Receipt of Formal Support and Help-Seeking Among Caregivers of Older Americans

Background and Purpose

The U.S. population is aging. The rapid growth of U.S. older adult population, along with age-associated chronic conditions, will likely increase the demands of care placed on the older adults’ informal support network members (e.g., family or friends). Informal caregiving has a critical role in affecting older adults’ quality of life yet has long been associated with caregiver burdens such as chronic stress, physical conditions, and mental health problems. Thus, it is crucial to have organized and efficient formal support to mitigate burdens experienced by informal caregivers. Yet, recent national data suggests a low rate (approximately 30%) of past-year formal support receipt among caregivers. Additionally, there is a significant unmet need among caregivers who wanted but did not receive formal support. The low receipt rate and large service gap point to the need for a refined understanding about the factors associated with the receipt of formal support and help-seeking. Guided by Andersen’s Behavioral Model of Health Services Utilization, this study aims to address the knowledge gap by examining the socio-demographic correlates of formal support receipt and help-seeking behaviors in a nationally representative sample of caregivers.

Methods

This study used a cross-sectional research design. Data were drawn from the 2017 National Study of Caregiving (NSOC), which included caregivers of Medicare enrollees aged 65 and older. The current analysis focused on NSOC participants who received formal support (N = 2013) and who did not receive formal support but looked for formal services from different sources (i.e., formal help-seeking, N = 171). Formal support receipt was measured using an index of 4 formal services, including support group, respite service, caregiver training, and financial help. Formal help-seeking was assessed using an index of 6 information sources (e.g., government or community agency, healthcare professionals or social worker, and church). Separate multiple linear regression models were conducted to examine the predisposing (e.g., caregiver age, race), enabling (e.g., caregiver income, education), and need (e.g., care recipient’s dementia status, needs for ADL and IADL assistance, and caregiver role overload) factors as potential correlates of formal support receipt and formal help-seeking, respectively.

Results

Results indicated that being racial/ethnic minorities, providing care to older individuals with dementia, and caring for those with greater needs for ADL and IADL assistance were associated with receiving higher levels of formal support. Also, having some college education or a college degree was related to higher levels of formal support compared to having a high school degree or below. In addition, caregiver role overload was positively associated with both formal support receipt and formal help-seeking.

Conclusions and Implications

Formal support is critical to reduce caregiver burden and meet the ever-increasing demands of care. Study findings highlight the need for future research and tailored strategies to facilitate the use and seeking of formal support among caregivers, particularly among those who report actual (e.g., caring for an individual with dementia) and perceived (e.g., role overload) needs.