National Family Caregiver Support Program

Aging Practice Update from the National Association of Social Workers
Volume 1, Number 2, January 2002

Lisa Yagoda, MSW, LICSW Senior Staff Associate for Aging


  • The NFCSP is the largest new support program under the Older Americans Act since 1972, when Congress established a nutritional program to serve older Americans.
  • 22.4 million families are providing physical and emotional assistance for older relatives or friends (MetLife, 2001, p. 1).
  • People over 85 years of age are the fastest growing segment of the population. Half of them need some help with personal care (National Family Caregivers Association, 1998).
  • Approximately 80 percent of home care services are provided by family caregivers. (National Family Caregivers Association, 1998).
  • 61 percent of "intense" family caregivers -- those providing at least 21 hours of care a week -- have suffered from depression (National Family Caregivers Association, 1998).
  • Caregivers of people with dementia who use adult day services experience less stress and better psychological well-being than those who do not use the service (Zarit, Stephens, Townsend, & Greene, 1998).


Families provide much of the financial and emotional support needed to help older adults continue to live independently in the community. To perform their role as caregiver, families often rely on external supports such as social services or social insurance entitlements, and many have no guarantee that they will receive assistance when it is needed (NASW, 2000).

The Older Americans Act (OAA) of 1965 (P.L. 89-73) is the public policy that provides the basis for a substantial portion of community aging services for older adults in the United States. Traditionally, the Older Americans Act, did not call for services or programs that would provide direct assistance to family caregivers. The demographics of U.S. society have changed considerably since the OAA’s inception in 1965, resulting in a shift in the way society, public policy, and social work professionals must address the needs of older adults and their caregivers.

The National Association of Social Workers places a high priority on supporting and strengthening families (NASW, 2000). The National Family Caregiver Support Program (NFCSP) is a beginning step toward recognizing and meeting the needs of family caregivers. The purpose of this practice update is to provide a starting point for discussion and guidance about the NFCSP, which is the most recent amendment of the Older Americans Act. A general overview of the program and resources are provided to help social work professionals better assist clients with access to the services they need and deserve.

What is the National Family Caregiver Support Program?

In November 2000 Congress reauthorized the Older Americans Act and created the National Family Caregiver Support Program, an important program designed to help family members provide care for an older adult at home. The NFCSP was developed by the Administration on Aging (AoA) of the U.S. Department of Health and Human Services. The principle component of the program calls for all states to work in partnership with local Area Agencies on Aging and other service providers to put the services under this program into place. The five basic services outlined under the NFCSP are as follows (AoA, 2001):

  • information for caregivers about available services
  • assistance to caregivers in gaining access to services
  • individual counseling, organizing of support groups, and caregiver training to assist caregivers in making decisions and solving problems relating to their caregiving role
  • respite care to help temporarily relieve caregivers from their caregiving responsibilities
  • supplemental services, on a limited basis, to complement the care provided by caregivers.

Who is eligible to receive services from the National Caregiver Support Program?

  • family caregivers of older adults
  • grandparents and relative caregivers of children not more than 18 years of age (including grandparents who are sole caregivers of grandchildren and the individuals who are affected by mental retardation and developmental disabilities).

According to the AoA (2001), "there is no requirement that the grandchildren have a disability. Under the NFCSP, states may design services for grandparents or older individuals who are relative caregivers. In these instances, the grandparent or relative caregiver must be an older individual (60+), who lives with the child, is primary caregiver of the child, and has a legal relationship to the child or is raising the child informally. The child must be not more than 18 years old." (p. 2)

Other components of the NFCSP include grants for innovative projects that would improve the delivery of information and services to older Americans and a new program to support family caregivers of Native American elders. Although the details are still unclear, it is expected that the AoA will issue more information about implementation of these provisions in the near future.

Questions and Guidance

  • For Providers: The Administration on Aging will provide ongoing technical assistance to states to assist in implementing the National Family Caregiver Support Program. The agency maintains a Caregiving Resources for the Aging Network.
  • For Caregivers: The local Area Agency on Aging (AAA) is one of the first resources a caregiver should consider contacting when help is needed. Almost every state has at least one AAA, which serves older adults and families. Local AAAs generally are listed in the city or county government sections of the telephone directory. Caregivers also can find their local AAA by contacting the Eldercare Locator at 1-800-677-1116.


  • Administration on Aging. (2001, July). Frequently asked questions
  • Administration on Aging. (2001, August). The national family caregiver support program
  • Metlife Mature Market Institute. (2001, March). The MetLife study of employed caregivers: Does long-term care insurance make a difference? New York: Metropolitan Life Insurance Company.
  • National Association of Social Workers. (2000). Family policy. In Social work speaks, NASW policy statements, 2000–2003 (pp.117–122). Washington, DC: NASW Press.
  • National Family Caregivers Association. (1998). Family caregiving statistics
  • Older Americans Act of 1965, P.L. 89-73, 79 Stat. 218.
  • Zarit, S. H., Stephens, M.A.P., Townsend, A., & Greene, R. (1998). Stress reduction of family caregivers: Effects of adult day care use. Journal of Gerontology: Social Sciences, 533B, 267–277.

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