title: Caregivers of frail elders: updating a national profile.
abstract: OBJECTIVE
  Family caregivers comprise the backbone of long-term-care provision in the United States, yet little is known about how the composition and experience of family caregiving has changed over time.
  
  
  METHODS
  Data are drawn from the 1989 and 1999 National Long-Term Care Survey and Informal Caregiver Survey to develop nationally representative profiles of disabled older adults and their primary informal caregivers at two points in time.
  
  
  RESULTS
  The proportion of chronically disabled community-dwelling older adults who were receiving informal assistance from family or friends declined over the period of interest, whereas the proportion receiving no human help increased. On average, recipients of informal care were older and more disabled in 1999 than in 1989. Primary caregivers were children (41.3%), spouses (38.4%), and other family or friends (20.4%); children were more likely and others less likely to serve as primary caregivers in 1999 relative to 1989. Primary caregivers provided frequent and high levels of help at both points in time. A striking increase was found (from 34.9% to 52.8%) in the proportion of primary caregivers working alone, without secondary caregiver involvement.
  
  
  CONCLUSIONS
  In the context of projected demographic trends and budgetary constraints to public health insurance programs, these data underscore the importance of identifying viable strategies to monitor and support family caregivers in the coming years.
authors.affiliation: Department of Health Policy and Management, Roger C. Lipitz Center for Integrated Health Care, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 692, Baltimore, MD 21205, USA. jwolff@jhsph.edu
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Wolff
authors.forename: Judith D
authors.initials: JD
authors.lastname: Kasper
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States