Family and unpaid caregivers play an important role in health care for older adults with disabilities. This study examines caregiver involvement in health care and related caregiving outcomes. Data are from the 2011 National Health and Aging Trends Study and National Study of Caregiving. Of 14.7 million caregivers assisting older adults, 6.5 million provided substantial health care help, 4.4 million some help, and 3.8 million no help. Half of caregivers providing substantial help were assisting people with dementia. They provided care for more hours than other caregivers; had significantly higher rates of emotional, physical, and financial difficulty; and were five times as likely to experience restriction of participation in valued activities and three times as likely to experience work productivity loss.