Frail older adults are one of the most vulnerable groups in the nation. Disproportionately female, widowed, and in their 80s and 90s, most older people with disabilities living outside of nursing homes have little education and limited financial resources. Given the scarcity of public financing for home-based care, about three-quarters of those receiving assistance rely exclusively on unpaid caregivers. Providing help is often a burden on spouses, children, and friends, leaving some older Americans without the care they need. As the population ages, the demands on government and families will only intensify and put more older people at risk.