Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are family caregivers of someone age 65 and older who needs help because of a limitation in their physical, mental, or cognitive functioning. As a society, we have always depended on family caregivers to provide the lion's share of long-term services and supports (LTSS) for our elders. Yet the need to recognize and support caregivers is among the most significant overlooked challenges facing the aging U.S. population, their families, and society.

For decades, demographers, gerontologists, health researchers, health care professionals, economists, and other experts have called attention to the nation's rapidly aging population. However, little action has been taken to prepare the health care and LTSS systems for this unprecedented demographic shift. By 2030, 72.8 million—more than one in five U.S. residents—will be age 65 or older. The greatest growth will be in the numbers of the “oldest old,” the population that is most in need of help because they are the most likely to have physical, cognitive, and other functional limitations.

The increasing diversity of older Americans may further increase the demand for caregivers because data indicate that older African-American and Hispanic adults have been more likely than white adults to have functional impairments. In less than 15 years, nearly 3 in 10 older Americans will identify as a member of a minority group. Differences in culture, along with differences in income, education, neighborhood environments, lifetime access to health care, and occupational hazards will have a significant impact on the need for care, the availability and willingness of family caregivers to provide it, and the most effective and appropriate ways to provide caregiver support. Developing programs and services that are accessible, affordable, and tailored to the needs of diverse communities of caregivers presents significant challenges.

While the need for caregiving is rapidly increasing, the pool of potential family caregivers is shrinking. Families have fewer children, older adults are more likely to have never married or to be divorced, and adult children often live far from their parents or may be caring for more than one older adult or their own children. In the past, families could rely on women to provide what is often referred to as eldercare, especially daughters, daughters-in-law, and wives who were not in the workforce. Today, the typical caregiver is still female. But that caregiver is almost as likely as a male caregiver to be employed, to need employment income, and to have limited schedule flexibility to juggle caregiving, work, and other responsibilities.

Family caregiving is a critical issue of public policy. The committee calls for a transformation in the policies and practices affecting the role of families in the support and care of older adults. Today's emphasis on person-centered care needs to evolve into a focus on person- and family-centered care. The committee urges that support of family caregivers be recognized as an integral part of the nation's collective responsibility for caring for older Americans.

Read the full article about family caregiving at National Academy of Sciences.