The role of family caregivers has dramatically expanded to include performing medical/nursing tasks once only provided in hospitals, says a new report by the AARP Public Policy Institute and the United Hospital Fund. The report is based on a nationally representative population-based online survey of 1,677 family caregivers to determine what medical/nursing tasks they perform.

Almost half (46%) of caregivers performed medical/nursing tasks for family members with multiple chronic physical and cognitive conditions. Three out of 4 (78%) family caregivers who provided medical/nursing tasks were managing medications, including administering intravenous fluids and injections. Caregivers reported finding wound care very challenging; more than a third (38%) wanted more training.

The report reveals the complexity and difficulty of specific tasks, the lack of support and training family caregivers receive, and the effect on their quality of life. It makes 10 recommendations, including:

• revisiting measures used to define what caregivers do
• strengthening oversight of how effectively institutions meet family caregiver needs and requiring corrective steps to address deficiencies
• conducting further studies to understand medical/nursing tasks performed by different types of family caregivers and their needs for training and support

"No single profession or health care provider is solely responsible for ensuring that family caregivers who take on these daunting responsibilities are trained and supported," the authors write. "This effort requires the coordinated efforts of all sectors—hospitals, home care agencies, community agencies, nursing homes, hospices, and physician and other clinician practices—and a level of teamwork that challenges attitudes and behaviors so firmly entrenched in the current system."