The Workforce Problem Hiding Inside Family Caregiving

After more than 16 years working with older adults and their families, I have learned that caregiving rarely begins with a single dramatic event. More often, it grows one task at a time. A daughter starts calling each morning. A son begins managing medications. Someone takes over transportation, bills or communication with physicians. Before long, one family member is coordinating a small care system without ever agreeing to run one.

That work follows people into the workplace. An executive steps out of a meeting to answer a call from a parent's physician. A nurse manager uses a break to resolve a prescription problem. An attorney checks whether a home care aide arrived before beginning a deposition. No absence is recorded. No leave is requested. The work may still get done, but part of the employee's time and attention is already somewhere else.

AARP and the National Alliance for Caregiving estimated that 63 million American adults provided ongoing care in 2024, nearly one in four adults. That does not mean one quarter of every workforce faces the same burden. It does mean that a large employer almost certainly employs caregivers at every level, including many people who would never use that word to describe themselves.

The difficult part is often not the individual task. It is keeping everything connected. One medical appointment may involve transportation, schedule changes, medication instructions, follow-up calls and conversations with siblings or paid caregivers. A hospital discharge can change the entire plan overnight. A missed call can leave the working caregiver wondering whether something is routine, concerning or urgent.

Someone is already coordinating the care. In most families, they are doing it manually. There is no common calendar, no reliable handoff and often no backup. One employee becomes the only person who can see the whole picture. That is where a family responsibility becomes a workforce issue.

For a CEO or COO, the concern is operational reliability. For a CHRO, it is attendance, focus, advancement and retention. For a benefits leader, the question is whether a program actually removes work or simply points the employee toward more resources. Brokers face the same test when recommending a solution to clients. A longer list of services is not automatically better support.

Care orchestration addresses the work between services. It begins with what the older adult needs and what matters to that person. It assigns responsibility, establishes a backup, confirms that the task occurred and sends an exception to the right person. It does not replace the physician, the home care agency or the family. It helps them work from the same plan.

This will not eliminate every crisis. Serious illness will still require time, judgment and human presence. The realistic opportunity is to reduce the avoidable interruptions caused by missed handoffs, incomplete information and unclear responsibility. That is a narrower promise, but it is one an employer can test.

Employees do not decide that a company is a preferred employer by reading the benefits guide. They decide when life becomes difficult. Did the benefit produce a next step, or another phone number? Did the manager respond fairly? Did the organization reduce the burden, or move it into the evening? Those experiences are remembered long after enrollment ends.

The first leadership question should not be, “Do we offer a caregiving benefit?” It should be, “When an employee needs help, does our support make the situation more manageable?” The next article looks at the first visible consequence when the answer is no: an absence that appears sudden but often began with a failed care handoff days earlier.

Sources

1. AARP and National Alliance for Caregiving, Caregiving in the U.S. 2025. Published July 24, 2025; survey data collected in 2024.
2. National Academies of Sciences, Engineering, and Medicine, Families Caring for an Aging America. Published September 13, 2016.