Family Caregivers Are Vital in America

In Everett, WA, Mae Hochstetler has two jobs: a patient health navigator and she works as a caregiver for her son Josh, 25. Josh is autistic and has other health challenges, including epilepsy. His sisters also provide respite care for Josh.

Twin sister Joy is a paid caregiver for Josh, while Hope is currently working on the necessary training. At times, a neighbor of the Hochstetler’s also helps care for Josh. Hochstetler wasn’t always able to be a paid caregiver for her son. The State of Washington doesn’t allow parents to be paid for providing care to minor children.

In Snohomish County, about 4,000 people are eligible to receive home care services through Medicaid. State lawmakers are considering legislation and a budget that could help ease the way for others like Hochstetler by increasing pay and expanding who can be a family caregiver.

According to Bea Rector, assistant secretary of Washington’s Aging and Long-Term Support Administration, the average wait period for a home healthcare professional is now around two months for those who qualify for Medicaid, and considerably longer in rural regions or for persons with complex medical needs.

House Bill 1694 would broaden who can be designated a family caregiver, making it easier for grandparents and cousins to receive training. Hochstetler says the state must investigate the viability of compensating minors’ parents to be caregivers.

Hochstetler tried to work while Josh was growing up. She often worked in sales or customer service. However, she struggled to work while dealing with Josh’s disabilities. Employers repeatedly fired her because she needed to take care of Josh’s needs.

Her employment as a parent provider was a wonderful surprise and opportunity for her in 2019, providing her with a steady paycheck and health insurance.

At the height of the COVID public health emergency, the legislature approved hazard pay for caregivers. For Hochstetler, the raise in pay has meant “everything.” During the start of the pandemic, Joshua, Mae, and her daughter Joy all lost their jobs within a week of each other.

Hochstetler also wants spouses to be able to be paid caretakers. The bill mandates that DSHS create a pilot project.

She sees married couples separated owing to a lack of home care providers in her patient navigator role because one person has a medical need for caregiving services. In Hochstetler’s opinion, if a spouse could be paid for providing care, they could stay home and remain married.

Caring for a loved one is not uncommon. In 2020, AARP found that more than one-fifth of Americans (21.3 percent) now provide care. having cared for an adult or child with disabilities in the previous 12 months. Caregiving can also impact finances. A report from AARP titled Caregiving Can Be Costly — Even Financially shows that family caregivers spend more than $7,000 a year on expenses related to caregiving.

The cost of caregiving is exceptionally high, both monetarily and otherwise. Caregivers allow millions of disabled and elderly people to live in their communities. Without the proper support, our lives would be much different.


AARP and National Alliance for Caregiving. Caregiving in the United States 2020. Washington, DC: AARP. May 2020.

Borkholder, Joy. “To Solve Home Care Aide Shortage, Washington May Expand Who Can Be One.” The Everett Herald, Sound Publishing, Inc., 2 Mar. 2023,

Goldstein, Avram. “The Work of Family Caregiving: Invisible, Costly, and Taxing.” California Health Care Foundation, California Health Care Foundation, 8 Jan. 2022,

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