Associations between Caregiver-Provider Communication Quality and Unmet Care Needs Among Older Adults

Unmet care needs (lack of assistance with daily activities) among older adults are common and linked to adverse health outcomes, greater healthcare utilization, and caregiver burden. While effective patient-provider communication is known to improve care quality, less is understood about the role of caregiver-provider communication, particularly across sociodemographic, health, and caregiving contexts.

We conducted a cross-sectional secondary analysis of pooled 2021-2023 National Health and Aging Trends Study (NHATS) and National Study of Caregiving (NSOC) data, restricted to community-dwelling older adults (65 + years) who received assistance from caregivers due to difficulty with daily activities, and had at least 1 caregiver who communicated with medical providers in the past year. The unit of analysis was the caregiver-older adult pair, with clustering at the older adult level. The outcome was unmet care needs (0, 1, or 2+, across 12 daily activities). The primary predictor was caregiver-reported provider communication quality (range: 3-12). Weighted ordered logistic regression estimated associations between communication quality and unmet care needs, adjusting for older adult and caregiver sociodemographic, health, and caregiving characteristics.

The analytic sample included 1,414 older adults (weighted N = 9.34M) and 1,910 caregivers (weighted N = 21.05M). Half (50.5%) of older adults reported no unmet care needs, 23.5% reported one, and 26.0% reported 2 or more. Higher communication quality was associated with lower odds of greater unmet needs (OR = 0.93, 95%CI: 0.89-0.97). The association was stronger for low-income households (<$30K/year), for adult child caregivers and other relatives compared with spouses, and for caregivers providing < 20 hours or > 40 hours/month of care.

Improving caregiver-provider communication may be an effective strategy for reducing unmet care needs among older adults with long-term care needs. Targeted efforts might be particularly needed for low-income families and non-spousal caregivers, but strategies must address systemic and logistical barriers to ensure equitable benefit.