LAUSR

T he US health care system relies on family caregivers. More than 40 million adults provide unpaid support to a relative age 50 or older, which does not account for youth who provide caregiving. COVID-19 has aggravated deficiencies within caregiving policy and highlights the need to integrate family caregiving into the broader healthcare system. Not only have those infected by COVID-19 required caregiving, but the pandemic has made caregiving more difficult. These caregiving challenges will not disappear when COVID-19 does. The Biden administration has proposed spending nearly $800 billion to support caregivers—with $400 billion to support home and community-based caregiving as well as enhanced benefits and protections for caregivers of adults. Though essential to infrastructure, too often caregiving is invisible. Nearly two-thirds of family caregivers are employed; most work full-time, and more than a quarter provide over 20 hours a week on unpaid caregiving responsibilities. Yet, financial support, while needed, merely puts a band-aid on a wound that requires more attention. Success in integrating family caregiving in the healthcare system through training, coordination efforts with others in the healthcare system, and compensation for their efforts, requires a fundamental redefining of what family caregiving means. The failures of current caregiving policy are shaped by many factors. Here, we highlight how federal policy applies a narrow, one-size-fits-all approach to supporting states, caregivers and patients, and devolves authority to the states, resulting in a patchwork of uncoordinated programs and benefits that harm caregiving. NARROWING OF FEDERAL POLICY