Family and Friends Provide Most Care for Elderly Americans – Americans Are in Denial About Elder Care

More than 80% of Americans over 65 needing care rely on family and friends.

A recent analysis reveals that informal elder care remains the backbone of support in the United States and other developed nations, challenging the widespread assumption that professional services have supplanted kinship roles. This reliance persists despite formal care systems and significant public expenditures in countries like the Netherlands.

In the U.S., about two-thirds of elderly individuals depend solely on informal care, typically provided by spouses, children, or close relatives. Research shows the intensity of care correlates strongly with proximity: those living with parents offer roughly twice the care hours of those on the same block, and beyond five miles, support drops sharply. Experts including Deborah Carr and Emily Kenway emphasize that most older adults do not reside in nursing homes and that family caregivers coordinate complex care efforts. Meanwhile, emotional and logistical challenges complicate accepting paid help, as illustrated by Susan Fordham’s experience and Jody Day’s alternative kinship circle in rural Ireland. The proportion of older adults with daily care needs that will go unmet is expected to grow by more than 30% by 2050, underscoring the urgency of planning informal networks.

Residents and policymakers might consider how local norms and zoning policies could support closer living arrangements or alternative care models to address evolving elder care needs.

Americans Are in Denial About Elder Care
By Stephanie H. Murray, The Atlantic