Half Of Older Americans Have Care Needs, Majority Receive Informal Help

Nearly one-half of older Americans, or 18 million people, had difficulty or received help in the last month with daily activities, according to a recent study published in The Milbank Quarterly.

“The older population—especially those with few economic resources—has substantial late-life care needs,” the study says. “Policies to improve long-term services and supports and reduce unmet need could benefit both older adults and those who care for them.”

Those needing help in settings other than a nursing home had at least one informal caregiver, such as a family member or close friend, and the average number of network members was four. About three in 10 older Americans needing assistance received paid care.


But although the family continues to be the major provider of care for older adults, the number of potential family caregivers is declining, the study says, noting that societal trends toward delayed childbearing and women’s greater participation in the labor force have placed competing demands on potential family caregivers’ time.

Today, about one in five older people with limitations in activities of daily living report need more help than what is received.

A shift among where older adults receive care is also occurring, the study found — the number of people living in residential care settings other than nursing homes is growing.


Nearly 3 million Medicare recipients received assistance with three or more self-care or mobility activities in settings other than nursing homes.

“With continuing care shifts away from nursing homes, strategies are needed to improve community-based long-term care services and supports to aid both older adults and the informal caregivers who provide most care,” the study says.

Of those receiving help from a paid caregiver, 60% said they had an adverse consequence in the last month related to an unmet need.

Levels of informal assistance, primarily from family caregivers, was significant for older adults receiving help in the community, at 164 hours a month, and living in supportive care settings at 50 hours a month.

The study was based on the 2011 National Health and Aging Trends Study, a national panel study of more than 8,000 Medicare enrollees.

Access the study here.

Written by Cassandra Dowell

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