AARP and the National Nursing Alliance recently released the 2025 Caregiving in the United States. The extensive report, released in 2020, provides a comprehensive snapshot of the ever-evolving home care landscape. It focuses on the experience of adult home care workers, identifying trends, challenges and reform opportunities.
One of the most striking findings is the rapid growth of home care. Almost one in four adults (63 million Americans) provide ongoing care for adults (59 million) or children (4 million) with complex medical conditions or disability, up 45% since 2015. This surge not only highlights the critical role of home care workers, but also continues to fail all over themselves and urgently needs to reform their staff.
Here are a few key findings from moving to parity improvements.
Caregivers’ experience and demographics
There are many caregivers. The average caregiver is 51 years old and women continue to consider the majority of caregivers (61%). They are non-Hispanic white (61%); Latino/Hispanic (16%); African-American/Black (13%); Asian-American, Hawaiian and Pacific Islander (6%). 20% live in rural areas and 24% support more than one caregiver. Most people are caring for relatives, such as parents or spouses, but 11% are caring for friends who disagree, such as friends or neighbors.
Most people are caring for relatives, but 11% care for non-comrades, such as friends or neighbors.
Nursing is a full-time job. On average, caregivers spend 27 hours per week providing care, and nearly a quarter of them provide more than 40 hours per week. One third has been five years or more, a significant increase from 2020.
Nursing trajectories vary throughout the life cycle. Care recipients are mainly older people; nearly half are over 75 years old, and most face multiple chronic diseases such as Alzheimer's disease or other dementia, mobility restrictions, cancer and postoperative recovery. Caregivers under 50 are more likely to manage short-term or mental health conditions, while elderly care workers often support people with long-term physical health problems.
The “sandwich generation” in the United States is very thin. Nearly one-third of caregivers are also raising children under the age of 18 when caring for adult relatives. Among caregivers under 50, that number rose to 47%.
Care trends and challenges
Inadequate training. Two-thirds of caregivers can help with at least one daily life (ADL), such as diet, bathing or dressing, while 84% of caregivers can help with three or more daily life (IADL), such as managing finances, preparing hot meals, shopping, shopping and housekeeping services. However, only 11% of caregivers received any formal training in preparing for these tasks, and although more than half of medical and nursing tasks (such as injection, wound care, or drug management), only more than 20% of medical and nursing tasks were formally trained.
Only 11% of caregivers receive any formal training in preparation for assisting them in their daily activities of life.
Financial pressure. Because of responsibility, nearly half of caregivers experience at least one major negative financial impact. One-third stopped saving money, while others reported taking on more debt, delayed retirement and faced housing instability.
Work while caring. Seven of the 10 working ages (18-64) family caregivers also engage in paid work. This is often a challenging balance – HALF reports work interruptions, such as being late or leaving early to take care of loved ones. They often feel isolated and face negative financial impacts, such as leaving the bill unpaid.
Workplace support. Access to caregiver-friendly workplace benefits have improved since 2015, but access remains unbalanced. Salary workers enjoy telecommuting, paid leave and employee assistance programs better than hourly workers. Additionally, many caregivers are reluctant to reveal their roles – only 49% say their supervisors know they are carers.
Only 49% of caregivers said their supervisors knew they were carers.
Community-based services. Over the past decade, it has been difficult for more and more home care workers (28%) to find affordable services for their caregivers, such as home health assistants, transportation and dining. Care workers in rural areas (34%) often have difficulty finding affordable services.
Caregivers' health. Caregivers may have difficulty maintaining their physical and emotional health. One in five people see health as fair or poor, and nearly one in four says they have a hard time taking care of themselves. Many caregivers experience high emotional stress (64%) and physical stress (45%).
Policy and planning reforms. Caregivers report that they will benefit from financial support in the form of tax credits (69%), direct payment plans (68%) or partial paid leave (55%). In addition to finance, caregivers seek services such as temporary care, emotional support and training for health care professionals. They also want to help ensure that loved ones are safe, manage complex paperwork, and plan for the future.
These findings “a springboard for action.”
As the report points out, these findings “a springboard for action – for families, policy makers and everyone who plays a role in developing systems to support and maintain important contributions to home caregivers.” This includes common sense changes to improve caregivers’ health and economic security and ensure that the country’s health care and long-term service and support infrastructure can best predict and meet growing care needs.
