In addition to hands-on assistance, caregivers may arrange, supervise, or pay for formal care to be provided to the care recipient, either as temporary relief from the caregiver's responsibilities (i.e., respite care) or on a more permanent basis. Background

Family caregivers fulfill the majority of the need for long-term care by older persons with chronic disabilities in the United States. Demographic trends such as increases in life expectancy, as well as advances in medical care, have enabled persons with disabilities to live longer. The aging of the baby-boom generation is also likely to increase demand for family caregiving to the older population. As demand for caregiving to older persons with disabilities is likely to increase, other demographic trends, such as smaller family sizes and increased divorce rates, may limit the number of available caregivers to older individuals, as well as the capacity for caregivers to provide needed care. Family caregivers are diverse in terms of gender, age, relationship to the care recipient, and life circumstances. Recognizing family caregivers as an important part of the nation's long-term care delivery system, the federal government has established programs and initiatives that provide direct support to caregivers. Direct supports such as respite care, education and training, tax relief, and cash assistance are targeted at caregivers to reduce stress and financial hardship, and to improve caregiving skills, among other things. Other federal programs and initiatives provide home and community-based long-term care services and supports to the care recipient. These programs can indirectly benefit caregivers in relieving caregiver burden by either supplementing the informal care being provided or substituting some informal care with paid support. However, these federal provisions (discussed in the next section) are not widely used for the purpose of caring for an older frail family member. The Effects of Family Caregiving

		The Physical, Emotional, and Financial Effects of Caregiving

While many family members find caregiving a rewarding and satisfying activity, caregivers may also face increased physical strain, emotional stress, and financial hardship as a result of caregiving responsibilities. Other federal programs and initiatives provide home and community-based long-term care services and supports to the care recipient. This section briefly describes three sets of policies that would expand or enhance the federal government's role in providing direct assistance to family caregivers to older adults. These policy issues, which have either received recent congressional attention or otherwise been the subject of discussion among federal policy makers and other interested stakeholders, are organized into the following topics: enhancing and expanding caregiver services and supports, assisting employed caregivers through flexible workplace accommodations and income security, and providing caregivers with opportunities for additional tax credits.
Family caregiving to older individuals in need of long-term care encompasses a wide range of activities, services, and supports. Caregiving can include assistance with personal care needs, such as bathing, dressing, and eating, as well as other activities necessary for independent living, such as shopping, medication management, and meal preparation. In addition, family caregivers may arrange, supervise, or pay for formal or paid care to be provided to the care recipient.
Family caregivers fulfill the majority of the need for long-term care by older persons with chronic disabilities in the United States. As a result of increases in life expectancy, as well as the aging of the baby-boom generation, demand for family caregiving to the older population is likely to increase. However, demographic trends such as reduced fertility, increased divorce rates, and greater labor force participation among women may limit the number of available caregivers to older individuals, as well as the capacity for caregivers to provide needed care.
Although many family caregivers find caregiving for an older family member a rewarding experience, other life circumstances, in addition to caregiving, may increase caregiver stress. For example, family members may not live in close proximity to the care recipient, they may face the competing demands of child care and elder care, and they may have to manage work with caregiving responsibilities. As a result, family caregiving can lead to emotional and physical strain and financial hardship. These effects are more likely to be felt among those caring for persons with high levels of disability or cognitive impairment. Caregiver stress has been linked to nursing home admission for the care recipient, thus interventions that can reduce stress may also reduce nursing home placement.
Recognizing family caregivers as an important part of the nation's long-term care delivery system, the federal government has established programs and initiatives that provide direct supports to caregivers, such as respite care, education and training, tax relief, and cash assistance. These benefits are targeted at family caregivers to reduce stress and financial hardship, and to improve caregiving skills, among other things. Other federal programs and initiatives provide home and community-based long-term care services and supports to the care recipient. These programs can indirectly benefit caregivers in relieving caregiver burden by either supplementing the informal care they are providing or substituting with paid support.
Three sets of policies that would provide direct assistance to family caregivers to older adults are briefly discussed in the last section of this report. These policy issues, which have been the subject of discussion among federal policymakers and other interested stakeholders, include the following: caregiver services and supports, flexible workplace accommodations and income security, and additional tax credits.