This study finds that the prevalence of informal, family care for the frail elderly declined between the mid 1980s and mid 1990s, while the use of formal, paid services increased. This pattern was more pronounced among those who had spouses and children, the dominant source of informal care. On the other hand, the decline in informal care appears to be entirely among those playing a secondary role. A larger proportion of those who were providing informal care were the primary source of care in the later year, and those who were receiving care were more disabled, suggesting that a smaller proportion of near kin may have been providing a greater level of care. The implications for public policy, informal caregiving, and the burden on families as the Baby Boom Generation ages into frailty are discussed. (The Milbank Quarterly 2000 Fall; 78(3):347-374)
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