This document describes the TEACH (Train the Elderly And their Caregivers at Home) project, a demonstration project developed by Florida's District 12 Veterans Administration and the Florida Department of Health and Rehabilitative Services to reduce Medicaid nursing home expenditures by delaying or avoiding nursing home placement and to provide improved support for informal care by the family and other caregivers. It focuses on the role of the caregiver. The TEACH service delivery model is described, issues for the caregiver now and in the future are considered, and the planned TEACH evaluation project is explained. Past policy options for addressing the issues involved in long-term care are reviewed, the purpose of TEACH services is defined, the conceptual model of TEACH service intervention is presented, and the evaluation of TEACH service hypotheses is discussed. Future requirements of caregivers are projected and three alternatives are identified: (1) purchasing care for the medically dependent through formal services, including home health, nursing home care, and other means; (2) providing requisite care at home through family members, friends, neighbors, or other informal means; or (3) some combination of these mechanisms over the period of time needed. Future caregiver problems are discussed with regard to how the TEACH evaluation effort can offer guidance to possible solutions to some of those problems. (NB)