Spousal caregivers are significantly more likely than other family caregivers to perform the complex medical tasks of professionals while being far less likely to receive vital support, according to new findings published by the United Hospital Fund and the AARP Public Policy Institute.

Spousal caregivers tend to be older, less educated and less financially stable than non-spousal caregivers, such as adult children or siblings. The average age of a spousal caregiver is 64, a decade older than non-spousal caregivers, according to the 2011 survey of more than 1,600 caregivers. Nearly 50 percent of spousal caregivers have only a high school education or less, and more than half have incomes of less than $50,000. Only one-third are employed.

The most common physical health conditions of spousal care recipients are stroke and hypertension, musculoskeletal diseases (arthritis), heart disease, diabetes, cancer and lung disease. Spouses may be less attuned to changes in cognitive status and sensory deficits, because they spend so much time with their spouses, according to the study.

“The challenges spouses who are caregivers face are daunting,” said Susan Reinhard, senior vice president and director of the Public Policy Institute and co-author of the report. “Nearly three-quarters of the spouses they care for were taking five or more medications, which are not easy to coordinate. And some of these medications were administered in non-pill forms, including injections and infusion pumps, with greater frequency than one might expect.” Nearly half of spousal caregivers provide care for three years or more.

The researchers said they expected to see caregivers reporting their help with activities of daily living, such as bathing, dressing, eating, shopping and managing finances. However, most spousal caregivers also reported performing complex medical and nursing tasks, including medication management, wound care, and using meters or monitors. Seventy-three percent of spouses who said that medication management was one of their two most difficult medical tasks performed it at least daily.

While all family caregivers reported their care recipients received few home visits from health care professionals, spouses fared far worse: 84 percent of spousal care recipients received no home visits, compared to 65 percent of non-spousal care recipients. More than half of spousal caregivers also reported receiving little to no help from friends or family.

“As a former spousal caregiver, I certainly understand the desire to take care of all of a spouse’s needs,” co-author Carol Levine, director of the Families and Health Care Project, told AARP. “But the care that is needed and the responsibilities thrust upon family caregivers by our health care system— typically, without adequate support— are more than any family caregiver, particularly an older spouse, can handle alone.”

It remains unclear why spouses receive less support, but the research suggests it could be due to a lack of awareness about resources, financial limitations or fear of losing independence. Reinhard and Levine call for additional research on spousal caregivers to help better tailor interventions that support, but do not supplant, the bond between spouses. “Spouses may know their partner, but they are not trained to be nurses or social workers.”

In 2009, there were an estimated 42 million unpaid caregivers in the U.S., providing an estimated $450 billion worth of unpaid care to adult and aging relatives and friends, according to an AARP survey.