The Older Americans Act and Family Caregiving: Perspectives from Federal and State Levels

Informal caregivers, including family, friends, or neighbors, are typically the first line of support to an older adult in need and are major providers of long-term care for older adults. In 2013, about 40 million caregivers in the United States provided 37 billion hours of care to an adult with limitations in daily activities (National Alliance for Caregiving & AARP Public Policy Institute, 2015). Although caregiving is not a new phenomenon, the ways in which the caregiving role is carried out have shifted significantly with the demographic trends of increased lifespans and the aging of the notably large Baby Boomer generation. Caregiving is often a group effort, wherein family members and friends collaborate as primary and secondary caregivers to support their care recipient. Moreover, caregiving is not an activity with an active role and a passive role, but rather one that entails the active engagement of the care recipient. Caregiving is a demanding and complex undertaking that has demonstrated extensive physical, emotional, relational, and financial burdens on families. Given the multifaceted role of caregiving and the shift from long-term care institutions toward community-based services, a wide range of supports and services are needed for caregivers to maintain their health and well-being, build their skills, and sustain their roles. As part of the reauthorization of the Older Americans Act (OAA) in 2000, the National Family Caregiver Support Program (NFCSP) was established in an effort to support family caregivers. NFCSP funds a range of supports that assist families in caring for dependent older adults. This paper examines the process and outcome evaluations of NFCSP, identifying areas of strength and improvement. Utilizing New York State as an example, we examine the way the NFCSP interfaces with caregiving policies and programs at the state level, offering further insight into the OAA’s value to caregiver support services and into future directions of this work.