America’s caregivers are facing significant financial consequences and are struggling to afford basic needs like food and housing. And their health is only fair or poor with one out of every four feeling completely alone, according to the latest Caregiving in the U.S. report from AARP and the National Alliance for Caregiving. Despite these challenges, more people will become caregivers in the coming decades with fewer resources and support.

Approximately 63 million family caregivers, or about one in four American adults, provide care to an adult 18 or older or a child with a complex medical condition or disability, usually for no pay, the report revealed. That’s a 45% jump from a decade ago.

Yet, given the 2026 budget bill, many of the services and supports they rely on will likely see significant cutbacks or disappear completely, according to AARP CEO Dr. Myechia Minter-Jordan. 

“They are holding up our entire health care system,” Minter-Jordan said during a July 24 press briefing. The report is based on a national survey of some 7,000 caregivers.

More complex care

The reality is much more complex than the numbers suggest, said Jason Resendez, president and CEO of the National Alliance for Caregiving. Caregivers are providing increasingly more complex care like wound care or infusion therapy, as older adults live longer with multiple serious health conditions and overwhelmingly prefer to age at home or in their own communities. There are about 60 million people 65 and older in the U.S., a number projected to increase to 80 million by 2040. But, the gap between longevity and healthy longevity is about 13 years, a gap caregivers must fill.

Only 13 states and the District of Columbia have established a paid family leave policy. Others, like Nebraska, have enacted caregiver tax credits, while Washington has created a long-term care insurance policy. These policies aren’t nearly enough, and there’s still plenty of room for progress, including action by the federal government to translate this urgency into solid action, Resendez said.

Why this matters

Journalists can keep this issue front and center by including local caregivers’ voices in their reporting, and weaving these local accounts together to create a national picture of how this caregiving crisis is impacting America — encompassing workforce and economic issues, physical and mental health, immigration, the strain on health systems and programs, and hard choices for national and state policymakers. “States are going to be faced with even tougher choices going forward,” Minter-Jordan said.

Another angle reporters can look at is the increasing diversity of family caregivers. While women continue to shoulder the bulk of the nation’s caregiving responsibility, about 40% of caregivers now are men, Resendez said. “That’s a big opportunity to pull back the curtain on the caregiver experience among men to build solidarity and some of that political will,” he said. The national conversation happening around the role of men and boys in society is equally applicable to caregiving. 

There are also more younger caregivers, according to the report. While the average age of family caregivers is 51, there are 4 million Americans under the age of 18 who are part of caregiving teams — an underreported angle to pursue. Ask how high schools and colleges are responding to support and identify these younger family caregivers. Or how caregiving impacts education mobility and economic opportunity. 

“I think these are rich areas for local and national coverage,” Resendez said.

The ‘sandwich’ generation

One in three caregivers (About 17 million) is part of the “sandwich” generation that cares for both younger children and aging parents. And more families, especially from certain cultures, live in multigenerational households. How will housing policy adapt to meet this growing trend? 

“This dual responsibility is a recipe for burnout and requires solutions that recognize caregiving happens across the lifespan,” Resendez said.

Don’t neglect coverage on the impact of Medicaid cuts on caregivers either. Nearly 8 million caregivers who rely on Medicaid coverage for their health care will now be subject to increased eligibility checks and work requirements. Home and community-based services and consumer-directed programs at the state level provide support for about 11 million caregivers as part of their caregiving journey. 

Those paths will likely diminish because of tough choices states will have to make in terms of what to fund with fewer federal Medicaid dollars, Resendez said. “Historically, when states have less money and are forced to make decisions, home and community-based services are the first optional benefits to get cut, and that will impact these consumer-directed pathways,” he added.

‘Bold’ policy solutions

The advocacy arms of the AARP and the National Alliance for Caregiving are pushing for what Minter-Jordan called “bold” policy solutions:

  • A national paid family and medical leave policy.
  • A federal tax credit to ease out-of-pocket costs.
  • Greater access to respite care, training and support services.
  • Stronger workplace protections recognizing caregiving responsibilities.

Minter-Jordan said AARP is seeing progress at the state level in Oklahoma, Nebraska, Maine and Michigan with policies like caregiver tax credits and expanded respite services, but most caregivers still lack the support they need.

The National Alliance for Caregiving is advancing complementary strategies:

  • Expanded access to paid family and medical leave.
  • Strengthening Medicare recognition of family caregivers as essential partners.
  • Caregiver training service reimbursement codes.
  • Reauthorizing and fully funding Older Americans Act programs.
  • Protecting home and community-based services (HCBS) through Medicaid from cuts.

Despite the challenges, just over half (51%) of caregivers report that their role gives them a strong sense of purpose and meaning in their life.

“Our data shows remarkable resilience among family caregivers, but purpose is not a substitute for support,” Resendez said. “We need a comprehensive national response.”

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