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Process Evaluation of the Older Americans Act Title III-E National Family Caregiver Support Program: Final Report

Administration for Community Living / Lewin Group. "Process Evaluation of the Older Americans Act Title III-E National Family Caregiver Support Program: Final Report." March 2016. First full-scale evaluation of the NFCSP, based on surveys of all 54 SUAs, all 619 AAAs, and 579 sampled Local Service Providers (LSPs) conducted January–December 2015.

Key findings used in wiki

What the NFCSP is

  • The NFCSP (Title III-E of the Older Americans Act) was established in 2000 as the first comprehensive federal program designed to support family caregivers of older adults and grandparent/older-relative caregivers of minor children.
  • It is administered through the Aging Network — State Units on Aging (SUAs) work with Area Agencies on Aging (AAAs) and Local Service Providers (LSPs) to deliver services on the ground.
  • Its ultimate goal is to support individuals who prefer to age in their own homes and communities, as opposed to institutional settings, through lower-cost non-medical services and supports.
  • Eligible caregivers include adult family members caring for someone aged 60+, and adult family members caring for someone of any age with Alzheimer's disease or a related disorder.

Five core services

NFCSP requires states and tribes to offer five core services to family caregivers:

  1. Information to caregivers about available services
  2. Access assistance for caregivers to supportive services
  3. Individual counseling, support groups, and caregiver trainings
  4. Respite care
  5. Supplemental services (flexibly tailored to local need)

Structural impact of the program

Comparing services available to caregivers before vs. after the NFCSP started, SUAs reported dramatic growth:

  • +247% support group services
  • +227% training and education services
  • +563% caregiver counseling services
  • +93% respite care services
  • +47% information and referral services

Before 2000, only 27.6% of AAAs operated a caregiver-specific program; 51.8% reported no prior program. NFCSP created caregiver-specific service infrastructure where almost none existed.

Mental-health and population findings from the literature review

  • Roughly 8.4 million Americans provide care to an adult with a mental illness; nearly three-quarters report high emotional stress in the cited national study.
  • Stigma and isolation make it harder for mental-illness caregivers to talk about the experience and care for their own health.
  • Mental-illness caregivers struggle to find affordable, high-quality services; respite, education, and navigation support are priority unmet needs.
  • In the LGBT review, the report documents greater reliance on chosen family, ongoing provider discrimination and cultural-competence gaps, and higher risk of social isolation and service underuse among LGBT older adults and caregivers.
  • Caregiving strain is not only emotional: it can also narrow social participation, disrupt work, and compound financial stress.

Why it matters for the wiki

  • Anchors the federal-infrastructure framing for benefits/nfcsp.md, domain/benefits-landscape.md, and evidence/federal-caregiver-policy.md.
  • Evidence that caregiver-specific services were systematically under-supplied before 2000 and remain unevenly available today — the multi-hundred-percent growth figures are a direct answer to "why do we still need caregiver-facing products?"
  • Anchors the mental-illness-caregiving and LGBT-caregiving passages elsewhere in the wiki without duplicating content.