Unpaid Elder Care in District of Columbia

District of Columbia

While many older adults receive the additional care they need in assisted living facilities or from home health services, unpaid elder care is also often provided by family members, friends or volunteers. Caregiving may involve assistance with grooming, cooking, cleaning and transportation, as well as providing companionship. 

Those providing unpaid care for loved ones they don’t live with dedicate an average of 23.7 hours a week to caregiving, while those living with the care recipient dedicate an average of 37.4 hours weekly. In the two-year period of 2021-2022, there were 37.1 million unpaid elder care providers in the United States, 59% of whom were women. Studies have found that lacking adequate care options for loved ones hinders many women from fully participating in the workforce. 

As the U.S. population ages, the demand for elder care will also increase. By 2030, 20% of the population will have reached retirement age, increasing the need for elder care. 

Unpaid caregivers face various challenges, including financial strain, worse health outcomes, caregiver burnout and higher rates of anxiety and depression. According to the AARP, the value of care provided by unpaid family caregivers in the U.S. in 2021 was $600 billion — a $130 billion increase from 2019.

The prevalence of unpaid elder care work is higher among:

• Women compared with men. Women age 55 and older account for more than one-third of unpaid elder caregivers in the U.S.
• Adults ages 45-64 compared with younger adults. 
• Family members compared with friends or volunteers. 
• Adults living in nonmetropolitan areas compared with those living in metropolitan areas. Caregiving in rural areas comes with unique challenges, such as limited access to health services, longer travel distances to reach care recipients and fewer available resources.

Addressing unpaid elder care in the U.S. requires implementing policies and programs that support caregivers. Expanding tax credits for family caregivers is one way to provide financial support. The proposed Credit for Caring Act offers a nonrefundable federal tax credit of up to $5,000 for eligible working family caregivers, reducing the financial burden they may face due to caregiving expenses. 

The National Family Caregiver Support Program allocates funds to states and territories to assist family members and other informal caregivers in caring for older adults at home for as long as possible. Services include individual counseling, caregiver training, respite care and supplemental services. Research indicates that these services strengthen the health and well-being of caregivers and enable them to provide care for longer.

Providing training and education programs for caregivers is essential for improving their skills and mitigating their stress. The American College of Physicians has a tool kit for physicians and caregivers on informal caregiving. This tool kit offers training, best practices and additional resources to help physicians connect with their patients’ caregivers to share knowledge and support. 

The AARP also offers a variety of resources to support individuals caring for their loved ones, including coping strategies, caregiving tool kits and tips for unique challenges such as dementia. The Family Caregivers Alliance provides educational resources and caregiver training as well.

Healthy People 2030 has multiple objectives aimed at supporting caregivers, including: 

• Reducing anxiety and depression in family caregivers of people with disabilities.
• Reducing the impact of chronic pain that frequently limits life or work activities on loved ones.
• Increasing the proportion of older adults with dementia, or their caregivers, who know they have it.

Cohen, Steven A., Zachary J. Kunicki, Caitlin C. Nash, Megan M. Drohan, and Mary L. Greaney. “Rural-Urban Differences in Caregiver Burden Due to the COVID-19 Pandemic among a National Sample of Informal Caregivers.” Gerontology and Geriatric Medicine 7 (January 2021): 233372142110251. https://doi.org/10.1177/23337214211025124.

Fields, Beth, Juleen Rodakowski, Vanessa D. Jewell, Sajay Arthanat, Melissa Park, Catherine Verrier Piersol, Stacey L. Schepens Niemiec, Jennifer Womack, and Tracy M. Mroz. “Unpaid Caregiving and Aging in Place in the United States: Advancing the Value of Occupational Therapy.” The American Journal of Occupational Therapy 75, no. 5 (September 1, 2021): 7505347010. https://doi.org/10.5014/ajot.2021.044735.

Livingston, Gretchen. “Older Women and Unpaid Caregiving in the U.S.” Issue Brief. Washington, D.C.: U.S. Department of Labor, Women’s Bureau, November 2023. https://www.dol.gov/sites/dolgov/files/WB/WBIssueBrief-OlderWomenAndUnpaidCaregiving.pdf.

Schulz, Richard, and Paula R. Sherwood. “Physical and Mental Health Effects of Family Caregiving.” The American Journal of Nursing 108, no. 9 (September 2008): 23–27. https://doi.org/10.1097/01.NAJ.0000336406.45248.4c.