Chronic Illness Trends and the Challenges to Family Caregivers: Organizational and Health System Barriers

This chapter discusses the environmental context in which healthcare and long-term services and supports are organized, financed, and delivered, and how these factors relate to the experiences of family caregivers. We begin with an overview of population and chronic illness trends that frame the nature and demands of family caregiving. We then discuss the current health and long-term care (LTC) reimbursement and delivery environment for individuals with complex care needs and their involved family caregivers. Finally, we consider how population trends and the service delivery environment relate to family caregivers' preparedness and experiences, the impacts of engaging in the caregiving role, and implications for clinical practice and policy solutions. While these topics are of worldwide interest, the orientation of this chapter is specific to the regulatory framework, reimbursement paradigm, and delivery system of the United States.