Objectives 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. Methods We surveyed a nationally representative sample of 1,037 American Life Panel respondents aged 18 years and older. Results 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. Discussion Gray market care represents a substantial proportion of paid, long-term care for older adults and may fill gaps in access to care.
ACCELERATING THE PACE OF CHANGE IN THE U.S.: ACHIEVING A HIGH PERFORMING LONG TERM CARE SYSTEM