In 2024, 59 million family caregivers in the United States provided 49.5 billion hours of unpaid care. AARP’s Valuing the Invaluable 2026 report values that work at more than $1 trillion a year, more than annual Medicaid spending and the equivalent of 23.8 million full-time workers, or about 17 percent of the country’s full-time workforce.

Rita Choula, who oversaw the report, says the number exists to make invisible work visible. Hours are climbing because families are taking on clinical tasks, from medication regimens running to ten or twenty drugs to wound care. Her first policy ask is financial relief, because caregivers spend over $7,000 a year of their own money.

Ishanya Anthapur: One of the largest workforces in America, equivalent to about 17% of the full-time workforce, is one that most people probably never even think about. In 2024, 59 million family caregivers provided nearly 50 billion hours of care to aging parents, spouses, relatives and loved ones. If that care were paid at market rates, it would be worth more than one trillion dollars annually. Yet most of that labor remains unpaid, invisible and, in many ways, largely unsupported.

This is AI-Powered Caregiving, and I’m your host from Zemplee, Ishanya Anthapur. Joining us today is Rita Choula, Director of Caregiving at AARP’s Public Policy Institute. Rita has spent her career researching aging, long-term care and the critical role family caregivers play in our healthcare systems. Today we’re diving into a fascinating recent report on family caregivers that she and her team oversaw, called Valuing the Invaluable 2026, which you can find on AARP’s website. Welcome to the podcast, Rita.

Rita Choula: Thanks for having me, Ishanya.

Ishanya Anthapur: Before we dive into the report, I’d love to understand a bit about your personal connection to caregiving. You’ve spent so much of your career studying aging and family caregivers, and working on policy around that. Was there a specific experience that drew you to this field?

Rita Choula: Absolutely. We talk all the time about how caregiving touches every family, and my situation is an example of that. I started caring for my grandmother when I was in my mid-20s, as she aged. Then, pretty quickly after she passed away, my mom, who was only in her mid-50s at the time, started exhibiting symptoms that were just very different. We knew that something wasn’t right. Fast forward past misdiagnoses of Alzheimer’s: three years later, we found out that she had frontotemporal degeneration, popularly known as FTD.

It is a very challenging condition to care for someone with, especially because it impacts younger people. So I was in my late thirties, caring for my mom. Fast forward a year or so, I had my first child, and two years later another child. So I was part of what we call the sandwich generation. I was sandwiched in between care at both ends of the lifespan, and it was extremely challenging, especially because I was working full time.

So it was really the care of my grandmother that brought me into the caregiving field. But I continued in that space because of my experiences. While I would do it a hundred times over — caring for my mom, my grandmother and whomever else — I would not want individuals to have to go through many of the challenges that I faced. So that’s how I spend my days: very passionate about ensuring that other individuals providing that same care really have the chance to be the daughter, the granddaughter, the son, the uncle, whatever their relation is to the person they’re caring for, and not be faced with so many challenges.

Ishanya Anthapur: Well said. It sounds like you’ve really had personal experience with the ups and downs of caregiving, and that’s what drives your passion in this work.

One of the more striking findings of the report your team recently put out, Valuing the Invaluable 2026 — which puts a value on the unpaid labor family caregivers undertake in America — is that the hours family caregivers are putting in keep growing. They’ve gone up from 36 billion hours in 2021 to close to 50 billion hours of care in 2024. From what you’re seeing, what’s driving that increase in the hours of care?

Rita Choula: One thing we know is that while we are living longer, we’re not always living healthier. As we age, and even before you get to being older, you can have different conditions, and many times that really impacts how we’re able to care for ourselves and the support and help we need. So what we see is more family caregivers, more families and more friends really stepping in to help their family members and others with various activities.

We see individuals who are providing transportation, preparing meals, helping with bills. But we also see individuals increasingly doing complex care. When we look at that complex care, it goes beyond the trip to the doctor. It becomes someone who is managing a heavy medication regimen — helping someone take five or more medications, oftentimes in the tens and twenties. We also see individuals providing wound care. Think about the types of care you would typically expect someone to get from a registered nurse or another healthcare professional. Family caregivers are being asked to do those things right now.

So that’s what we see adding not just to the type and complexity of care being provided, but also to the number of hours individuals are having to take to provide that care.

Ishanya Anthapur: Do you think the cost of having a formal RN or a formal caregiver come in is also a factor, maybe having families rely more on each other to accomplish some of these tasks?

Rita Choula: Absolutely, absolutely. We know that the cost of formal care is continuing to rise, and it’s getting increasingly challenging for family members to write a check, so to speak, to have paid care workers come into the home. So who then is left standing in the gap? It is that family member, that friend, who recognizes the need, but the money is not there to provide that support. So they’re taking it on themselves.

Ishanya Anthapur: That’s something we totally understand at Zemplee. The cost of formal care is rising and is already out of certain people’s reach, and it’s something we’re hoping to change. So it’s really fascinating to hear that you’re seeing that too.

I’m wondering if you think more and more generations are getting involved with family caregiving because, as you said, people are tending to live longer. I wonder if caregiving is spreading from just the daughters or the sons to the granddaughters, grandsons and so on.

Rita Choula: Absolutely. We are increasingly seeing younger caregivers. To your point, a lot of times when we think about caregiving, we picture that caregiver being in their 50s or older. But increasingly, we’re seeing family caregivers in their forties, thirties and even younger. And the impacts of providing care at those various life stages are something we can’t ignore.

Being responsible for someone when you’re 20 and trying to go to college while you’re caring for a parent or another family member can be incredibly challenging. We see individuals in their 30s and 40s at that life stage trying to progress in their careers. They’re having to make difficult choices in their own careers and their own lives based on the care they’re providing and the responsibilities being asked of them.

Ishanya Anthapur: The report says the unpaid family caregiver work is equivalent to upwards of a trillion dollars. That actually exceeds annual Medicaid spending and private-sector healthcare spending in the US. When people hear that one trillion dollars — the value of that care, if we put a monetary value on it — what do you hope they understand? How would putting a number on it help, say, the 30- or 40-year-old who knows they need to make some trade-offs to give unpaid care?

Rita Choula: I think our hope is that it makes it real. When we think about family caregiving, oftentimes we look to the other. We talk a lot about how the role of family caregivers, and what they’re doing, is invisible. This trillion-dollar number is a huge number. When you go to someone and say, you’re part of a trillion dollars in unpaid care, it’s really hard to get your head around.

But what we want is for individual caregivers to see that they’re not alone. So often in the caregiving role, you really feel like it’s just you. But the reality is that there are millions of family caregivers quietly, almost invisibly, holding up our care system each and every day. And this number shows that. It shows the types of care being provided, and how all of those hours of care, those 50 billion hours, really add up to that $1 trillion in unpaid care.

What happens if that family caregiver suddenly goes away? One of the numbers we talk about in the report is that $1 trillion is the equivalent of nearly 24 million full-time workers earning $20 an hour. So the more you break down what that number means, the more you see how essential family caregivers are. This really is a wake-up call about what they’re doing without pay, and too often without resources and support.

Ishanya Anthapur: I think that’s really valuable, to be able to say, hey, your labor is being recognized in some way. It’s being recognized in this report, and you can even put a monetary value on it, and some people’s brains work that way. It’s a good way to measure the scale of caregiving and show, as you said, Rita, that there is so much family caregiving going on in America. It’s not really talked about, but the value of it is huge. It’s immeasurable. We’re talking Elon Musk numbers here.

Do you think being able to value this can influence policymakers, employers or healthcare systems?

Rita Choula: Absolutely. If we look at that trillion-dollar number and realize that these are individuals, individual families, behind that number, it helps us see the reality of what is happening. What we’re seeing is that policymakers, employers and, as you said, healthcare professionals within systems and in the community are really starting to recognize the role these family caregivers play, and what happens when they’re not supported.

We do a lot of work in this space to make sure these different organizations know that family caregivers aren’t just an addendum. They’re not just on the side. They are what is keeping things moving. They’re a critical part of that care infrastructure.

Ishanya Anthapur: Certainly. You mentioned it would be equivalent to 24 million full-time workers, which I got from the paper is just under 20% of the entire US full-time workforce.

Editor’s note: The report puts 23.8 million full-time workers at about 17 percent of the U.S. full-time workforce, the figure used at the top of the episode.

If policymakers, employers and the people who design benefits packages were to hear these numbers, we would hope they’d think about what would happen if that workforce disappeared overnight — if caregivers were called in for longer hours at work and just couldn’t do family care anymore. What would happen to the entire healthcare and long-term care system?

Rita Choula: Well, let’s think about it. The impact would be enormous. At the top of our conversation, I talked about all of the complex care tasks family caregivers are providing, in addition to transportation and paying bills. I always like to say: what if family caregivers went on strike for a week? Who would take care of the individuals they’re currently caring for? We know there are millions of older adults, and people living with disabilities, who rely on family caregivers every day. Who would take care of them?

That goes back to my point. Too often we talk about what family caregivers are doing as invisible. Honestly, I’d say it’s being ignored. It’s being taken for granted. And it’s not until that care stopped happening — and we know that’s not going to happen — that people would really begin to realize the critical infrastructure family caregivers provide.

Ishanya Anthapur: Definitely. And I like your point that caregiving isn’t just about taking care of an older parent or older loved one. It takes so many forms and shapes, from caring for a sibling with a disability to what you were doing, and what so many other people are doing, which is several of those at once. You have an older parent, a sibling with a disability and children at the same time, and you’re managing a full-time job.

At Zemplee, we are in awe of family caregivers, in whatever shape or form that takes. Something I’ve heard from family caregivers is that they just feel alone. They don’t know if they’re doing a good job, and no one’s there giving them a pat on the back. You’re just not getting any appreciation. So seeing this report, seeing the numbers, seeing a value put on it, is really impactful and really powerful. I encourage everyone to go check out the report online.

Rita Choula: Absolutely. And just to add to that, I really think there’s an expectation that family caregivers are going to be there, and that they’re going to continue to provide this support for as long as they can. What I would love to see is an expectation that the institutions and organizations family caregivers are holding up are responsible for providing caregivers with the supports they need.

Ishanya Anthapur: So if you could make one policy change, whether for a company, a state-level mandate or even federal, what would that change look like to help the 59 million family caregivers?

Rita Choula: There are so many changes, so much help and support family caregivers could benefit from. One thing I would prioritize is meaningful financial relief. Family caregivers are coming out of their own pockets to the tune of over $7,000 a year for various expenses. We also know that family members often struggle to provide care for the person in their lives while also trying to take care of themselves as individuals. We know they are forgoing savings, forgoing retirement savings. And we even recognize that many family caregivers are struggling to provide food for themselves, because they are making that sacrifice to provide care for someone else.

So whatever we can do to seriously provide financial relief, I think, is really critical. At AARP, we support solutions such as caregiver tax credits. We look at paid family leave, which is very critical. It’s in effect in 13 states and DC. When you think about paid family leave, think about an individual who is providing care and right now may have to take off work and not get paid for the time they’re away. With paid family leave, many family caregivers have the flexibility to provide that care while knowing they can still get paid.

So the more we can ensure that family caregivers are financially stable and have some financial relief for the care they’re providing, the better. I think that is truly critical.

Ishanya Anthapur: I think those are great points, and I’m so glad you jumped straight to financial relief. That’s obviously what would impact a family caregiver’s life most significantly. Added perks and extra benefits are perks, like I said, but significant financial relief would be really, really impactful.

My next question: do you think technology can help, either with financial relief or by reducing the hours of care that are needed?

Rita Choula: There’s absolutely a role for technology to support family caregivers. The critical thing is ensuring the technology really is built to support that caregiver. Oftentimes what we see are the best intentions: an app or another technology is developed with the intention of supporting the caregiver. But so often, these developments happen without a caregiver being part of the process — without really understanding what it means to support a caregiver, and what their needs are. So as long as the technology is inclusive of the reality a caregiver faces day to day, it absolutely can help improve and really support family caregivers.

Ishanya Anthapur: Yes, I agree with that. It needs to be not just another app, some extra thing for a family caregiver to manage, but really integrated into what they’re already doing.

Rita Choula: And if I can add to the technology piece — and I think this goes to the financial piece as well — family caregivers come from all socioeconomic backgrounds. Very often we see the family caregiver who is in the middle. Not the family caregiver at the higher income range who can pay for things without even thinking about it, or the family caregivers who may be able to receive government or other support, but those individuals in the middle who find themselves paying out of pocket for so much. Oftentimes we see services, including technology, that are not built for those individuals in the middle. So as people develop technologies and think about resources for family caregivers, keep in mind supporting caregivers across the socioeconomic spectrum.

Ishanya Anthapur: That’s a wonderful idea, and so valuable to anyone out there trying to build a product in this space. I know there are a lot of well-intentioned people, but like Rita said, you have to keep the family caregiver centered in the conversation, and build for that middle-income family caregiver.

Thank you so much, Rita, for your wisdom. It was really fascinating to speak to someone on the inside of policy development, research and reporting, especially on this topic. We value the work that you do so much.

Rita Choula: Thanks for having me.

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