Family Caregiver Factors Associated with Unmet Needs for Care of Older Adults

OBJECTIVES: To examine caregiver factors associated with unmet needs for care of older adults. DESIGN: Population-based surveys of caregivers and older adult care recipients in the United States in 2011. SETTING: 2011 National Health and Aging Trends Study and National Study of Caregiving. PARTICIPANTS: Family caregivers (n = 1,996) of community-dwelling older adults with disabilities (n = 1,366). MEASUREMENTS: Disabled care recipient reports of unmet needs for care in the past month with activities of daily living (ADLs; e.g., wet or soiled clothing), mobility (e.g., have to stay inside), or instrumental activities of daily living (IADLs; e.g., medication errors). Caregiver reported sociodemographic characteristics, caregiving intensity and tasks performed, health, and psychosocial effects. RESULTS: Of the care recipients, 44.3% reported at least one unmet need for care in the past month (38.2% ADL related, 14.6% IADL related). Younger caregivers, caregiving sons, caregivers not living with care recipients, and having supplemental paid caregivers were associated with more unmet needs. Caregivers with recipients reporting two or more unmet needs were more likely to spend more than 100 hours per month caregiving, help with skin care and wounds, report caregiving as emotionally and physically difficult, and report restricted participation in valued activities (all P < .001). CONCLUSION: Unmet ADL needs are prevalent among older adults with family caregivers. Caregivers experiencing high levels of burden, stress, and negative physical and psychosocial impacts may provide substandard or poor care to older adults, which may be a risk factor for neglect. Clinicians caring for disabled older adults should assess their unmet needs and the capacity of caregivers to address them.