As 2025 approaches, caregivers and families all over the U.S. are experiencing a new level of foreboding. This deepening anxiety colors their everyday experiences and choices. The landscape of family caregiving has changed dramatically, with the number of family caregivers spiking to 63 million — a jaw-dropping increase of 45% over the last ten years. That’s almost 20 million new caregivers who’ve entered the workforce. With this surge comes profound challenges, forcing many of them to wonder how they can continue to do their jobs with big legislative changes coming down the pike.
Celina Su, a professor of political science, is a documentary case study in that tension. During most of 2025, she has been focusing her time on caregiving for her terminally ill father and her sickly six-year-old daughter. Her story is far from unusual. Millions of caregivers struggle with the weight of caring for their families, while managing the health complications of their loved ones. “No one teaches us how to live or how to die,” reflects an anonymous source, summing up the emotional turmoil faced by many in similar situations.
Dessy Acevedo, 55, turned into a full-time caregiver when both her parents got Alzheimer’s and dementia. As the incidence and prevalence of these complex, multi-system conditions continue to increase, the burden on families compounds. Caregivers such as Kris, one member of this new wave of “sandwich generationites,” can attest that the stress is very real. Countless others let their anger loose in the one place meant to provide comfort and reassurance, the support group.
Julie Gayer Kris articulates these sentiments: “The systems are terrible. It’s so hard to get the right care – and to get approved for it.” In searching for help for their loved ones, caregivers are bombarded with bureaucratic red tape that only creates more burdens and anxiety. She continues in detail, “It’s a multi-layered sandwich of crap. This heart-wrenching story shines a light on the tangled and maddening maze of family caregiving.
A major challenge for caregivers is the health complexity of their aging parents. As these parents live longer, they’re facing more complex health problems. The economic unpredictability related to constant policy shifts in healthcare deepens their suffering. Proposed health spending legislation such as the One Big Beautiful Bill Act would eliminate $1 trillion from critical healthcare programs over the next 10 years. This radical reduction endangers the health and safety of the working families that depend on these essential services.
Julie Croghan, another caregiver navigating these uncertain waters, expresses her apprehension regarding the future: “What’s going to happen if I don’t? I don’t have retirement saved – I am working on that right now. I am pumping it so hard, with three kids in college right now and a disabled kid.” Her concerns underscore a broader anxiety among caregivers about financial security as they balance caregiving duties with their professional lives.
The proposed change to labor rules has thrown a wrench into the works. It withdraws wage and overtime protections from millions of home care workers. Brigid Schulte warns, “You’re seeing childcare workers leave and childcare centers close. I can only imagine what the loss of Medicaid will do to home care and home care workers.” These changes would be disastrous in their impact. They ask critical questions about whether caregiving can be a long-term occupation for millions of families in coming decades.
Despite these challenges, some caregivers have indicated that their health has stabilized though. Yet, despite this reassurance, they continue to struggle under the “sword of Damocles” themselves. Celina Su’s heartbreaking reunion with her dad brings home the human cost of it all. On his last day, she obtained special permission for them to meet. As one more activity to the chaos of caretaking, together they pressed their hands into clay, producing a memento of love and loss that spoke to the depth hidden even in the storm.
Caregivers encounter a daunting environment rife with personal obstacles. They address systemic issues that disproportionately impact the quality and length of their lives. As historian Danilyn Rutherford recently observed, “There’s a savagery to our society now. As she astutely points out, for many, societal pressures make caregiving a daunting and crushing burden.
The alarming statistic that 47% of caregivers under 50 are managing both a parent and a child highlights the pressing need for societal recognition of these responsibilities. The individualization of health risk has shifted public health away from collective risk factors. This paradigm change has the potential to drastically improve our expectation of, and experience with, eldercare.