In the United States, the vast majority of care that allows
older people to live in their own homes is provided by
family members who do not receive pay for their services.
As the older share of the population increases and people
live longer with chronic disabling conditions, particularly
dementia, meeting the care needs of older Americans will
become more challenging for families.
This report highlights recent National Institute on Agingsupported
research on the impact of caregiving on family
members, the dynamics of caregiving within extended
families, and the future need and availability of family care.
As policies deemphasize nursing home care in favor of
community-based long-term support services, a better
understanding of the familys central role in caregiving is
needed. This perspective can help policymakers, health care
providers, and planners identify and implement strategies that
better meet the care needs of older Americans and
improve the lives of the family members who care for them.
Caregiver Availability and Constraints
A variety of trends have contributed to a widening gap
between older Americans need for care and the availability
of family members to provide that care, raising the potential
for growing unmet needs, a heavier burden on individual
caregivers, and increased demand for paid care. The combined
effects of delayed childbearing and longer life expectancy
mean more adults in later-middle age may be sandwiched
between the competing demands of their children
and those of their aging parents and parents-in-law. Women
who have traditionally served as parent care providersare
more likely to be employed than in previous generations,
limiting their availability, and increasing their time constraints.
- Almost half of U.S. adults ages 65 and older report they either need help or are currently receiving help with routine daily activities, such as shopping, transportation, bathing, meal preparation, or managing medication.
- Family members provide more than 95 percent of the informal care for older adults who do not live in nursing homes.
- The number of U.S. 75-year-olds without the types of family members who are the most common family care providers (a living spouse or a child living nearby) is projected to increase substantially between 2010 and 2030: The number without a living spouse is expected to more than double from roughly 875,000 to 1.8 million, and those without an adult child within 10 miles could increase by a multiple of sixfrom about 100,000 to more than 600,000.
- Nearly two out of three caregivers rated their caregiving experience as largely positive, pointing to benefits such as feeling closer to the care recipient and assured that the recipient is receiving high-quality care. However, one in10 caregivers found caregiving a negative experience overall, citing financial difficulties, physical problems, or stress.
- The estimated dollar value of the informal care that family and friends provide for older Americans totals $522 billion a yearmore than Medicaid spending in 2014
- On average, dementia is the most costly and time intensive health condition for family caregivers.
- For older adults leaving full-time employment, those with new caregiving responsibilities are less likely to be able to work part time if they want or need to do so.
- Disabled older adults in cohabiting relationships were considerably less likely to receive care from their live-in partners than older married people with disabilities.