• Maryam Navaie-Waliser, Aubrey Spriggs, and Penny H Feldman.
• Center for Home Care Policy and Research, Visiting Nurse Service of New York, 5 Penn Plaza, 11th Floor, New York, NY 10001, USA. maryam.navaie@vnsny.org
• Med Care. 2002 Dec 1;40(12):1249-59.

BackgroundWith an aging population and public policies that limit accessible and affordable formal care services, informal caregivers, largely women, will continue bearing the overwhelming responsibility for home and long-term care services provision.ObjectivesThis study examined gender differences among informal caregivers in caregiving activities, intensity, challenges, and coping strategies and assessed the differential effects of caregiving on their physical and emotional well-being.Research DesignCross-sectional study conducted between May and September 1998.SubjectsTelephone interviews were conducted with a randomly selected, nationally representative sample of 1002 informal caregivers.MeasuresCaregivers' sociodemographic, and physical and emotional health characteristics; caregiving type and intensity; formal care support; difficulty with care provision; unmet needs; coping strategies; and the care recipients' health and relationship with caregiver were examined between the genders using descriptive and multivariate analyses.ResultsCompared with men caregivers, women caregivers were significantly more likely to be 65 years of age or older, black, married, better educated, unemployed, and primary caregivers; provide more intensive and complex care; have difficulty with care provision and balancing caregiving with other family and employment responsibilities; suffer from poorer emotional health secondary to caregiving; and cope with caregiving responsibilities by forgoing respite participation and engaging in increased religious activities.ConclusionsInformal caregivers, particularly women, are under considerable stress to provide a large volume of care with little support from formal caregivers. Program planners, policy makers, and formal care providers must act together to provide accessible, affordable, and innovative support services and programs that reduce family caregiving strain.

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