein report. "In 2019, St. John's launched 'At Home' services for clients living in their own homes. This monthly subscription service is offered on a sliding scale and provides seniors with rides to medical appointments, help with household tasks, social outings, and other supports."

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