The cost of late-life dependency is projected to grow rapidly as the number of older adults in the United States increases in the coming decades. To provide a context for framing relevant policy discussions, we investigated activity limitations and assistance, care resources, and unmet need for a national sample of older adults.Using Medicare enrollment data from the 2011 National Health and Aging Trends Study -- a national sample of 8,246 older adults -- researchers from the University of Michigan and the Urban Institute determined that nearly 50 percent older Americans – 18 million people – have trouble, or receive assistance, with daily activities.
- Among the 49 percent of seniors receiving help, one in four lived in either a supportive care setting (15 percent) or a nursing home (10 percent).
- Severe disability is more common among lower-income seniors, a disproportionate share of whom received assistance with at least three self-care or mobility activities in settings other than nursing homes.
- Nearly all older adults had at least one potential informal care network member - family or household member, or close friend. The average network size was four people.
- Older adults who lived at home reported receiving an average of 164 hours of care a month from informal caregivers - more than five hours a day. Older adults living in supportive care settings reported nearly 50 hours of informal care per month. (That number is lower because so many of this group’s needs are “automatically” taken care of.)
- About 70 percent of those getting help received assistance from family, friends, and other unpaid caregivers, while about 30 percent received paid care.
- There were considerable unmet needs, especially among seniors receiving paid assistance. According to co-author Spillman, "Among the 18 million who had difficulty or received help, 30 percent had an adverse consequence in the last month related to unmet need. Among community residents with a paid caregiver, the figure was nearly 60 percent."