Family Caregivers in the United States: The Hidden Backbone of Long-Term Care

Where My Journey Began

I often say my caregiving journey began long before I understood what caregiving was truly going to mean. For me, it started with my mother-in-law’s diagnosis of dementia. When Fred and I married in 2004, we didn’t just become husband and wife—we quietly became caregivers.

Her home was in Queens, New York, where attentive neighbors kept a watchful eye. But emergencies don’t come with warning labels. One day, a neighbor called my newlywed husband to report that a homeless man was staying at her house…at her invitation. Fred dropped everything, jumped in the car, and made the four-hour drive to intervene.

Before long, those trips became our trips. Four hours up. Four hours back. Managing her affairs. Untangling emergencies. Gently pleading with her to join us in Maryland.

We didn’t know it then, but this was our initiation into a community far larger, more resilient, and more compassionate than we ever realized.

A Community of Millions

What we were doing—showing up for family—is something millions of people across the United States do every single day. Family caregivers are the unseen backbone of long-term care, providing essential, unpaid support that keeps the entire care system running.

They care for aging parents, spouses, children, siblings, and friends.
They drive to appointments, manage medications, prepare meals, and offer emotional comfort that no policy or institution can duplicate.

“Family caregivers give everything: time, strength, patience, and a love that keeps another person going.”

And yet, despite the magnitude of their contributions, caregivers often navigate overwhelming responsibilities with limited support—financially, emotionally, and physically.

The staggering reality

In 2021 alone, family caregivers in the U.S. provided:

• 36 billion hours of unpaid care

• Valued at nearly $600 billion

That number—$600 billion—is higher than all out-of-pocket health-care spending in the country (AARP Public Policy Institute, 2023).

And still, many caregivers feel invisible, exhausted, or left to figure it out on their own.

You Are Not Alone

If you are reading this, whether you are new to caregiving or waist-deep in it:

Please take this to heart…

• You are not alone.

• You are not forgotten.

• What you do matters more than you know.

• You deserve help, rest, and compassion, too.

There is help out there—but sometimes help arrives only when we find the courage to say, “I can’t do this by myself.” You were not meant to carry this role in silence.

“Caregiving is not a solo assignment. Love may be the fuel, but community is the vehicle that carries you through.”