A randomized 3-year study assessed the effect of expanded community-based services and case management on 5,254 caregivers of dementia clients. A tested policy concern was whether the financing of formal care would result in a reduction of informal assistance. Unmet needs task assistance for the demonstration's treatment group caregivers decreased by 30 percent within 6 months and by about 20 percent over 36 months relative to controls. While treatment group members used slightly more formal care over time, there were no differences between treatment and control groups in primary caregiver hours after 36 months, or in the number of tasks in which primary or secondary caregivers provided assistance.