One in five older caregivers has no one to call if they fall ill themselves

University of Michigan National Poll on Healthy Aging, U-M Institute for Healthcare Policy and Innovation, supported by Michigan Medicine. Poll conducted by NORC at the University of Chicago, Septembe

What happens when the person everyone depends on has no one to depend on?

It's not a hypothetical. According to the latest data from the University of Michigan National Poll on Healthy Aging, roughly 32% of Americans over age 50 are providing regular, unpaid care to an adult relative or friend dealing with a health condition or disability. That's nearly one in three. And among those caregivers, about one in five reports having no close friends or family they could turn to if their own health took a bad turn.

The numbers sketch a picture of a caregiving workforce — if you can call it that — operating with enormous responsibility and startlingly little safety net.

Who's caring, and who's caring alone?

The poll, conducted in September 2025 by NORC at the University of Chicago, surveyed 2,698 adults aged 50 to 95. It found that 22% of people over 50 had served as caregivers in the past year for someone they don't live with, while 12% cared for someone in their own household. Overlap between the two groups means the combined figure sits at 32%.

Across the full caregiver population, 17% said they lack the support they need to manage their responsibilities. That figure alone is worth pausing on — it means roughly one in six caregivers feels they're doing this without adequate help.

But split the data by social isolation, and the gap becomes a chasm. Among caregivers who do have close friends or family to lean on, only 11% said they lacked support. Among those without that personal network? The figure jumped to 41%.

"This is an issue we need to keep our eyes on as our nation continues to grapple with the growing demand for unpaid, untrained caregiving for older adults and for people with disabilities and serious health needs," said Florence Johnson, Ph.D., an Assistant Professor at the U-M School of Nursing and member of the Institute for Healthcare Policy and Innovation. Johnson noted that 23% of all Americans over 50 — including many already serving as caregivers — may lack family or friends to support them with their own health needs.

The bill nobody's paying

Caregiving costs money. Transportation, time off work, supplies, household adjustments — the expenses pile up. And most family or friend caregivers can't bill insurance or government programs for any of it.

The poll found that 34% of caregivers reported financial challenges tied to their caregiving role. That rate climbed to 40% among those aged 50 to 64, compared with 27% for those over 65 — a difference likely reflecting the collision between peak caregiving demands and the need to maintain employment. Caregivers in fair or poor health, or those with disabilities themselves, also reported higher financial strain.

Among the most isolated group — caregivers without friends or family to help with their own needs — 47% said caregiving had created financial difficulties. Nearly half.

When the poll team asked unsupported caregivers what would help most, the answer wasn't even close. Financial assistance or subsidies for caregiving expenses topped the list at 69%. The runner-up, respite care, came in at 39%. Money, it turns out, is both the most pressing need and the one least likely to be met.

Programs that exist but nobody seems to know about

Here's where the data gets frustrating. Programs designed to help caregivers — adult day programs, respite care, Area Agencies on Aging — already exist in many communities. They're not perfect, and they don't solve the financial problem, but they can offer real relief. The trouble is that the people who need them most often don't know they're there.

Take adult day programs, which provide supervised, structured activities for older adults or people with disabilities for a few hours to a full day. They give caregivers breathing room — time to work, rest, run errands, or just decompress. Only 9% of caregivers said the person they care for had used one. Another 60% had heard of such programs but never used them. And 21% had never heard of them at all.

The awareness gap was even wider for respite care — services that provide temporary relief through an in-home helper, a short-term residential stay, or emergency coverage if a caregiver suddenly falls ill. Only 11% of caregivers had used any form of respite. A full 32% had never even heard of it, with male caregivers particularly unlikely to be aware. Among those who had used respite services, the reasons were telling: a third said it was to take time for themselves, and another third said it was to prevent burnout.

Among caregivers who already felt unsupported, 39% identified respite care as the service that could help them most. So you have a situation where people are naming the very thing they need — and then not using it, often because they don't know it exists.

The doctor's office as missed opportunity

Poll director Jeffrey Kullgren, M.D., M.P.H., an Associate Professor of Internal Medicine at the U-M Medical School who also provides primary care at the VA Ann Arbor Healthcare System, pointed to health care settings as an underused channel for connecting caregivers with resources.

"We see a real awareness gap here, and health care providers can help by making sure that information about local resources is available in waiting areas, patient education packets and more," Kullgren said. The idea isn't complicated — brochures in a waiting room, a question during a checkup, a handout at discharge — but it requires clinicians to think about their patients not just as patients, but as potential caregivers carrying invisible weight.

Kullgren made another point worth underlining: when caregivers feel unsupported or stressed, it doesn't just affect them. It erodes their ability to maintain healthy habits, manage chronic conditions, and sustain the very caregiving that someone else depends on. The system, in other words, has a direct interest in keeping caregivers afloat.

A Michigan mirror

The poll included a deeper look at Michigan residents, supported by the Michigan Health Endowment Fund. The state-level numbers tracked closely with national findings. Among Michiganders over 50, 31% serve as caregivers, 33% of those report financial challenges, and 17% say they lack adequate support. Awareness gaps persisted: only 10% of Michigan caregivers said the person they care for had used adult day programs, and 26% had never heard of them. For respite care, 15% had used it, but 30% had never heard of it.

The consistency between Michigan and national data suggests this isn't a regional story. It's a structural one.

So what comes next?

The poll doesn't offer policy prescriptions, but the contours of the problem are clear enough. A growing population of older Americans is providing unpaid, largely untrained care to family members and friends. A significant minority of those caregivers have no personal safety net. Nearly half of isolated caregivers face financial strain. And the programs that could help — respite care, adult day programs, local aging agencies — remain invisible to the people who need them most.

The question isn't whether these caregivers exist. We know they do, in large and growing numbers. The question is whether the systems around them — health care, government, community organizations — will reach them before they reach their breaking point. The poll data suggests that for many, that outreach hasn't happened yet.

There's something worth sitting with in the core finding: people who spend their days looking after others are, disproportionately, the ones with no one looking after them.