(February 2016) 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 Aging-supported 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 family’s 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.


  • 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 six—from 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 in 10 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 year—more than Medicaid spending in 2014.
  • On average, dementia is the most costly and time intensive health condition for family caregivers in the United States.
  • 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.

Click on the image below to view the full infographic:

Paola Scommegna is a senior writer at PRB.