National Alliance calls caregivers infrastructure

Family caregiving sounds private. A daughter helps her dad after surgery. A spouse manages medications. A parent learns to use feeding equipment. But that “private” work is now doing a huge amount of public-system labor. That is the point the National Alliance for Caregiving is trying to drive home with its Caregiving in the US 2025 data and its newer language around caregivers as “essential” or “invisible” infrastructure. ### What changed here? The big change is not just a new report. It is the frame around the report. NAC and AARP released Caregiving in the US 2025 in July 2025, then NAC spent the following months pushing a broader argument: stop treating caregiving as a private family issue and start treating it as part of the country’s healthcare and economic infrastructure. That is a political and cultural shift, not just a research update. (caregiving.org) ### Why call caregivers “infrastructure”? Because infrastructure is the stuff a system quietly depends on. Roads do that. Power grids do that. Family caregivers do that too — just without the same visibility or funding. They manage appointments, medications, bathing, transportation, meals, paperwork, and increasingly complex medical tasks that used to sit more clearly inside clinics, hospitals, or paid home care. If that work disappeared, the formal care system would seize up fast. (aarp.org) ### How big is this, really? Bigger than a lot of people realize. The 2025 report puts the number at 63 million family caregivers in the US — about 1 in 4 adults. That is up from 43 million in 2015, a 45% jump in a decade. Nearly a third are “sandwich generation” caregivers, meaning they are caring for both children and adults at the same time. (aarp.org) ### What kind of care are they doing? Not just errands and check-ins. More than 40% now provide high-intensity care. Many handle injections, wound care, or medical equipment, but only 22% receive training for those complex tasks. That gap is one reason the infrastructure metaphor lands — the system is relying on people to do skilled work without building the support around them. (caregiving.org) ### Who is carrying the load? Mostly working-age adults, and disproportionately women. The average caregiver is 51. One in three is under 50. About 61% are women. Seven in 10 caregivers are employed, and 61% say caregiving affects their work life. So this is not a niche issue sitting off to the side of the labor market — it is woven into it. (aarp.org) ### What does the strain look like? It looks expensive, exhausting, and isolating. About half of caregivers report negative financial effects. One in five has taken on debt. One in four feels isolated. Two-thirds face moderate to high emotional stress. And the pressure is not evenly spread — Black, Latino, rural, lower-income, and hourly workers often have less cushion and fewer workplace benefits. (caregiving.org) ### Why does this framing matter in policy fights? Because language decides what government and employers think they owe. If caregiving is framed as a private moral duty, support looks optional. If caregiving is framed as infrastructure, then training, respite care, paid leave, tax credits, Medicaid supports, and workplace protections start to look like maintenance spending for a system everyone relies on. That is basically the strategic move NAC is making. (caregiving.org) ### What is the bottom line? The new idea is simple, but it changes the stakes. Family caregivers are no longer being described as invisible helpers around the edges of healthcare. They are being described as part of the machinery itself. Once you see the scale — 63 million people doing complex, often unpaid care — it gets much harder to pretend the system runs without them. (caregiving.org) (aarp.org)