In this article, the author presents a historical overview of four decades of scholarship and changing public policy on family and informal caregiving for older adults. Families are changing at a dizzying pace. Changes in family composition, cultural diversity, geographic mobility, and societal norms, coupled with increasing numbers of older adults living with high levels of disability, are changing how caregiving for older adults is balanced among families, informal networks, and formal supports. Social policy, practice models, and empirical research have not kept pace with these changes. This country has yet to develop a comprehensive, integrated, long-term care system that views informal caregivers both as care partners and as service recipients in their own right. Moreover, recent policy changes designed to reduce government expenditures put families at risk for having to take on even greater care responsibilities. For better and for worse, communication and technologic interventions are gradually replacing some forms of direct human contact. It is still unclear whether older adults and their caregivers will become more isolated or whether new social contracts within families and between families and society will arise, rooted in the belief that even disabled older adults have a contribution to make, that they deserve to have their basic needs met, and that families should not be solely responsible for meeting those needs.