A nation of caregivers - past, present, and future expectations of caregiving

Sep 30, 2026

Uploaded by hdkawk

Record numbers of Americans are living with serious illness and disability, shifting long-term care management and financing toward older adults and people with disabilities, often relying on unpaid family caregivers. Using Spring 2025 nationally representative survey data (N=2020), the study estimates past, current, and expected future caregiving and tests associations with sociodemographic factors and caregiving responsibilities via logistic regression. Results show one in four reported caregiving in the prior year and 60% expected future caregiving, without political-ideology differences.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Introduction

Methods

Results

Conclusion

Key words

A nation of caregivers: past, present, and future expectations of caregiving Katherine E.M. Miller 1,2, *, Jennifer L. Wolff 1, Brian C. Castrucci3, Sandro Galea4, Catherine K. Ettman 1 1 Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA 2VA Partnered Evidence-Based Policy Resource Center, Boston VA Health Care System, Boston, MA 02130, USA 3Office of the President, de Beaumont Foundation, Bethesda, MD 20814, USA 4Office of the Dean, School of Public Health, Washington University in St. Louis, MO 63130, USA *Corresponding author: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 1812 Ashland Ave, Baltimore, MD 21205, USA. Email: [kmill177@jh.edu](kmill177@jh.edu) Abstract Introduction: Record numbers of Americans are living with serious illness and disability. Increasingly, older adults and persons with disability will be responsible for managing and financing their care needs into older age, putting more onus on individuals and their families to arrange care. Understanding the current and expected caregiving landscape can inform efforts to prepare for future population needs. Methods: We used nationally representative survey data collected in Spring 2025 (N = 2020) to estimate the prevalence of past, current, and expected future caregiving and examine the association of sociodemographic characteristics and caregiving responsibilities using logistic regression. Results: We found that one in four U. S. adults reported caregiving within the last year, and most (60%) expected future caregiving responsibilities, corresponding to over 155 million adults. After adjusting for socioeconomic characteristics, the strongest positive predictors of expected caregiving were prior or current caregiving experiences. We found no significant difference in anticipated future caregiving across political ideology. Conclusion: Our findings collectively underscore the universality of caregiving, and, within the context of scarce long-term care insurance uptake and declining funding for Medicaid, amplify the importance of scaling policies that support current and future family caregivers who provide the bulk of long-term care in the United States. Key words: caregiving; long-term care insurance; Medicaid. Introduction A record number of Americans reached age 65 in 2024,1 reflective of the ongoing demographic transition of population aging.2 Although 70% of older adults are expected to develop physical or cognitive disabilities that are severe enough to require long-term care,3 nearly half do not anticipate long-term care needs, and 62% incorrectly believe Medicare will pay for nursing home care.4 Consequently, most older adults have not planned for long-term care needs and are therefore exposed to potentially high out-of-pocket costs.4 In 2011, the former First Lady Rosalynn Carter testified during a Senate hearing on the reauthorization of the Older Americans Act and said: “I like to say that there are only four kinds of people in the world-those who have been caregivers, those who are currently caregivers, those who will be caregivers, and those who will need caregivers.” Carter’s highly cited comment captures the ubiquity of caregiving, that people from all walks of life—across age, sex, race, education, geography, and political affiliation—can become family caregivers or will need care during their lives.5 While caregiving has historically been provided by women, the gender gap has decreased in recent years, with approximately 40% of caregivers currently estimated to be men, making caregiving an increasingly common, and shared, experience.6 Similarly, while caregiving can vary by race and education, caregiving is experienced by people of all backgrounds, regardless of sociodemographic characteristics, place of residence, or political affiliation.5–12 While nationally representative surveys document car

FAQs

What does the study examine about caregiving?

It estimates the prevalence of past, current, and expected future caregiving and evaluates how sociodemographic characteristics and caregiving responsibilities are associated with these expectations.

How common is caregiving and expected future caregiving among U.S. adults?

One in four U.S. adults reported caregiving within the last year, while most (60%) expected future caregiving responsibilities, corresponding to over 155 million adults.

What predicts expected future caregiving in the analysis?

After adjusting for socioeconomic characteristics, prior or current caregiving experiences were the strongest positive predictors of expected caregiving.

Sep 30, 2026

Uploaded by hdkawk