policies is largely symbolic rather than meaningful (Jenson and Jacobzone, 2000). Research in this area is critically important and is a task that could be undertaken by a national center spanning multiple disciplines and federal agencies.

As described in Chapter 3, the committee recommends that the Congress and private foundations increase support for research that promotes the effective use of the workforce to care for older persons. One important topic that needs to be investigated through research is the effect of financial incentives on informal caregiving.


Patients and informal caregivers play a substantial, but often underappreciated, role in the health care delivery process. Their roles will be even more substantial in the future, given the rising incidence of chronic disease, which requires greater self-monitoring on the part of patients, and the rapidly increasing number of older Americans, which will place greater responsibilities on family and friends to provide care assistance. Informal, unpaid caregiving is an essential component of an optimal health care workforce for an aging population. However, the trend toward fewer informal caregivers at a time when the number of older persons is expanding underscores the importance of identifying effective strategies to support informal caregivers, such as offering them increased training opportunities. It will also be important to develop and distribute technologies that promote greater independent functioning among older adults and reduce their reliance on the direct-care workforce and on informal caregivers.


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Allen, S. M., and V. Mor. 1997. The prevalence and consequences of unmet need. Contrasts between older and younger adults with disability. Medical Care 35(11):1132-1148.

AOA (Administration on Aging). 2007. The national family caregiver support program. http://www.aoa.gov/prof/aoaprog/caregiver/careprof/progguidance/research/NFCSP_BROCHURE.pdf (accessed October 10, 2007).

Arno, P. S. 2006. Economic value of informal caregiving: 2004. Presented at the Care Coordination & the Caregiver Forum, Bethesda, MD. January 25-27.

ASPE and AOA (The Office of the Assistant Secretary for Planning and Evaluation and the Administration on Aging). 1998. Informal caregiving: Compassion in action. Washington, DC: Department of Health and Human Services (HHS) and AOA.

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