Prevalence and Correlates of Gray Market Use for Aging and Dementia Long-Term Care in the U.S.

Abstract

To estimate the national prevalence and sociodemographic correlates of gray market utilization, consisting of paid providers who are unrelated to the recipient, not working for a regulated agency, and potentially unscreened and untrained, for aging and dementia-related long-term care. We surveyed a nationally representative sample of 1,037 American Life Panel respondents aged 18 years and older. Nearly a third of Americans who arranged paid care sought gray market care for persons with dementia, and most (65%) combined it with unpaid care. Respondents who arranged gray market care had 66% lower odds of currently working, and those living in rural areas had an almost 5-times higher odds of arranging dementia gray market care. Gray market care represents a substantial proportion of paid, long-term care for older adults and may fill gaps in access to care.