NSOC Dashboards Methods and Measures

To be eligible for NSOC, the older adult had to receive help with daily activities for health and functioning reasons in the prior month from one or more family or unpaid caregivers. Older adults were all ages 65 and older in 2011 and ages 66 and older in 2023.

Family and unpaid caregivers were eligible for NSOC if they assisted with one or more of the following activities self-care (eating, dressing, bathing, toileting), mobility (transferring, getting around inside, getting around outside), household activities (laundry, meals, shopping for personal items, bills and banking), and other activities (money matters other than bills or banking, medical related care such as physician visits or insurance decisions, and or transportation). 

Caregivers were asked how often in the last month they helped with or did household activities for an older adult because of older adults’ health and functioning. Assistance with household activities identifies caregivers who have ever helped in the last month with each and any of four activities: chores (including laundry, cleaning, or making hot meals); shopping (for groceries or personal items); ordering prescribed medicines; and handling bills or banking. Caregivers missing data on an activity are assumed not to assist with that activity. 

Caregivers were asked how often in the last month they helped with self-care and mobility activities. Assistance with self-care and mobility identifies caregivers who ever helped in the last month with each and any of six activities: personal care (including eating, showering or bathing, dressing or grooming, or using the toilet); dental care (teeth or dentures); foot care (like clipping nails); getting around home (including getting in and out of bed, getting around inside home, or leaving home to go outside); driving older adults places; and other transportation (go with older adult in a van, shuttle or cab, or on public transportation). Caregivers missing data on an activity are assumed not to assist with that activity. 

Assistance with medical care identifies caregivers who ever provided help in the last month with each and any of nine activities: keeping track of medications; taking shots or injections; managing medical tasks (like ostomy care, IVs or testing blood); skin care (related to wounds or sores); help with exercises; help with a special diet; communicating with medical providers about care;  making medical appointments; and managing health insurance (change or add health insurance or prescription drug plan; or handle any other health insurance matters related to older adults’ medical care). Caregivers missing data on an activity are assumed not to assist with that activity. 

Other assistance identifies caregivers who ever provided help in the last year with: securing mobility devices (devices to get around more easily such as a cane, walker, wheelchair or scooter); making home safer (by adding features such as railing or ramp, grab bars in the bathroom, a seat for the shower or tub, or an emergency call system); finding a paid helper (to do household chores or personal care). Caregivers missing data on an activity are assumed not to assist with that activity. 

• Duration of caregiving identifies the number of years that caregivers have been providing assistance to an older adult (0-2 years, 3-5 years, more than 5 years). Caregivers missing data on duration of care are assigned the mean number of years by survey round. 
• Hours of care identifies the number of hours per week that caregivers provide assistance (<1 to 10 hours per week, 11 to 39 hours per week, and 40+ hours per week). Caregivers missing hours of care data are assigned the mean number of hours by number of days per week or month they provide help. If days per week or month are unknown, mean hours by type of care schedule (regular or varied) are assigned. 
• Caregiver strain is measured using the NSOC caregiver strain scale (NSOC-CSS). The scale includes: three indicators of emotional strain (amount of emotional difficulty (0-5); frequency of feeling upset (0-5); frequency of feeling calm and peaceful (0-4; reverse coded); four indicators of non-emotional strain (amount of physical difficulty (0-5); amount of financial difficulty (0-5); leisure time restrictions (0-3); and no time for self (0-2; reverse coded); and four indicators of balancing responsibilities with caregiving (care is more than caregiver can handle (0-2; reverse coded); frequency that care interrupts sleep (0-4; reverse coded); whether exhausted at night (0-2; reverse coded); and whether care routine keeps changing (0-2; reverse coded). Each item is normalized to account for differences in the number of response categories, and the normalized items are summed to create a scale ranging from 0-11. A categorical strain measure identifies caregivers with no or very low strain (0-1), low strain (2-3), and moderate or high strain (4-11). Missing data on each scale item are recoded to the mode. See NHATS Technical Paper #54 (Freedman & Wolff, 2025), available at nhats.org, for additional details. 

• Age reflects age group at the time of the interview 
• Sex is categorized into men and women.
• Marital status classifies individuals as to their status at the time of the interview: married/partnered, separated/divorced, widowed, or never married. For caregivers missing marital status, we assigned the most common group by gender for a given year. 
• Children less than age 18 identifies caregivers with at least one minor child. Caregivers missing data are assumed to not have any children less than age 18. 
• Work status indicates whether a caregiver worked for pay last week or usually works for pay but was absent last week because of illness, vacation, or some other reason. Caregivers missing data are assumed to not be working for pay. 
• Relationship to older adult reflects whether the caregiver is a spouse, adult child (biological or step), other family, or non-family. 
• Travel time to older adult indicates the number of minutes it takes for the caregiver to get to the older adult’s home: coresident, 1-10, 11-29, and 30+ minutes. If the caregiver travels by airplane, 30+ minutes was assumed. For other caregivers missing travel time, 1-10 minutes (the modal response) was assigned. 

• Older adult race/ethnicity categorizes individuals into four groups according to their primary reported race/ethnicity: non-Hispanic White; non-Hispanic Black; Hispanic; and other race/ethnicity. Individuals reporting missing information about race/ethnicity were imputed to be non-Hispanic White or Black based on a logistic regression model with the base weight, five-year age group and sampling strata or were assigned to a race/ethnic group based on race/ethnic distribution within strata or interview language. 
• Older adult dementia status identifies individuals who meet at least one of the following criteria: a report of a doctor’s diagnosis of dementia or Alzheimer’s disease; a score indicating likely dementia on a dementia screening instrument administered to proxy respondents; or impairment based on cognitive tests that evaluate memory, orientation, and executive function (with a score of ≥1.5 standard deviations below the mean in at least two domains). For details see Kasper JD, Freedman VA, Spillman B. 2013. Classification of Persons by Dementia Status in the National Health and Aging Trends Study. NHATS Technical Paper #5. Baltimore: Johns Hopkins University School of Public Health. Available at www.NHATS.org. 
• Older adult residential setting classifies individuals into two groups: living in traditional community settings and residential care settings other than nursing homes. 
• Older adult metropolitan location reflects whether the older adult lives in a non-metropolitan or a metropolitan area.