A National Profile of Caregivers for the Oldest-Old

INTRODUCTIONOne of the potentially distinct subpopulation of older adults that help us understand diversity in the older population is the oldest-old: those are generally defined as over 85 years. It is expected that this segment of older population will continue to grow with substantial socioeconomic impacts (Christensen, Doblhammer, Rau, and Vaupel, 2009; Olshansky, Goldman, Zheng, and Rowe, 2009). Ryan et al., (2012) point out that the first Baby Boomers will turn 85 years of age in 2030, with all surviving members of this cohort achieving oldestold status by 2050; resulting in an oldest-old population that is triple what it is today. Furthermore, much of the care needs are likely to be among the oldest-old. For example, many major health problems such as cancer, osteoporosis, dementia, and general limitations in daily activities tend to be observed among the oldest-old (Davey et al., 2010). Reports also show that average health care expense per person among the oldest-old tends to be almost three times more than the one of those youngest-old (i.e., 65-74 years) (Alemayehu and Warner, 2004).Maintaining a sufficient caregiving workforce for growing numbers of oldest-old population is unlikely in the current social and political environment. Despite the expected growth of the oldest-old who are more likely to present caregiving needs, availability of family caregivers-the primary care provider for the majority of older adults in need of assistance-may be declining. Decreased fertility rates and increasing job mobility among younger generations mean that the younger generation of adult children may not be as readily available as caregivers as previously assumed (Uhlenberg and Cheuk, 2008). The projection for the Baby Boomers as the next cohort of the oldest-old seems even more challenging. The study by Ryan et al., (2012) showed that this very large group is less likely than today's oldest-old to have either an adult child or a spouse nearby to provide informal care services needed in late life. Similarly, Lin and Brown (2012) found that, in the 2009 American Community Survey, one out of three Baby Boomers was single thus would not be able to expect a traditionally expected informal caregiver for their care (Lin and Brown, 2012). On the other hand, the need of maintaining sufficient informal caregivers is critical more than ever, because of national policy initiatives to foster "aging in place" as a strategy that has efficiencies for public dollars and is preferred by the older adults (Wiles, Leibing, Guberman, Reeve, and Allen, 2012). To date, only limited information exists on the family life and caregiving of the oldest-old (Freeman, Kurosawa, Ebihara, and Kohzuki, 2010; Sanborn and Bould, 1991). Existing studies suggest that the care networks of the oldest-old may significantly differ from the ones of younger generations; therefore accurate understanding and assessment of health and caregiving needs of older population requires more exclusive focus on the oldest-old.Assessing Caregiving for the Oldest-OldAssessment of caregiving for the oldest-old needs to start with comparative analyses of their socio-demographic and health-related characteristics, as these indicators would help us identify the levels of needs and resources that are unique to this population. Among these characteristics also include patterns of informal and formal care service utilization, as such data are expected to provide information regarding the types of resources drawn to meet the needs of care and ways in which informal and formal care may supplement or compliment the needs of caregiving (e.g., Davey et al., 2005; McMaughan Moudouni, Ohsfeldt, Miller, and Phillips, 2012).Since the family has always been the major care provider for older adults in need of support (Miller, Allen, and Mor, 2009; Uhlenberg and Cheuk, 2008), a close examination of their informal caregivers is also critical in assessing caregiving situations for the oldest-old. …