Long-Term Care Insurance Adds Caregiving Hours, Does Not Reduce Amount of Informal Care, Study Finds

Study of the impact of private long-term care insurance on patterns of formal and informal caregiving

From 1997 to 1999, researchers at the Center for Health and Long-Term Care Research, under the direction of Marc A. Cohen, PhD, and Jessica Miller, PhD, studied how private long-term care insurance affects the level and mix of formal and informal services used.

The project was part of the Robert Wood Johnson Foundation (RWJF) Home Care Research Initiative national program.

Researchers compared the experiences of people with long-term care insurance who have used home and community-based care and institutional benefits to those of people who do not have this insurance. They examined the effects of long-term care insurance on unpaid informal caregivers of older adults who are disabled and living in the community.

They interviewed older adults who are disabled, long-term care policyholders and their caregivers, and analyzed data from the federal Department of Health and Human Services' 1994 National Long-Term Care Survey and 1995 National Nursing Home Survey.

Key Findings

  • 86 percent of long-term care claimants are satisfied with their policies. About half of all claimants and informal (unpaid) caregivers said that without private long-term care insurance they would have to seek a nursing home or assisted living facility.

  • The effects of caregiving on the employment of informal caregivers are pervasive and wide ranging (e.g., 40% of unpaid informal caregivers had to take time off from work for caregiving).

  • For most informal caregivers, formal (paid) care does not substitute for informal care.

  • The presence of insurance benefits has not significantly reduced the level of informal care claimants received. 72 percent of institutionalized claimants were living in nursing homes, and 28 percent were living in assisted living facilities.

  • Long-term care insurance is the primary payment source for between 70 and 80 percent of claimants.

The principal investigator, Marc A. Cohen, PhD, is now working on related research on long-term care policyholders, with funding from RWJF (ID# 043223) and the U.S. Assistant Secretary for Planning and Evaluation.