Understanding the role of informal caregiving in keeping chronically disabled elders out of nursing homes is increasingly important for policy. Demographic shifts are likely to increase the caregiving burden for a smaller number of caregivers per elder in the coming decades. This study examines how informal care, paid formal care, and stress or burden experienced by caregivers relate to nursing home placement. Data are from the 1999 National Long Term Care Survey and Informal Caregiver Survey merged with Minimum Data Set and other external data. Results from instrumental variables models indicate that stress is a strong predictor of nursing home entry over follow-up periods of up to two years, and that caregiving-related physical strain, financial hardship, and recipient behavior problems are important predictors of high levels of caregiver stress.
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