The Price of Care: Trends in Financial Transfers to Aging Parents.

OBJECTIVES: Rising eldercare expenditures and rapid aging of the US population have intensified pressures on families, who increasingly provide both direct "hands-on" care and financial support ("transfers") to aging relatives. To elucidate how population aging is reflected in families' financial caregiving roles, this study characterizes national trends in out-of-pocket financial transfers to parents.

DESIGN: Repeated cross-sectional analysis from the Health and Retirement Study (2002-2018).

SETTING AND PARTICIPANTS: Eight thousand eight hundred fifty-nine US households in which either the respondent or their spouses reported providing financial assistance to a parent or a parent-in-law.

METHODS: Outcomes included (1) whether households provided any financial transfer (≥$500) and (2) the total transfer amount (in 2018 dollars) among those that provided support. Caregiving subgroups were defined by parental need for assistance with activities of daily living, the presence of dementia, and coresidence. We used generalized linear models with household survey weights to estimate nationally representative time trends and conducted subgroup analyses by caregiving subgroups.

RESULTS: Coresiding households had disproportionately lower income and wealth, yet consistently displayed the highest probability of providing financial transfers, exceeding 30% in most years. Households assisting with activities of daily living or supporting a parent with dementia were also more likely to contribute financially and reported higher annual transfers. Adjusted mean contributions peaked at $10,614 in 2008 but overall remained relatively consistent through 2018, including among households with heightened parental care needs.

CONCLUSIONS AND IMPLICATIONS: Families continue to shoulder a substantial share of aging-related care expenses, with financial burdens disproportionately concentrated among households providing intensive caregiving and those with fewer economic resources. These findings underline the hidden costs of population aging that are borne inequitably across socioeconomic status and signal the need for policy solutions that mitigate the financial burden on families supporting aging parents.