The 63 Million Caregivers Crisis: What the AARP Data Means for Long-Distance Families

The number is 63 million.

That’s how many Americans are now family caregivers, according to the Caregiving in the US 2025 report released by AARP and the National Alliance for Caregiving in July 2025. It represents nearly 1 in 4 US adults — a 45 percent increase from just a decade ago, when the count stood at 43 million.

The report paints a detailed picture: caregivers averaging 51 years old, 3 in 5 of them women. Nearly a third juggling aging parents alongside their own children under 18. Forty-four percent providing high-intensity care. Only 11 percent receiving any medical training for tasks they routinely perform. Average out-of-pocket costs of $7,200 per year. The survey methodology was rigorous — 6,858 caregivers on a probability-based online panel conducted by IPSOS.

For families where the caregiver lives near the person they support, these numbers describe a difficult reality. For families where the caregiver lives across the country — a different state, a different time zone, sometimes a different continent — they describe something else: a set of compound challenges the report’s national averages can’t fully capture.

If you’re part of the 63 million, and you live far from the person you love and support, this analysis breaks down what the AARP data actually shows — and what it means specifically for families managing care from a distance.

The numbers behind the crisis

The scale

Family caregivers now number 63 million in the United States — a jump of 20 million people from 2015. Of those, approximately 59 million care for adults, and 4 million care for children with disabilities. The 45 percent increase over the past decade reflects both the accelerating aging of the US population and a growing recognition, in research and policy circles, of what family caregiving actually entails.

Who caregivers are

The average family caregiver is 51 years old. Three in five are women. These demographics matter because they describe a cohort caught between peak career years and peak family obligation — people who moved for jobs, for partners, for opportunity, and now find themselves geographically separated from aging parents who increasingly need support.

The intensity

44 percent of family caregivers now provide high-intensity care. Nearly 1 in 4 spend 40 or more hours per week caregiving — the equivalent of a full-time job stacked on top of their actual full-time job. Thirty percent have been in the caregiver role for five years or longer. This isn’t occasional errand-running. It’s sustained, ongoing labor that’s been building for years before most families recognize it as such.

The training gap

Perhaps the most striking finding: only 11 percent of family caregivers have received any medical training for the tasks they routinely perform. Over half now manage complex medical duties — administering injections, managing feeding tubes, coordinating care across multiple providers — without formal instruction. AARP describes this as an invisible workforce doing skilled healthcare labor with almost no preparation.

The economic weight

AARP’s companion report — Valuing the Invaluable 2026 — put a number on what this workforce contributes: $1 trillion in unpaid caregiving labor in 2024 alone. That exceeds all US private business healthcare spending ($967 billion) and total Medicaid expenditures ($932 billion). Family caregivers provided 49.5 billion hours of care in 2024 — equivalent to 17 percent of all full-time workers in the United States.

Read AARP’s full report: Caregiving in the US 2025

What the numbers miss: the long-distance reality

AARP’s data describes caregiving broadly. The report doesn’t distinguish between caregivers who share a household with their loved one and those who manage care from 1,500 miles away. That distinction matters, because long-distance caregiving doesn’t just add difficulty to the challenges AARP documents — it compounds them.

Travel costs on top of already-high expenses

The $7,200 average out-of-pocket cost AARP reports doesn’t include what long-distance caregivers routinely absorb: flights booked on short notice, hotels near hospitals, rental cars, missed days of work for each trip. Depending on distance and frequency, these travel costs add $3,000 to $10,000 or more annually beyond the national average — costs that don’t appear in the aggregate data because they’re diluted by the majority of caregivers who don’t incur them.

The coordination cost of managing remotely

Local caregivers can drive to the pharmacy, attend appointments in person, and observe directly. Long-distance caregivers manage through a relay of phone calls to providers, coordination with hired help they’ve never met in person, verification of medication compliance they can’t see, and endless scheduling across time zones. This coordination work is substantial — and it isn’t captured in AARP’s estimates of caregiving hours, which tend to measure direct care tasks rather than remote management.

The information gap

Local caregivers observe their loved one regularly and notice gradual changes. Long-distance caregivers depend on phone calls where aging parents often minimize concerns. The “I’m fine” that hides real decline — a pattern we’ve written about in our guide to long-distance caregiving — is particularly acute when your only data point is a weekly Sunday call. You know you’re missing something. You don’t know what.

The emotional weight of distance

AARP found 39 percent of caregivers report high emotional stress, with significant variation by state (ranging from 26 percent in Pennsylvania to 51 percent in Colorado). For long-distance caregivers, that stress carries a specific texture: guilt about absence. Guilt about not visiting more. Guilt about relying on people you’ve had to hire to do what you feel you should be doing yourself. The emotional burden of caregiving from a distance often exceeds the burden of local caregiving — precisely because it’s less visible and less acknowledged.

Isolation from support networks

Families who share a community with the person they care for have neighbors who notice, friends who pitch in, informal networks that provide support. Long-distance caregivers often navigate the caregiving experience in isolation — without local peers who understand the specific challenges of remote care, and without the low-effort support that proximity makes possible.

The sandwich generation compound

Nearly 1 in 3 family caregivers are what AARP calls the sandwich generation — adults simultaneously caring for aging parents or older loved ones and raising children under 18 of their own. Among caregivers under 50, that number rises to 47 percent. The burden falls disproportionately on Latino (43 percent) and Black (36 percent) families.

For long-distance sandwich generation caregivers, this creates a particularly difficult calculus. Their aging parents often live in the state where they grew up — the place they left for a career, for a partner, for a different life. Their children live with them, requiring daily presence and engagement. The competing demands aren’t just logistical. They’re moral: Do I visit my parent this weekend, or attend my child’s event? Do I spend vacation days on my parent’s medical appointments, or on family time my own children need?

AARP’s data specifically notes higher stress and financial strain among sandwich generation caregivers. When those caregivers also live across the country from their parents, the strain becomes structural — a set of recurring impossible choices rather than an occasional difficulty to navigate.

If you’re coordinating care alongside a sibling in another state, our guide to coordinating care with siblings across states covers the specific dynamics that tend to emerge — and the conversations that often need to happen first.

What research suggests actually helps

The AARP data documents the scope of the problem. It doesn’t offer easy solutions — and genuinely easy solutions don’t exist. But a combination of research findings and practical experience points toward several approaches that consistently make long-distance caregiving more sustainable.

Consistent structured contact matters more than occasional intensive contact. Research on aging and social connection consistently finds that regularity — not quantity — is what supports older adults’ cognitive and emotional wellbeing. A scheduled call every Tuesday at 3pm often provides more stability than three calls in one week followed by two weeks of silence. Structure creates predictability, and predictability reduces anxiety for both the parent and the adult child.

Distributing burden through practical delegation reduces long-distance coordination load. The AARP data shows only 11 million of the 63 million caregivers currently participate in paid family caregiver programs through Medicaid HCBS waivers. Many more families could benefit from professional support alongside family effort: medication management services, transportation providers, meal delivery, local care managers who can attend appointments in your absence. Each delegated task is one fewer remote coordination problem.

Written correspondence has documented cognitive and emotional benefits for older adults. A growing body of longitudinal research — including the English Longitudinal Study of Aging’s 8-year follow-up on 6,442 participants — associates regular written correspondence with better cognitive outcomes and reduced loneliness in aging adults. We’ve covered this research in depth in a separate article on email correspondence and cognitive health. For long-distance families, this offers a specific, low-logistics intervention that research supports.

Neutral third-party support has documented value. The HEAL-HOA randomized clinical trial (2026, published in JAMA Network Open) demonstrated that structured contact from trained lay counselors — not family members, not therapists — significantly reduced loneliness in older adults at 12 months. Adding outside emotional support to family caregiving isn’t a replacement for family. Research suggests it’s often what makes family caregiving sustainable over the long term.

Recognizing what you cannot do is the beginning of building what works. AARP’s data implicitly makes a point that families often resist: 63 million people are doing labor worth $1 trillion annually with minimal training and insufficient support. Not every gap is one any individual family can close from a distance. Acknowledging that is where realistic, sustainable caregiving systems actually begin. Our guide to managing guilt about not visiting more addresses the emotional work this recognition requires.

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