National Family Caregiver Support Program (NFCSP)
Free support services for family members and informal caregivers who provide care for older adults, people with disabilities, and grandparents raising grandchildren. The program provides respite care, counseling, support groups, training, information, and assistance in accessing services through a nationwide network of Area Agencies on Aging and local community organizations.
You Can’t Pour from an Empty Cup: The National Family Caregiver Support Program
Behind every older adult living at home with a chronic illness, every person with Alzheimer’s disease maintaining dignity and comfort, every grandchild being raised by a loving grandparent, there is often an invisible workforce—the family caregiver. Approximately 53 million Americans provide unpaid care to an adult family member or friend, and millions more grandparents serve as primary caregivers for their grandchildren. These caregivers perform an extraordinary service, providing care valued at an estimated $600 billion annually—more than the entire Medicaid budget and more than the combined revenue of the largest home health, hospital, and nursing home companies in the country.
But caregiving takes a devastating toll. Family caregivers experience higher rates of depression, anxiety, and emotional distress than non-caregivers. They suffer physical health consequences from the strain of lifting, transferring, and assisting care recipients. They lose income, career advancement, and retirement savings when they reduce work hours or leave jobs to provide care. They become socially isolated as caregiving responsibilities consume their time and energy. And many caregivers—especially those providing high-intensity care for people with dementia—experience burnout so severe that their own health collapses, sometimes leading to hospitalization or premature death.
The National Family Caregiver Support Program (NFCSP) was created by Congress in 2000 as part of the reauthorization of the Older Americans Act, recognizing that supporting family caregivers is not just a compassionate policy but a practical one—because when caregivers break down, the people they care for often end up in costly institutional settings. Funded at approximately $200 million per year and administered through the nationwide network of 56 State Units on Aging, 622 Area Agencies on Aging, and hundreds of local service providers, the NFCSP provides a range of free services designed to sustain caregivers, improve their well-being, and help them continue the extraordinary work they do.
Opportunity Snapshot
| Detail | Information |
|---|---|
| Program Type | Support services for unpaid family caregivers |
| Who It Serves | Family caregivers, grandparent caregivers, and older relative caregivers |
| Cost | Free for most services |
| Annual Federal Funding | ~$200 million |
| Service Delivery | Through 622 Area Agencies on Aging and local providers |
| Core Services | Respite care, counseling, training, information, access assistance |
| Federal Authority | Title III-E of the Older Americans Act |
| Administered By | Administration for Community Living (ACL), HHS |
Five Core Services
The NFCSP is structured around five core service categories, each designed to address a different aspect of the caregiving experience:
1. Information About Available Services
Many caregivers don’t know what help is available to them. They may be aware of Medicare and Medicaid but unaware of programs like LIHEAP, SNAP, the 340B drug pricing program, veterans benefits, state pharmaceutical assistance, and dozens of other resources that could ease their burden. NFCSP provides comprehensive information about caregiving resources in the community, disease-specific information and education (particularly for Alzheimer’s and related dementias), information about government benefit programs the care recipient may be eligible for, legal information regarding advance directives, guardianship, and financial planning, and referrals to specialized agencies and organizations.
This information is delivered through one-on-one consultations, printed materials, websites, webinars, community presentations, and caregiver resource fairs.
2. Assistance in Gaining Access to Services
Beyond information, NFCSP helps caregivers actually navigate the complex service landscape and connect with needed resources. Case managers and care coordinators work with caregivers to assess the caregiver’s and care recipient’s needs, identify appropriate community services, help with applications for benefits and programs, coordinate among multiple service providers, follow up to ensure services are received and needs are met, and advocate on behalf of the caregiver and care recipient.
This service is particularly valuable for caregivers who are overwhelmed, have limited English proficiency, lack familiarity with the social service system, or are dealing with complex situations involving multiple agencies and programs.
3. Individual Counseling, Support Groups, and Caregiver Training
The emotional demands of caregiving can be as challenging as the physical ones. NFCSP provides individual counseling by licensed professionals to address depression, anxiety, grief, guilt, anger, and other emotions common to caregiving, support groups where caregivers can share experiences, exchange practical advice, and find solidarity with others who understand their situation, specialized support for specific populations including spouse caregivers, adult child caregivers, LGBTQ+ caregivers, caregivers of color, and grandparent caregivers, disease-specific support particularly for caregivers of individuals with Alzheimer’s disease and related dementias, and online and telephone-based support options for caregivers who cannot attend in-person meetings.
Caregiver training programs teach practical skills including safe lifting, transferring, and mobility techniques, medication management, nutrition and meal preparation for special diets, managing behavioral symptoms of dementia, using medical equipment and assistive technology, understanding disease progression and what to expect, communicating effectively with healthcare providers, and self-care strategies to prevent burnout.
4. Respite Care
Respite care—temporary relief from the demands of caregiving—is consistently identified as the most needed and most valued service among family caregivers. Respite allows the caregiver to rest, attend to their own health needs, maintain social connections, run errands, or simply take a break. Without respite, caregiver burnout becomes inevitable.
NFCSP funds several types of respite care. In-home respite brings a trained aide into the home to care for the care recipient while the caregiver steps away—for a few hours, a full day, or overnight. Adult day programs provide supervised activities, socialization, meals, and health services for older adults in a community setting during daytime hours, giving the caregiver regular scheduled relief. Institutional respite provides temporary placement in a nursing facility, assisted living facility, or hospital for short periods (typically one to several weeks) when the caregiver needs extended relief—for example, to recover from surgery, take a vacation, or address a family emergency. Emergency respite provides immediate short-term relief when an unexpected crisis makes the caregiver temporarily unavailable.
The amount of respite care available varies by state and locality and is often limited by funding. Many NFCSP programs provide a set number of respite hours per year (commonly 50-200 hours), while others use a dollar cap or a combination of time and cost limits. Despite these limitations, even modest amounts of respite can make an enormous difference in a caregiver’s ability to sustain their role.
5. Supplemental Services
On a limited basis, NFCSP may provide supplemental services to complement the care provided by the caregiver. These may include home modifications (grab bars, ramp installation, bathroom modifications) to make caregiving safer and easier, assistive devices and technology (medical alert systems, medication reminders, specialized equipment), transportation for the care recipient to medical appointments or adult day programs, nutritional supplements and specialized food items, legal assistance for advance care planning and guardianship matters, and emergency supplies.
Supplemental services are typically provided on a case-by-case basis based on assessed need and available funding. Many NFCSP programs prioritize supplemental services for caregivers with the greatest social and economic need.
Who Is Eligible
NFCSP serves three primary categories of caregivers:
Category 1: Family caregivers of older adults. If you are an informal (unpaid) caregiver providing care for a family member, partner, or friend who is age 60 or older, you are eligible for NFCSP services. This includes caregivers of individuals with Alzheimer’s disease, Parkinson’s disease, stroke, cancer, heart disease, diabetes, and any other condition that requires assistance with daily activities. The care recipient must be age 60 or older, but the caregiver may be any age.
Category 2: Caregivers of individuals with Alzheimer’s or related disorders. If you are an informal caregiver for an individual of any age with Alzheimer’s disease or a related neurological disorder (such as Lewy body dementia, frontotemporal dementia, vascular dementia, or Huntington’s disease), you are eligible for NFCSP services regardless of the care recipient’s age.
Category 3: Grandparent and older relative caregivers. If you are a grandparent age 55 or older who is the primary caregiver for a child age 18 or younger, or an older relative age 55 or older caring for an adult age 18-59 with a disability, you are eligible for NFCSP services.
Income and Means Testing
NFCSP does not have a strict income test for most services—caregivers at all income levels are welcome to access information, assistance, counseling, support groups, and training. However, because demand typically exceeds funding, many NFCSP programs prioritize services for caregivers with the greatest social and economic need, particularly those who are low-income, members of minority groups, and those living in rural areas. Some supplemental services may have income-based eligibility criteria or sliding fee scales.
Accessing NFCSP Services
The primary access point for NFCSP services is your local Area Agency on Aging (AAA). To find your AAA:
Call the Eldercare Locator at 1-800-677-1116 (Monday-Friday, 9 AM - 8 PM ET) and ask about caregiver support services. Visit eldercare.acl.gov and search by zip code for local caregiver resources. Call 211 from any phone for local referrals to caregiver support programs. Contact the Alzheimer’s Association 24/7 Helpline at 1-800-272-3900 for dementia-specific caregiver support and NFCSP referrals. Ask your care recipient’s doctor, hospital social worker, or case manager about local caregiver support programs.
The Evidence for Caregiver Support
Research consistently demonstrates that programs like the NFCSP produce meaningful outcomes. Respite care reduces caregiver stress, depression, and physical health symptoms. Caregiver training and education improve caregiving skills and reduce feelings of helplessness. Support groups reduce social isolation and improve emotional well-being. Counseling interventions for dementia caregivers can delay nursing home placement of the care recipient by an average of 1.5 years—generating enormous savings for families and for Medicaid.
A landmark study by Dr. Mary Mittelman at NYU found that a counseling and support intervention for spouse caregivers of individuals with Alzheimer’s disease resulted in an average delay of 557 days in nursing home placement—nearly 1.5 years of additional time at home. At an average nursing home cost of over $100,000 per year, this represents extraordinary value.
Frequently Asked Questions
Do I have to be related to the person I care for to qualify? No. NFCSP defines “family caregiver” broadly to include any informal (unpaid) caregiver—family members, partners, friends, and neighbors all qualify.
Can I get paid for caregiving through NFCSP? NFCSP does not directly pay caregivers for their caregiving work. However, your local AAA can connect you with programs that do provide caregiver payment, such as Medicaid Self-Directed Services, the Veterans Directed Care Program, and state-funded caregiver compensation programs.
Is there a limit on how much respite care I can receive? Yes. Respite care is typically limited based on available funding. Most programs provide a set number of hours or dollars per year, which varies by state and locality.
What if I’m a caregiver AND I need services for myself? Many caregivers are also older adults who have their own health and service needs. NFCSP counselors and case managers can help you access services for both yourself and the person you care for, including services under the Older Americans Act, Medicaid, Medicare, and other programs.
Can I access NFCSP services if I live in a rural area? Yes. NFCSP funds are distributed to every state and to Area Agencies on Aging serving rural communities. However, the availability of specific services may be more limited in rural areas due to provider shortages.
How to Get Started
- Call the Eldercare Locator at 1-800-677-1116 for local caregiver services
- Visit eldercare.acl.gov and search for caregiver support
- Call 211 for local caregiver resource referrals
- Contact the Alzheimer’s Association at 1-800-272-3900 for dementia caregiver support
- Visit acl.gov/programs/support-caregivers for program information
- Contact your local Area Agency on Aging directly
You cannot care for someone else if you don’t take care of yourself. The National Family Caregiver Support Program recognizes that the caregiver’s well-being is just as important as the care recipient’s—and provides the services and support to help you sustain the extraordinary work you do, day after day.