Abstract Discussions about future care needs of U.S. older adults have frequently called attention to ongoing changes in families as the harbinger of a looming family care shortfall. To explore this premise, we paired estimates from the National Health and Aging Trends Study with projections of kinship patterns by age, sex, race through 2040. We defined care gaps in two complementary ways: the number of older adults with care needs who have (1) no family caregivers and (2) unmet care needs, whether they have caregivers or not. We projected outcomes for the overall older adult population and by sex, marital status, and racial groups, accounting first for only population growth and then allowing shifts in age structure, family structure, and family size. We projected that because of population growth alone, by 2040 the number of U.S. older adults with care needs but no family caregivers will reach 7.7 million and the number with unmet care needs will reach 14 million, up 22.9% from 2022 figures. Population growth and aging together resulted in a 32.5% and 33.9% increase, respectively, in these numbers. Impending changes in family structure and family size did not appreciably increase these estimates. Patterns for subgroups were substantially similar. We conclude that care gaps are projected to grow substantially in the United States by 2040, but contrary to prevailing concerns, population growth and changes in the age structure of the older population are primarily responsible, rather than shifts in family structure and family size.
Freedman et al. (Mon,) studied this question.