We demand training and minimum staffing levels for aides at nursing homes, where fewer than one-in-10 frail seniors live. But we do almost nothing to prepare those family members who care for about 80 percent of those needing personal assistance. We’d fire a nurse or aide with insufficient skills in a heartbeat. But we seem to expect family members to provide difficult technical care with no training at all.

The JAMA study did find that family caregivers were twice as likely to receive some training if an older adult had been hospitalized in the prior year. And family caregivers who were paid were four times more likely to receive some training than those who were not.

More often, hospitals or skilled nursing facilities do little more than give families a sheet of paper that describes (poorly) how to change dressings on surgical incisions, for example. Or a nurse may spend a few hurried minutes with a family as they were headed out the door during discharge.

Even long-term care insurance companies might be able to lower the cost of claims by training family members to help care for loved ones. In effect, with a bit of education, they could provide care that the insurer otherwise would be paying for.

Read more in Forbes.