MW America's 63 million family caregivers are mostly unpaid, stressed and begging for help

By Beth Pinsker

That's a huge 45% jump from 10 years ago, according to a new AARP study

Alma Valencia is the new face of caregiving. The Pasadena, Calif., resident quit her job in the fashion industry 10 years ago to take care of her mother, who has dementia, and Valencia has been struggling since to keep up with her increasing needs.

A new report from AARP and the National Alliance for Caregiving $(NAC)$ places her as just one of 63 million Americans in a similar position, which is up a staggering 45% from 10 years ago.

"I didn't plan for this, but somebody I loved needed me. It took me years to learn to care for my mother's needs, with no training," Valencia said during a press conference accounting the report, "Caregiving in the U.S."

"There's isolation, stress and the feeling that nobody sees what we're carrying," she added.

The AARP-NAC caregiving report is a much relied-upon resource to measure the caregiving crisis, and comes out every five years. This year's report surveyed 7,000 respondents, and covered ground ranging from demographic analysis to policy prescriptions that could help alleviate the pain points enumerated by the data. "It gives numbers to what so many of us face every day," Valencia said.

Some key numbers:

-- The average caregiver is 51 years old and lives with the person they care for.

-- 70% of those needing care are 65 or older.

-- Women account for 61% of caregivers.

-- 8 million caregivers are also receiving Medicaid benefits themselves.

-- 8% of caregivers are age 75 or older.

These all add up to a system in the U.S. where 1 in 4 American adults is a family caregiver. But of these, only 11.2 million family caregivers reported that they were paid for care in 2025, the study found - and most of those caregivers reported that they were only paid for some of their care, leaving a lot of their duties unpaid. With new work requirements and eligibility restrictions coming to Medicaid, many of these caregivers are in danger of losing their own benefits too.

"We need systems that value caregivers. They are holding up our entire healthcare system," said Myechia Minter-Jordan, chief executive of AARP, during the press conference.

What care is needed?

Care is measured by what are called activities of daily living (ADLs), and if a person needs help with two or more, they are usually considered eligible for services like home healthcare. The average respondent to the caregiving survey was helping with at least two of the six most basic tasks: bathing, dressing, eating, toileting, transferring and continence. But at least a third were helping with three or more of those tasks.

There are "instrumental" ADLs too, which encompass more normal life activities like managing finances, preparing hot meals, shopping, housekeeping and using transportation. Some 84% were helping with three or more of those on a regular basis in 2025, up from 77% in 2015.

Alongside this, the level of complex care required is rising quickly: 40% of caregivers are now in a "high-intensity" care situation, according to the Level of Care Index, with Black and Latino households bearing a greater share of those situations.

"What we're seeing is unprecedented complexity, with 30 million doing complex medical and nursing care like managing catheters, injections and medical equipment," said Jason Resendez, president of the NAC. Many are "sandwich generation" adults caring for their own children at the same time, which makes these demands "a recipe for burnout," he added.

And all of this is happening while only 11% of caregivers have received training of any kind, and just 22% are trained for complex medical tasks.

Policy advocacy

The caregiving report advocates for more support for caregivers - financially, emotionally and practically. One proposal, an income-tax credit to caregivers to help offset the cost of care, had the support of 69% of respondents. A similar percentage was in favor of a program where caregivers could be paid for at least some of the hours they provide care, which exists already in some states but is threatened by Medicaid cuts. Just over half were in favor of a partially paid leave of absence from work for caregivers who are employed.

Resendez is particularly concerned about the 8 million caregivers who receive Medicaid benefits of their own, as well as those those who are working their own jobs. While many caregivers report that caregiving gives their life "purpose," Resendez said: "Purpose is not a substitute for support."

He noted that expanded access to paid family medical leave is more critical than ever. "We're advocating to protect Medicaid at home from further cuts," he said.

AARP's Jordan, who is a physician, is worried that if services and benefits get cut, it could wreak havoc on the healthcare system as a whole. "If we don't take care of this, then we're going to pay for it in other places, like increased utilization of emergency departments," she said.

There's also a way for individuals and families to help themselves by saving more and planning for emergencies. "People need to be thinking about this much earlier," Jordan said. "Often, people wait until they need help. But when we think about financial wellness and planning, we can't wait until 65. We can't wait until 50."

Got a question about investing, how it fits into your overall financial plan and what strategies can help you make the most out of your money? You can write to me at beth.pinsker@marketwatch.com. Please put "Fix My Portfolio" in the subject line.

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-Beth Pinsker

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July 24, 2025 13:40 ET (17:40 GMT)

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