Estimating the quantity and economic value of family caregiving for community-dwelling older persons in the last year of life

Objectives: To estimate the quantity and economic value of informal care provided to older persons during their final year of life in the community. Design: Retrospective analysis of publicly available nationally representative survey data. Setting: This retrospective study used data from the Health and Retirement Study, a nationally representative, longitudinal study of community-dwelling older people. Participants: Older people who died between 2000 and 2002. Measurements: Data were extracted from the 2002 "exit survey" and linked with characteristics of caregivers from the helper file. Ordinary least squares regression was used to estimate hours of informal caregiving for community-dwelling older people (N=990). Adjusted hours were multiplied by the 2002 national average home aide wage ($9.16 per hour). Sensitivity tests were performed using the 10th percentile wage rate ($6.56) and 90th percentile wage rate ($12.34). Results: Older people who died in the community received on average 65.8 hours per week of informal care in the last year of life. The estimated economic value ranges from $22,514 to $42,351, which is equivalent to the annual direct replacement cost with a home aide in 2002. Conclusion: Family members provide substantial assistance during the last year of life for older people who die in the community. If the informal care provided in the last year of life is replaced with a home aide, the total economic value for the United States would be approximately $1.4 billion (in 2002).