Informal Caregiving for Older Americans: An Analysis of the 2011 National Study of Caregiving. Profile of Informal Caregivers and Hours of CARE Provided

04/01/2014

In 2011, about 18 million informal caregivers provided 1.3 billion hours of care on a monthly basis (Table 1) to more than 9 million recipients age 65 or older (Freedman & Spillman 2013). About one in five informal caregivers were spouses of care-recipients, 29.3% were daughters, 18.3% were sons, and 22.3% were other relatives, about half of whom were sons-in-law or daughters-in-law or grandchildren. Fewer than 10% were non-relatives. Spouses provided a disproportionately high 31.1% of aggregate hours, reflecting in part that nearly half of spouses were the sole informal caregiver (not shown). Daughters provided about 30% of aggregate monthly hours, while sons provided about half that proportion, a somewhat smaller proportion of hours than provided by other relatives. Nearly 20% of daughters and about 12% of sons, other relatives, and non-relatives were the only informal caregiver (not shown).

TABLE 1. Number of Informal Caregivers and Hours of Help Provided in the Last Month to Recipients Age 65 or Older Living Outside Nursing Homes, 2011

    Number of  
Caregivers
(000s)
  Percent of  
Caregivers
  Aggregate Monthly  
Hours Provided
(000s)
  Percent of Aggregate  
Hours of Health
All caregivers 17,949 100.0 1,342,520 100.0
Relationship to recipient
   Spouse 3,802 21.2 417,018 31.1
   Daughter 5,263 29.3 411,138 30.6
   Son 3,287 18.3 213,530 15.9
   Other relative 4,011 22.3 245,508 18.3
   Other non-relative 1,586 8.8 55,326 4.1
Help reported by recipient
   Household/other activities onlya   5,581 31.1 284,530 21.2
   Self-care or mobility 12,368 68.9 1,057,990 78.8
      1-2 self-care/mobility tasks 6,823 38.0 434,406 32.4
      3+ self-care/mobility tasks 5,545 30.9 623,584 46.4
Recipient dementia status
   No dementia 9,369 52.2 608,435 45.3
   Possible dementia 2,741 15.3 197,236 14.7
   Probable dementia 5,838 32.5 536,849 40.0
Number of Informal Caregivers and Hours of Help Provided in the Last Month to Recipients Age 65 or Older Living Outside Nursing Homes, 2011


Number of Informal Caregivers and Hours of Help Provided in the Last Month to Recipients Age 65 or Older Living Outside Nursing

Relationship to recipient

Number of Caregivers (000s)Percent of CaregiversAggregate Monthly Hours Provided (000s)Percent of Aggregate Hours of Health
Spouse3,80221.2417,01831.1
Daughter5,26329.3411,13830.6
Son3,28718.3213,53015.9
Other relative4,01122.3245,50818.3
Other non-relative1,5868.855,3264.1

Number of Informal Caregivers and Hours of Help Provided in the Last Month to Recipients Age 65 or Older Living Outside Nursing

Help reported by recipient

Number of Caregivers (000s)Percent of CaregiversAggregate Monthly Hours Provided (000s)Percent of Aggregate Hours of Health
Household/other activities only (a)5,58131.1284,53021.2
Self-care or mobility12,36868.91,057,99078.8
1-2 self-care/mobility tasks6,82338.0434,40632.4
3+ self-care/mobility tasks5,54530.9623,58446.4

Number of Informal Caregivers and Hours of Help Provided in the Last Month to Recipients Age 65 or Older Living Outside Nursing

Recipient dementia status

Number of Caregivers (000s)Percent of CaregiversAggregate Monthly Hours Provided (000s)Percent of Aggregate Hours of Health
No dementia9,36952.2608,43545.3
Possible dementia2,74115.3197,23614.7
Probable dementia5,83832.5536,84940.0

 

SOURCES: Data from the baseline 2011 NHATS and the companion NSOC. Care-recipient characteristics are from NHATS. Hours of care and caregiver relationship to NHATS respondent are from the NSOC. N=1996 NSOC respondents who provided care in the month prior to interview.

NOTE:

Includes 35 caregivers assisting 28 NHATs respondents who live in residential care settings and report no self-care or mobility help and no household activity help for health or functioning reasons, although all have NSOC eligible caregivers who report providing these types of assistance.


The care-recipient’s physical and cognitive status, as expected, are related to both the distribution of caregivers and the hours of care provided. Caregivers helping recipients who report self-care or mobility assistance represent more than two-thirds of informal caregivers and provide nearly 80% of hours. The 31% of caregivers who assist recipients reporting 3+ self-care or mobility activities account for nearly half of hours. Even more striking is that although care-recipients with probable dementia represent only 11% of the older population (Kasper et al. 2014), their caregivers are nearly a third of informal caregivers and provide 40% of aggregate monthly hours. There is substantial overlap between the highest level of physical and cognitive impairment. Persons with probable dementia represent half the population receiving assistance with 3+ self-care or mobility activities (Kasper et al. 2014).

As a group, informal caregivers provided an average 75 hours per month (top panel of Table 2). Although only 69% of caregivers were helping recipients who reported assistance with self-care or mobility activities (see Table 1), more than three-quarters of caregivers reported that they assisted with these activities, and they provided an average 84 hours per month. Because self-care and mobility assistance is so prevalent, sample sizes for those not providing such assistance do not support separate estimates for those not assisting with self-care or mobility, but as a group, they provided an average 44 monthly hours (not shown).

Spouses provided 110 hours per month as a group and 127 hours if assisting with self-care or mobility activities. These monthly hours translate to 25-30 hours per week and 3.5-4.0 hours per day, far higher than for other caregivers. Daughters provided 78 hours of care overall (91 hours if they were assisting with self-care or mobility), and sons provided 65(69) hours of care, similar to the 61(67) hours per month provided by other relatives. The youngest (under age 45) and the oldest (age 75 or older) caregivers provided the most hours on average. Not surprisingly, 85% of the oldest caregivers were spouses (not shown). The youngest group was predominantly adult children (46%) and grandchildren (42%) (not shown). As expected, women comprised a larger proportion of caregivers and provided 15-20 more hours of care than men, depending on the level of assistance. Interestingly, about 44% of all caregivers were employed, and workers and non-workers were equally likely to be helping with self-care or mobility activities. Average hours of care provided by workers were substantially lower, however, and were lowest for those working the greatest number of hours per week.

The lower panel of Table 2 examines caregivers other than spouses. Thirty percent of non-spouse caregivers lived with the care-recipient, and these coresident caregivers were more likely to be providing self-care or mobility assistance than non-resident caregivers (85% vs. 75%). They also provided more than twice the hours of care--114 hours per month overall and 120 if assisting with self-care or mobility--representing 27-28 hours per week. The majority of non-spouse caregivers were married (58%), and they provided fewer hours of care on average than unmarried caregivers. One in five non-spouse caregivers were parents of children less than 18 years of age. Caregivers with and without minor children provided similar hours of care. Those with children were more likely to be providing assistance with self-care or mobility activities (84% vs. 76%). About half of non-spouse caregivers are employed. Care patterns are similar to those for seen for all caregivers, with workers providing fewer hours of care than non-workers (50-55 vs. 81-93), and lower average hours of care if working more hours per week.

TABLE 2. Characteristics of Informal Caregivers and Mean Hours of Care Provided in the Last Month to Recipients Age 65 or Older Living Outside of Nursing Homes, 2011

  All Informal Caregivers Caregivers Helping with Self-Care or Mobility
Number (000s) Percent Mean Hours of Help Number (000s) Percent of All Percent Mean Hours of Help
Percent of caregivers 17,949 100.0 75 13,784 76.8 100.0 84
Distribution by Characteristics, All Caregivers
Relationship to recipient
    Spouse 3,802 21.2 110 2,740 72.1 19.9 127
    Daughter 5,263 29.3 78 4,066 77.3 29.5 91
    Son 3,287 18.3 65 2,684 81.7 19.5 69
    Other relative 4,011 22.3 61 3,178 79.2 23.1 67
    Other non-relative 1,586 8.8 35 1,116 70.4 8.1 41
Caregiver age
    <45 2,948 16.8 85 2,480 84.1 18.4 87
    45-54 4,191 23.9 71 3,202 76.4 23.8 81
    55-64 4,760 27.1 67 3,790 79.6 28.2 77
    65-74 3,292 18.7 68 2,347 71.3 17.4 84
    75+ 2,373 13.5 97 1,635 68.9 12.2 111
Caregiver gender
    Male 6,853 38.2 65 5,471 79.8 39.7 72
    Female 11,096 61.8 81 8,313 74.9 60.3 92
Caregiver works for pay
    No 9,793 55.8 93 7,607 77.7 55.8 105
    Yes 7,838 44.2 53 6,032 77.0 44.2 58
    Hours worked per week
        20 or fewer 1,707 22.2 70 1,237 72.5 20.9 72
        21-39 1,830 23.8 54 1,404 76.7 23.7 63
        40+ 4,157 54.0 45 3,289 79.1 55.5 50
Non-Spouse Caregivers
Lives with recipient
    No 9,918 70.1 45 7,465 75.3 67.6 51
    Yes 4,229 29.9 114 3,579 84.6 32.4 120
Marital status
    Married/partnered 8,003 57.7 48 6,236 77.9 57.6 56
    Separated/ divorced 2,062 14.9 94 1,682 81.6 15.5 103
    Widowed 1,044 7.5 75 709 67.9 6.6 99
    Never married 2,771 20.0 92 2,191 79.1 20.3 96
Children under 18
     None 11,127 80.1 66 8,498 76.4 78.6 74
    Any 2,768 19.9 65 2,315 83.7 21.4 73
Caregiver works for pay
    No 6,778 49.1 81 5,389 79.5 49.3 93
    Yes 7,140 50.9 50 5,553 77.8 50.7 55
    Hours worked per week
        20 or fewer 1,472 20.9 74 1,130 76.7 20.7 74
        21-39 1,610 22.9 49 1,214 75.4 22.2 57
        40+ 3,949 56.2 42 3,124 79.1 57.1 46

SOURCE: Data from the baseline 2011 NHATS and the companion NSOC. NHATS functional level is taken from the NHATS. Hours of care and caregiver characteristics are taken from the NSOC. N=1996 NSOC respondents who provided care in the month prior to interview.

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