1 Family caregivers are the backbone of the nation's long-term care system, providing the support and assistance that enables millions of older Americans to remain in their homes despite a need for help with everyday activities. To sustain the efforts of family caregivers, states have developed a range of services that include specialized information and referral, family consultation, care management, support groups, education and training, and respite. Two 1999 national surveys of state caregiver supports have identified strategies that states have adopted to reach caregiver families and the programs the states have designed to meet caregiver needs. The surveys were conducted by the California Family Caregiver Alliance and the National Association of State Units on Aging.
States typically fund single-purpose caregiver support programs with general revenues.
However, most states also offer respite care as a specific service within a package of home and community-based care services that are funded by Medicaid or state general revenues. Eligibility criteria vary across the states by diagnostic or functional level, age, or income. Most of the services intended primarily for the family caregiver have no income requirements, operating through a sliding fee scale or other cost-sharing mechanism. Problems reported include inadequate funding, limited scope of services, and lack of public awareness of services. Innovative approaches to reaching caregivers include mobile day care centers, voucher programs, websites, and overnight and emergency respite services.