(paper). Men as Caregivers: Theory, Research, and Service

Those of us who are elderly, chronically ill, or dying, when we come to need care, usually prefer to receive it in our own homes, provided by familiar people. Because this is not always possible, we con-tinue to need nursing homes, which furnish what may often be an inferior alternative. But, for the great majority of chronically ill and disabled persons—75– 80 % by most estimates—family or friends, with very limited public assistance, provide continuing care in the United States today. Total reported expenditures for home health care in 2001 were $33.2 billion, or 2.3 % of all health care spending, which amounted to a third of what was spent on nursing home care and only 6.1 % of expenditures for hospital care (Levit et al., 2003). Private expenditures for home care—those that have come to the attention of re-porting agencies—amounted to only a quarter of the payments from public sources, but, because few out-of-pocket expenses are reimbursable, this is undoubt-edly an underestimate. The public part of the cost of long-term care is perceived as a rising burden on state and federal governments, but the lion’s share is actually borne b