We have an elephant in the room, and it is caregiving of the elderly-in-need. Standing quietly now, this elephant is going to rebel against the load it has to carry, or simply collapse under the strain, and then-look out!

There are not enough professional care providers, care facilities, or hospital beds to meet the growing demand as populations age throughout the developed world, Bermuda included.

Without the millions of dollars in care that is given so freely by family caregivers the system will collapse, but the strain is growing. It is time for the community, employers, and government to share the elephant's burden.

There is a world-wide shortage of professional care providers throughout the health-care profession, but especially for the growing number of seniors who require at-home and institutional care.

Also called care workers, much of the work is undervalued and underpaid, creating real social and economic challenges in filling the growing imbalance in supply and demand.

The subject of care facilities is complex but, suffice it to say, with more people living into their nineties and beyond, the need for more institutional care facilities increases.

This is seen most acutely where Alzheimer's disease, dementia, and other forms of mental illness are involved. And using hospital beds for senior care is a poor choice for seniors' mental and social well-being, in addition to the economic burden that this places on the health care system.

This means that the burden on family caregivers can only increase as the population ages. The good news is that most family caregivers want to care for their loved ones.

The bad news is that extended periods of caregiving are unsustainable without significant and meaningful support. The world has changed. Our economy has changed. Our families have changed.

The ways that women work outside the home have changed. Women, who form the majority of caregivers, are having fewer children to support an ageing population.

And never, in the history of mankind, have so many people lived to such a ripe, old age.

In 2004, a major research project was undertaken in Bermuda by Fordham University that resulted in the report, "Ageing in Bermuda: meeting the needs of seniors" (this report can be downloaded at Bermuda Council on Ageing, www.bdaca.org.).

It contains a wealth of information on the needs of our seniors. It also identifies, in no uncertain terms, the unrecognised and undervalued contribution of our caregivers. The statistics are alarming. Here is a sample:

84 percent of caregivers are female

66 percent of caregiving is for a parent

81 percent have been providing care for more than a year

76 percent report emotional strain

Of those persons surveyed, approximately 25 percent are caring for a person with Alzheimer's disease or dementia, both of which are widely recognised as the most stressful forms of caregiving.

Clearly, women in Bermuda are carrying a very heavy load. They are working, raising children, keeping families together in a chaotic world, and caring for the elderly.

Unfortunately, the load is going to get much heavier, with the number of persons over 65 doubling to 22 percent of our population by 2030.

As the number of seniors increases and those seniors advance to ever greater years, the need to share the load will grow.

Men are also caring for spouses and parents, but they are under-represented in caregiving for reasons that are quite apart from a cultural bias that defines caregiving as women's work.

One reason is that women tend to marry older men and provide care to their elderly husbands. Women also tend to live longer and outlive their men-folk, and then become dependent on their children, or the state, for care in their own old age.

Regardless of gender, the growth of caregiving for seniors is no longer a role that can be borne alone. We need to figure out the best ways of sharing the elephant's heavy load before it collapses from exhaustion.

Family, the community, employers, and government all have a moral obligation and role to play in dealing with the impact of our ageing population, and care for the elderly-in-need is at the top of the list.

Marian Sherratt is Executive Director, Bermuda Council on Ageing. She writes on issues concerning ageing each fortnight in The Royal Gazette . Send email responses to info[AT]bdaca.org.