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

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

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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

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	Number of Caregivers (000s)	Percent of Caregivers	Aggregate Monthly Hours Provided (000s)	Percent of Aggregate Hours of Health
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

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

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	Number of Caregivers (000s)	Percent of Caregivers	Aggregate Monthly Hours Provided (000s)	Percent of Aggregate Hours of Health
Household/other activities only (a)	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

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

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	Number of Caregivers (000s)	Percent of Caregivers	Aggregate Monthly Hours Provided (000s)	Percent of Aggregate Hours of Health
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

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:

^a 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

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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