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Standing Up and Stepping In

A modern look at caregivers in the US
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Two women, one who's undergoing cancer treatment, walking together with linked arms.

Caregiving in America is on the rise. Broadly speaking, 100 million US adults function as caregivers, providing care for a child, parent, or other relative.1 More narrowly, there are 53 million US adults who care for a spouse, elderly parent or relative, or special-needs child.2 That’s up from 43.5 million in 2015, and includes caregivers who also work full-time jobs.3

Since most (61%) US households are dependent on two incomes to remain financially stable,4 the implications of this increasing demand for loved ones to stand in as family caregivers would upset the financial balance of the average household in the most stable of economies. But, given recent inflation and other macroeconomic pressures, the growing demand for unpaid care increases the financial strain. On a macroeconomic level, the direct cost of caregiving on the US economy is nearly $44 billion, given the loss of more than 650,000 jobs and almost 800,000 individuals with absenteeism issues at work.5

Father and son going for a run together

There’s been a sharp rise in employees functioning as unpaid family caregivers — in addition to working full time

As the demand on workers' time to care for loved ones increases, the amount of time they still need to devote to work stays the same, leaving little breathing room and creating significant challenges. Almost a quarter (22%) of individuals must split their time between full-time work and caregiving duties that often include medical and nursing tasks — effectively pulling double duty.

In 2019, only 16% of the working US population also had caregiving responsibilities, effectively pulling double duty, and in 2022 this figure rose to 22% of the working adult population

There’s also been a dramatic increase in the time that caregivers spend caregiving. In 2020, caregivers spent an average of nine hours per week providing care.7 In 2023, that has increased to 26 hours per week. Almost half spend 10–29 hours of their week devoted to caregiving, and 27% spend 30 hours or more providing care.

24% spend less than 10 hours per week on their caretaking duties, 49% spend 10 to 29 hours per week, and 27% spend 30 or more hours per week, with the mean time spent each week for a single caregiver being 26 hours.

The number of people in the adult population providing care and working outside the household has increased from 1 in 7 in 2020 to 1 in 5 today.⁸ And the average time devoted to giving personal care to another has nearly tripled since 2020.

Who are the main care recipients?

When it comes to who needs to receive care, older adults lead at 41%, which stands to reason given Americans’ generally longer lifespans, followed by special-needs children at 29%. A fifth of these recipients may include other familial relations (e.g., siblings), but many may be unrelated loved ones.

Of those who receive care, 41% are parents, 29% are special-needs children, 18% are a spouse or partner of the caregiver, and 20% are someone else.

Women are disproportionately impacted by unpaid caregiving

Working Americans who also provide care to loved ones are predominantly women — at 56% versus 44% men, an increase from 2020. As caregiving needs in general continue to increase, the disproportionate demand on women might do the same.

56% of unpaid caregivers are women versus 44% men.

Nearly a quarter of caregivers of an elderly or sick adult also have young children under the age of 18. These caregivers belong to the “sandwich generation.”

Typically, caregiving needs have been picked up by a demographic that's been termed the “sandwich generation” — workers between the ages of 35–64 who are responsible for caring for both children and aging parents. At the same time, the average caregiver age has decreased: Millennials have surpassed Generation X in being the largest cohort of caregivers who also work full time. Millennials also represent the dominant generation in the workforce today, suggesting the number of full-time working caregivers is projected to grow.

Balancing work and caregiving duties negatively impacts physical and mental health

Only 1 in 4 caregivers report good physical health, 1 in 5 rate themselves highly at eating healthy and exercising, and only 1 in 3 say they keep up with annual physicals and routine doctor appointments. This inattention to their own needs can introduce health risks for informal caregivers.

Forty-one percent of caregivers report low overall well-being — 32% more than non-caregivers.

When it comes to mental well-being, not even a quarter (23%) of caregivers report "good" mental health, and 40% say that their caregiving responsibilities negatively impact their stress levels. Almost half (47%) have experienced increased anxiety, depression, or other mental health issue in the past year — 62% more than non-caregivers. This leads to more instances of substance abuse, as 26% more caregivers than non-caregivers also report having a substance abuse problem in the past year.

Caregiving duties can harm workers' professional lives

Balancing work with caregiving responsibilities puts a strain on caregivers in ways that affect their employment prospects, working lives, and income.

One in 5 caregivers have taken a leave of absence and/or a demotion to accommodate their caregiving duties.

Research shows that caregivers experience more frequent setbacks in their careers and have less promising job prospects. They are twice as likely as non-caregivers to have experienced a layoff (6% versus 3%), and 20% say that their caregiving responsibilities have limited their career growth and job opportunities. In addition, 29% of caregivers have had to reduce their work hours as opposed to only 14% of non-caregivers. Twenty-seven percent of caregivers were out of work last year for an extended period of at least 30 days due to a condition, illness, or injury compared to only 14% of non-caregivers.

Working caregivers are two times more likely to experience their own disability-related leave of absence.

Employers can take steps to support family caregivers

Splitting time between work and caregiving tends to affect workers' perception of their employers. Twenty-three percent of caregivers don’t think their employer cares about their overall well-being, and only 44% say their benefits meet their needs. That’s compared to 63% of employers who believe their organization provides adequate support for employees with caregiving responsibilities.

Unfortunately, when caregiving employees don’t feel their needs are met, their emotional health suffers. Thirty-five percent of caregivers who say that their employer supports their caregiving responsibilities report "excellent" or "very good" emotional health compared to only 22% of caregivers who say that their employer does not support their needs.

The same trend of dissatisfaction with employee policies extends to benefits. Nearly twice as many caregivers as non-caregivers disagree that their benefits positively impact their personal health and wellness. Predictably, these low opinions lead to a lack of trust, so it's not surprising that not all caregivers feel comfortable talking with their employers about their caregiving responsibilities.

Fewer than half of workers have communicated about their caregiving responsibilities with their managers.

Caregivers may also be afraid to share details about their caregiving duties out of fear it will draw negative attention. Indeed, half of employers admit that workers’ caregiving responsibilities negatively impact their health and productivity.

There’s significant room for improvement when it comes to how employers can better support caregivers and equip their workers to effectively care for their loved ones while having a productive experience at work — and much of it starts with reducing stigma around caregiving in the workplace, as well as encouraging work-life balance.

1 Do you see yourself as a caregiver? Guardian Life Insurance, 2023

2 Dementia Caregiving as a Public Health Strategy, Caregiving, CDC, September 2024

3 ibid.

4 Two Income Families Statistics and Trends in 2023, Gitnux Marketdata Report 2023, 2023

5 The U.S. "has become a nation of caregivers," expert says, Yahoo! Finance, 2023

6 Supporting Employee Caregivers Starts with Better Data, Harvard Business Review, 2022

7 Guardian 8th Annual Workplace Benefits Study, 2020

8 1 in 5 Americans Now Provide Unpaid Family Care, AARP, 2022

Unless otherwise noted, all data are sourced from Guardian’s 12th Annual Workplace Benefits Study, 2023. The Guardian Life Insurance Company of America (Guardian), New York, New York. GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of America. © Copyright 2023, The Guardian Life Insurance Company of America.

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