Aging in America News

| Harry Margolis

| Reposted with permission from Risking Old Age in America on Substack

| Two recent reports of the number of family caregivers in the United States, one from the Bureau of Labor Statistics (BLS) and the other a survey by the National Alliance for Caregiving (NAC) and the AARP peg the figure at 38 million or 63 million, a big range. The different results depend in large part on who they include. BLS counts only unpaid providers of elder care, while NAC adds in family members who are paid and those providing care to children with disabilities.

BLS Results

BLS finds that in 2023 and 2024, almost 15% of Americans aged 15 or over were providing unpaid care to someone aged 65 or older. Elder care itself is defined broadly as involving “a range of care activities, such as assisting with rooming, preparing meals, and providing transportation. Elder care also involves providing companionship or being available to assist when help is needed, and thus it can be associated with nearly any activity.”

By age, 6 out of 10 caregivers were 45 or older, with almost a quarter of people between ages 55 and 64 serving in this role. Women provided more elder care than men, with 28% of women in this age group doing so, compared to 20% of men.

But older caregivers seem to be providing more care, with 40% of those ages 65 and older providing on average almost five hours of care on any given day. They were also much more likely to be providing care to a spouse, with 28% doing so, compared to just 6% of those aged 55 to 64, and hardly anyone under 55.

The younger caregivers were much more likely to be caring for a parent, with 71% of caregivers aged 45 to 54 doing so. Those caring for a parent spend less time than older caregivers, about an hour a day on average.

BLS reports that 4.2 million caregivers were part of the so-called “sandwich” generation, providing care to a parent while still having children under age 18 living at home. Another 3.4 million with children at home were providing care to someone other than a parent and therefore should perhaps be counted as members of the “sandwich” generation.

NAC/AARP Results

NAC and the AARP conduct their survey of caregivers every five years. Their Caregiving in the U.S. 2025 report is broader than that of BLS because it includes people providing care to family members of any age, including children under age 18 who have disabilities. But excluding children, it finds that 59 million Americans provide care to another family member aged 18 or older, a 48% increase from 40 million a decade earlier.

They report that approximately 11 million family caregivers are paid under new Medicaid home- and community-based programs. The availability of such programs varies considerably from state to state.

Similar to the BLS report, the NAC/AARP survey finds that 6 out of 10 caregivers are women and a third are between the ages of 50 and 64. Six out of 10 in this age group are caring for a parent or parent-in-law, 12% for a spouse and 8% for a child. Nearly half of caregivers who are 75 or older care for a spouse.

Four in 10 caregivers live with their care recipient, and a fifth of them provide 21 or more hours of care a week. A third of family caregivers also have paid assistance.

The duration of caregiving ranges considerably, with a quarter having provided care for less than half a year and 15% for 10 or more years.

The NAC/AARP survey conducted a deep dive into the type of care provided. About two thirds of care recipients need assistance, with at least one of the six activities of daily living: dealing with incontinence, toileting, feeding, bathing, getting dressed, and getting in and out of beds and chairs. Almost all caregivers assist with one of the “instrumental” activities of daily living: shopping, transportation, housework, meal preparation, finances, giving medicine, or arranging outside services.

An increasing number of family caregivers are using some form of remote monitoring device, a quarter in 2025 as compared to 13% in 2020. These might include home cameras or wearables such as smart watches.

Seventy percent of caregivers between the ages of 18 and 64 are also employed, with 60% of them working 40 or more hours a week. Their employers are providing more benefits than was reported in previous surveys, including paid sick days, paid and unpaid family leave, flexible hours, remote work and programs to help caregivers.

But it’s still hard to juggle work and caregiving, with 56% employed family caregivers saying they had to go in late, leave early, or take time off from work due to their caregiving responsibilities, 18% having reduced their hours of work and 16% taken a leave of absence.

Fifty-six percent of family caregivers report some financial strain due to their caregiving responsibilities, with 18% experiencing significant strain. The negative effects strike Black and Hispanic caregivers more severely on average than white or Asian Americans.

In terms of support that caregivers seek, two thirds would like financial assistance through a tax credit for the cost of care or programs where they might be paid. Just over half would like paid family leave from employment. Four out of 10 would seek respite services, and a third say they would benefit from more attention from health care providers on their needs as caregivers.

The bottom line is that family caregiving is the core of elder care and the more family caregivers can be supported, the less stress there will be on the rest of the elder care system.

A longtime elder law attorney, Harry Margolis founded ElderLawAnswers.com, answers consumer estate planning questions at AskHarry.info, and hosts the podcast Risking Old Age in America.