Older Americans' Attitudes Toward Caregiving Cost Responsibility and Long-Term Care Access and Costs by Caregiver...

Rising numbers of older adults will intensify demand for unpaid care from family and friends (caregiving) and quality paid home, assisted living, or nursing home care (long-term care). With growing public desire for government support, it is important to explore older Americans (age ≥ 50) views, especially by caregiver status.

Data were collected from the February-March 2024 wave of the University of Michigan National Poll on Healthy Aging (NPHA), a nationally representative survey of community-dwelling U.S. adults age ≥ 50 (n = 3216).

We conducted a cross-sectional study using weighted regression models to examine older Americans' (1) views on who should primarily pay for caregiving (government, family/older adults, or others), (2) concerns about older adults in their community being able to access quality long-term care, and (3) concerns about long-term care costs. The key predictor was whether the respondent was a caregiver of an adult ≥ age 65.

Opinions on who should primarily pay for caregiving were evenly split between government (45%) and older adults and their families (45%). Caregivers were less likely to favor older adults and their families bearing primary financial responsibility relative to the government (RRR 0.68, p < 0.01). Most older Americans were somewhat or very concerned about quality long-term care access (80%) and costs (88%), and caregivers were more likely to be concerned about both access (b = 1.73, p < 0.001) and costs (b = 1.44, p < 0.01) than noncaregivers.

Most older Americans are concerned about access to long-term care and costs, yet remain divided on who primarily should pay for caregiving costs. Caregivers are both more concerned about long-term care access and more likely to support the government's primary responsibility for caregiving costs than noncaregivers. Policymakers should consider more options for access to affordable, high-quality long-term care, and financial supports for caregivers.