Gray market care represents a substantial proportion of paid, long-term care for older adults, according to a study published online June 11 in the Journal of Applied Gerontology.

Regina A. Shih, Ph.D., from the RAND Corporation in Arlington, Virginia, and colleagues surveyed a nationally representative sample of 1,037 American Life Panel adult respondents to estimate the national prevalence and sociodemographic correlates of gray market utilization, defined as paid providers for aging and dementia-related long-term care who are unrelated to the care recipient, not working for a regulated agency, and potentially unscreened and untrained.

The researchers found that nearly one-third of Americans who arranged paid care sought gray market care for persons with dementia, and nearly two-thirds (65 percent) combined it with unpaid care. Respondents who arranged gray market care had lower odds of currently working (66 percent). Additionally, respondents arranging gray market care and living in rural areas had almost five-times higher odds of arranging gray market care for dementia.

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