It is estimated that there are 734,400 care giver households in New York State (9.6% [±] 0.8% of all households). Categorization of all care givers on a 5 level “intensity of care” measure reveals that, on average, care givers provide 22.1 hours of care per week. Highest intensity level 5 care givers (9.2% of all care givers), provide, on average, 88 hours of care per week and account for 36.3% of all care giving. The annualized market contribution of all care givers to the NYS health care system is estimated at between $7.5 and $11.2 billion dollars. The combination of care levels 4 and 5 contributed 70% of all care giving and account for about $5.2 billion in market value. Level 4 and 5 care givers are more likely than other care givers to report difficulties including the recent death of the care-receiver (p < 0.001), financial and employment setbacks (p < 0.001), emotional stress from worrying about the patient’s future condition, dealing with cognitively impaired, physically unmanageable, opinionated, virtually immobile patient’s, and insufficient support from family members (p < 0.05). Nevertheless, they also report such rewards as feeling grateful for improving the quality of the care receiver’s life (43.5%) as well as love (17.2%). Of the nearly 15% of NYS care givers who used adult day care services, all reported that these services met their needs fully or partly. However, of the 85% who did not use the service, 33.5% were negative about it. And while use of adult day care services increases with intensity of care level, there is resistance to adult day care particularly among level 3 care givers, with negative statements from 46.8% of them.