As millions of Americans fired up their grills this Labor Day, an invisible army of 53 million unpaid caregivers remained on duty. These are the workers we don’t celebrate — the daughters juggling careers while caring for aging parents, the husbands learning to be nurses overnight, the granddaughters putting dreams on hold to tend to grandparents with dementia. They’re the backbone of our care infrastructure, and they’re in crisis.
Let’s start with a staggering number: $600 billion. That’s the annual economic value of unpaid caregiving in America, according to AARP. To put that in perspective, it’s more than the combined 2022 revenues of Apple, Amazon and Microsoft. Yet unlike the tech giants, this massive economic engine runs without recognition, without overtime, without so much as a paycheck.
Credit: Handout
Credit: Handout
Take Sarah, a 42-year-old marketing executive in Atlanta. She starts her day at 5 a.m., helping her father with Alzheimer’s get dressed before getting her kids ready for school. She squeezes in work calls during her lunch break and between doctor’s appointments. By the time she collapses into bed at midnight, she’s put in a full day at the office and another full shift as an unpaid caregiver. Sarah is the face of America’s “sandwich generation” — adults caught between caring for aging parents and raising their own children.
The long-term implications of this unseen labor are staggering. A study by MetLife and the National Alliance for Caregiving found that caregivers lose an average of $304,000 in wages and benefits over their lifetime. For women like Sarah, who make up 61% of caregivers, and disproportionately women of color, this exacerbates an already yawning gender wealth gap.
The pandemic has only poured gasoline on this smoldering crisis. As the coronavirus ravaged nursing homes, many families pulled loved ones out, shouldering the burden of 24/7 care. Women, already carrying a disproportionate share of caregiving, saw their careers disproportionately impacted. A McKinsey report found that one in three mothers considered leaving the workforce or downshifting their careers due to the pandemic — compared with one in four fathers.
This isn’t just a personal crisis; it’s a looming economic catastrophe. As America’s population ages — with 10,000 people turning 65 every day — we’re facing a caregiving cliff. By 2030, we’ll need an estimated 6.9 million direct care workers, according to PHI, a national organization focused on the direct care workforce. Yet we’re struggling to fill these roles, in part because we’ve failed to value care work as the skilled, essential labor it is.
So, what do we do?
First, we need to recognize caregiving for what it is: work. Essential work. Work that makes all other work possible. This isn’t just about feel-good rhetoric; it’s about fundamentally reshaping our economic policies to account for care labor.
Here’s what that could look like:
1. Paid family and medical leave: The United States remains the only developed nation without a federal paid leave policy. It’s not just an embarrassment; it’s economic malpractice. Paid leave would allow caregivers to maintain their careers while providing essential care, benefiting both families and the broader economy.
2. Social Security credits for caregivers: Time spent providing unpaid care should count toward Social Security benefits. This would help mitigate the long-term financial impact on caregivers, particularly women.
3. Expanded respite care services: Caregivers need breaks to avoid burnout. Increasing funding for respite care isn’t just humane; it’s economically smart, helping to keep caregivers in the workforce.
4. Better integration of home and community-based services into our health care system: This would provide more support for those who wish to age in place, reducing the burden on family caregivers and potentially creating jobs in the care economy.
5. Investment in caregiver training and support programs: Caregiving is skilled work. We need to provide caregivers with the tools and knowledge they need to succeed, both for their sake and for those they care for.
These aren’t pipe dreams. They’re practical policies that have been implemented successfully in other countries. In Germany, for example, family caregivers can take up to ten days of paid leave per year for emergencies, and up to six months of partially paid leave for longer-term care needs. In Japan, long-term care insurance provides a range of services to support both the elderly and their caregivers.
But policy changes alone aren’t enough. We need a cultural shift in how we view and value care work. This is where technology can play a crucial role. At CareYaya, we’re using AI to match caregivers with affordable, qualified help in their communities. Other startups are developing AI-powered health monitoring systems and robotic assistants for the elderly. These technologies aren’t replacing human care — they’re augmenting it, giving caregivers the support they desperately need.
As we re-imagine care work, we must also confront the racial and gender inequities baked into our current system. Women of color, in particular, have long been expected to provide care labor for low wages or no wages at all. Any solution that doesn’t address these systemic inequities is no solution at all.
This Labor Day, as we celebrated the contributions of American workers, we failed to recognize millions of caregivers who keep our nation running. They deserve more than a day off. They deserve recognition, support and a care infrastructure that works for everyone.
The next time you see a neighbor caring for an elderly parent or a co-worker juggling work calls with doctor’s appointments, remember that they’re not just family members doing their duty. They’re essential workers holding up our economy and our society. It’s time we treated them that way.
Let’s envision an America where caregiving is valued as the essential work it is. Where technology and policy work hand in hand to support caregivers. Where no one has to choose between caring for a loved one and pursuing their own dreams. That’s the America our caregivers deserve. And it’s the America we should all be working toward — on Labor Day, and every day.
Neal K. Shah is the chief executive officer of CareYaya Health Technologies, one of the fastest-growing health tech startups in America. He runs a social enterprise and applied research lab using AI and neurotech to advance health equity for the aging population.
