Nearly a quarter of U.S. adults care for disabled, ill, or elderly family members. A new report finds that their challenges differ greatly depending on their state. This information comes from a report AARP and the National Alliance for Caregiving released this week.
Nationwide, there are an estimated 63 million family caregivers, but there are wide geographical disparities. The percentage of adults taking on this role ranges from 20% in Washington, D.C., to 34% in Mississippi, according to the data.
Among family caregivers, 18% receive payment for some of the care they provide often through Medicaid home and community-based services self-direction waivers, or other government programs. However, state-level data shows wide variations. Only 10% of family caregivers in Iowa get paid, compared to a high of 28% in New Jersey.
“These state-by-state disparities expose how policy choices determine whether families thrive or collapse under caregiving responsibilities,” said Jason Resendez, president and CEO of the National Alliance for Caregiving. “When financial strain hits 59% of family caregivers in Georgia compared to just 34% in Minnesota — meaning where you live can double your risk of economic hardship — it’s clear that patchwork state solutions aren’t enough.”
Two-thirds of family caregivers help with at least one activity of daily living such as bathing, dressing, feeding, or toileting. Almost all of them assist with financial management, shopping, or other tasks essential for independent living. Nearly half of family caregivers provide high-intensity care, and 28% offer 40 or more hours of care each week. Tennessee has the highest percentage of caregivers working this many hours, at 37%.
These responsibilities are causing financial and health challenges for family caregivers. Many find it hard to access affordable local services for the person they are helping. Others struggle to take care of their own health. In 2020, 23% of caregivers said caregiving had made their own health worse.
“Caregivers are the invisible backbone of our broken long-term care system and economy, and too many are paying the price out of their own pockets, risking their own financial security by taking on more debt, using up savings, and leaving bills unpaid,” said Nancy LeaMond, executive vice president and chief advocacy and engagement officer at AARP. “This new data offers the clearest picture yet of America’s caregivers nationwide and a roadmap for the change they urgently need.”
This report highlights the fact that family caregivers face a variety of challenges based on their location. Without stronger and more consistent support in each state, many will keep struggling financially and emotionally. As the number of caregivers increases, so does the need for policies that protect their well-being and acknowledge the important role they fulfill.
Sources:
“AARP and National Alliance for Caregiving. Caregiving in the United States 2020. Washington, DC: AARP. May 2020. https://doi.org/10.26419/ppi.00103.00
Heasley, Shaun. “Family Caregivers Struggling in Some States More than Others.” Disability Scoop, Disability Scoop, 31 Oct. 2025, http://www.disabilityscoop.com/2025/10/31/family-caregivers-struggling-in-some-states-more-than-others/31710/.