The holidays are here. For many families, holiday dinners are the only time when multiple generations gather around the same table. We hug our parents, we study their faces, we watch them walk across the room. Quietly, we assess: “Does she look okay?” “Is he still driving?” “Do they seem different this year?”
These whispered questions often mark the moment when caregiving shifts from something “other people deal with” to something your own family must now navigate. As Rosalynn Carter famously said, “There are only four kinds of people… those who have been caregivers, those who are currently caregivers, those who will be caregivers, and those who will need caregivers.”
Despite the universality and inevitability of caregiving, few of us are prepared for it. My research team at the MIT AgeLab, in collaboration with John Hancock, recently released the Longevity Preparedness Index (LPI), measuring awareness and preparedness across eight domains essential to living longer and better, including care, community, daily activities, finance, health, home, life transitions, and social connection.
“It’s no longer just about how much you’ve saved or how healthy you are,” says Brooks Tingle, president and CEO, John Hancock.
“It’s also about where you’ll live, how you’ll get around, how you’ll spend your time, and who will be part of that journey. The LPI reframes longevity from an important but narrow focus on retirement savings to a broader view of sustained well-being across your lifespan.”
Preparedness is scored from 0 (not prepared at all) to 100 (prepared). The 2025 national average was 60, if it were a class grade, it would be a “D.”
And the lowest-performing domain? Care.
Despite caregiving touching nearly every family in the country, Americans scored a dismal 42 on preparedness for caring for a loved one or planning for their own future care needs. Again, if it were a grade, even with a generous curve, it would be a fail.
Caregiving is the great crack in America’s retirement and longevity plans. While financial security in retirement is, with good reason, often cited as a public crisis, caregiving remains largely a private problem that is only described as an issue. Crises command action. Issues are only politely discussed.
Two new reports released by A Place for Mom, a senior living referral service that provides families with free, personalized guidance from senior living advisors to help them find senior care options, bring that crack of caregiving in America’s retirement and longevity plans into sharp relief.
Caregiving Often Starts in Crisis
In an interview with Tatyana Zlotsky, CEO of A Place for Mom, she observes that, “What families misunderstand most is that caregiving often starts in crisis, but it doesn’t have to.”
She goes on to note that, “Over 70% of caregivers experienced a gradual decline in their loved one, not a single triggering event. Three out of four families who reach out to us (A Place For Mom) are already overwhelmed….”
Unlike other stages of life, there is no preparation for caregiving, let alone training. Zlotsky goes on to say, “There is no playbook for this role. 77% of caregivers tell us they feel unprepared.”
Recent AARP data shows that not only are family caregivers doing more, but they are also performing complex care tasks. Many are handling medical duties once reserved for professionals. Just 11% have any medical training to assist with basic daily activities. Slightly more than one in five have been formally trained for medical or nursing tasks, even though over half are now managing injections, wound care, and medication routines.
Caregiving’s Silent Emotional And Physical Tax
A Place for Mom’s 2025 State of Caregiving Report clearly shows what many families already feel but rarely say aloud: caregiving carries a deep emotional and physical weight. Nearly three-quarters of caregivers say they do not feel ready for the role. Most face ongoing stress or anxiety, and more than seven in ten often feel overwhelmed. Sleep problems affect two-thirds of caregivers, and nearly as many report feeling burned out. It depicts a national informal caregiving system quietly breaking down under pressure, mostly sustained by exhausted family members doing their best with inadequate support.
Caregiving’s Financial Costs
Caregiving’s emotional burden is only part of the story. The financial strain, often hidden, is just as significant. A Place for Mom’s study shows that most caregivers say the role impacts their finances, and a growing share report severe financial strain. Nearly half say their careers have been affected; some cut back hours, while 11% leave the workforce altogether. Lost work time alone amounts to an average income hit of about $21,000 a year.
To cope, families trim spending, delay purchases, draw down savings, or take on debt. These seemingly small decisions compound into long-term financial vulnerability and retirement insecurity.
This is far more than a budgeting challenge. Caregiving is quietly reducing workforce participation, suppressing earnings, and accelerating early retirement withdrawals, particularly for women caring for partners and for adult daughters, who are most likely, after a spouse, to provide care to an aging parent. The consequences, for both households and the broader economy, are profound.
Families Are Searching for Care Too Late
A Place for Mom’s second study, the 2025 Senior Care Search Trends Report, shows a pattern that should concern every family: most people start looking for care far later than they wish they had. The vast majority, 73%, are responding to a slow, gradual decline rather than a single event. More than half say they should have begun planning sooner, and among those currently searching, that number jumps to 77%.
And when the moment finally comes, it comes fast. Nearly 70% of families secure care within just 60 days. Far quicker than they ever imagined. Meanwhile, 88% say they need far more guidance to understand their options.
Families expect years to prepare for future care needs. They get weeks. They expect time to prepare. They get urgency within a few short days.
Today, caregiving is a 911 call, not a plan.
The Longevity Economy’s Missing Infrastructure: Care
We have poured enormous resources into extending life, but we’ve invested far less in the systems required to support one of longevity’s most predictable needs: care. Simply put, modern longevity has outpaced the infrastructure designed to carry it.
Most people have a 401(k), a savings plan, or, if fortunate, a pension. Very few have anything like a care plan. We talk endlessly about income in retirement, yet rarely about the practical and financial realities of caregiving. We have portfolios, but not the care budgets that will one day be necessary to manage everyday life.
For generations, caregiving was treated as a private matter, handled quietly inside families, most often by women. That model no longer fits the demographics. Families are smaller. More Americans, particularly women, now live alone. Adult children live farther away. And longer lives mean longer periods managing chronic conditions or functional limitations.
What looks like a private family issue is, in fact, a public problem hiding in plain sight. Caregiving is a critical piece of the nation’s longevity infrastructure. Today, we are hacking the nation’s caregiving needs, resulting in eroding workforce participation, household finances, community capacity, and the broader economy. Without redesign, across public policy, workplace benefits, community supports, and new technology, the weight of caregiving will continue to fall almost entirely on already strained families.
A Place for Mom’s Tatyana Zlotsky underscores the point:
“Families shouldn’t have to do this alone. We need to make it much easier to talk about caregiving earlier, to ask for support sooner, and to build systems that recognize the emotional, financial, and logistical weight families carry and respond with clarity, compassion, and coordination.”
Caregiving Is Inevitable. Doing It Alone Shouldn’t Be
The holidays will bring us together. We’ll be with the people we love, notice the small changes another year has written on their faces, and for some families, those moments will mark the first quiet steps into caregiving.
What begins with a simple question, “Does she seem different to you?” can quickly turn into a maze of spreadsheets, sleepless nights, late-night searches, and the constant feeling that you’re doing everything you can, yet it still doesn’t feel like it’s enough.
Caregiving is, at its core, an act of love. But love alone is not a system.
The Longevity Preparedness Index quantifies for decision-makers what families already know: they need more support. A Place for Mom’s new data adds high-resolution detail on where families are struggling and where our systems fall short. Together, these findings call us to do more than discuss caregiving as an issue; they compel policymakers, employers, insurers, and advocacy groups to address it as a public problem with action and urgency.
Because sooner or later, every one of us enters the caregiving circle. The question is whether we enter it alone or with a system designed to help us carry the load.
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