The State of Family Caregiving in the United States

Takeaways

• A 2025 report estimates 63 million Americans are family caregivers, with a significant number providing high-intensity care involving complex medical and daily living tasks, often without training.
• Caregiving exacts a heavy toll, resulting in negative financial effects and health decline for those providing care, especially those juggling employment.
• Caregiving experiences and available support vary significantly by state. Caregivers may benefit from proactively assessing their state's resources, seeking training, and planning for their own financial and health well-being.

Last month, AARP and the National Alliance for Caregiving published a joint report titled Caregiving in the U.S. 2025: Caring Across States. According to the research, an estimated 63 million Americans are serving as family caregivers. That is roughly one in four adults providing often unpaid care for a relative or friend with a disability, chronic illness, or other serious condition. The report also shows how caregiver experiences can vary across states.

Key Findings

Intensity and Complexity of Care

Family caregivers perform a range of tasks for their care recipients that vary in time commitment, physical demands, and complexity. About 44 percent of caregivers are in high‐intensity caregiving situations, meaning they spend a significant amount of time each week helping someone else with activities of daily living (ADLs), such as getting dressed or bathing. They may also experience difficulty coordinating care and may be their care recipient’s only helper.

The study found that 28 percent of caregivers provided either constant care or at least 40 hours of care per week. Nearly two-thirds of family caregivers assist their care recipient with at least one ADL, and almost a quarter of caregivers reported that these tasks are difficult to perform. Across the country, nearly all (99 percent) caregivers also help their care recipients with instrumental activities of daily living (IADLs), such as meal preparation, financial management, housework, and transportation.

According to a related report published earlier this year, about 55 percent of caregivers reported doing medical or nursing‐type tasks, such as giving injections and managing catheters, yet only 22 percent have received training for these tasks.

These reports show that for people caring for persons with disabilities, the demands can be substantial, and in many cases, caregivers are giving complex care without formal preparation or support.

Financial and Health Effects

Nearly half of family caregivers said caregiving has negatively affected their financial situation. Some reported that they have stopped saving or have had to dip into their savings. Others said they have taken on debt or paid bills late or not at all.

Health and well-being is another area where caregivers take a hit for their caregiving. One in five said they are in fair or poor health, and nearly a quarter reported that they are struggling to care for themselves.

Though 60 percent of caregivers also have a job, employment presents extra challenges and stresses. Working caregivers reported financial difficulty and feelings of loneliness more often than nonworking caregivers. Caregiving is likely to interrupt their work, and they may find that their workplace lacks sufficient support for their caregiving responsibilities.

For family caregivers of people with disabilities, this means they’re at risk not just of burnout, but also financial instability and health decline, especially if they are juggling work, caregiving, and other life demands.

State-by-State Variation

One of the standout insights from the study is that caregiving experiences are shaped by state policies, local supports, and the availability of services. The intensity of care (hours and tasks) differs by state, as does the financial burden and availability of paid caregiving support. Workplace support, respite services, and state policy frameworks differ as well.

In short, two caregivers with similar care‐recipient needs may have different experiences depending on where they live. That’s especially relevant when caring for someone with disabilities, where the caregiver may need to provide consistent long‐term support.

What This Means for Caregivers of Individuals With Disabilities

Know Your State’s Landscape

The report shows how each state stacks up with regard to support, services, paid caregiving options, and other factors. Depending on where you live, you may need to plan proactively to seek help from nonprofits, advocacy groups, or alternative supports.

Assess the Intensity of Your Caregiving Role

If you’re caring for someone with disabilities, chances are you’re doing more than “check-in” care. The data show many caregivers take on high-intensity tasks, so it’s important to recognize this and plan for support, such as training, respite, and self-care.

The report highlights caregiver health risks. Caring for someone with a disability often includes emotional strain, physical demands, and potential isolation. Build in time for yourself, in the form of respite, peer support, or therapy, and monitor your health.

Plan for Financial Workplace Implications

Hidden costs of caregiving, such as lost wages, poorer health, and burnout, are real. If you work while caring for a loved one, explore whether your employer offers flexible hours, remote work, paid leave, or whether there are state or federal programs that help.

Advocate for or Access Training

Only a small percentage of family caregivers get training for medical and nursing tasks. Consider seeking training through your local disability services, home health agencies, or state caregiver support programs. This helps your care recipient and protects your own well‐being.

Questions to Consider

• What caregiver supports are available in your state or where your care-recipient lives? These may include paid caregiver programs, training, respite services, or disability agency supports.
• How many hours do you (or your loved one’s primary caregiver) spend each week on caregiving? Does it qualify as high-intensity by the report’s standards (40+ hours or many ADLs/IADLs)? Recognizing that helps in planning.
• Are you taking on medical or nursing tasks without formal training? Seek credentialed training or a refresher to reduce risk to yourself and the person you’re caring for.
• How is your work life affected if you are juggling employment and caregiving? Explore making an employer accommodation request, working remotely, changing your schedule, or using state or federal caregiver leave options.

The Caregiving in the U.S. 2025 report highlights the monumental role family caregivers play in our country, especially those caring for individuals with disabilities or complex needs. The sheer scale, intensity of care, and massive variation from state to state all underscore that caregiving is both a national issue and a local one.

If you are a family caregiver, your state’s policies and supports matter. Use the report to inform your planning, advocate for services, and seek supports that help you and your care recipient thrive.

For additional reading on topics related to caregiving for people with disabilities, check out the following articles:

• Caring for Yourself and Your Child With Special Needs
• AI Tools Can Support Families Navigating Special Needs Care
• Respite Care for Caregivers of Loved Ones With Disabilities
• Medicaid Coverage and Home Care
• Special Needs Planning for Blended Families