The Care Squeeze: Why Working Caregivers Are the Workforce's Hidden Majority, and How Leaders Can Build Care-Ready Organizations
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Abstract: Unpaid family care for aging parents, children, and relatives with illness or disability has become one of the most widespread and least visible forces shaping employee performance and retention. This article synthesizes recent national data, including the AARP and National Alliance for Caregiving's Caregiving in the US 2025, Bureau of Labor Statistics time-use estimates, and the University of Kansas Care Board's October 2026 release, alongside peer-reviewed research on work-family conflict, family-supportive supervision, and randomized workplace interventions. It describes how caregiving shows up at work as schedule disruption, reduced hours, declined promotions, and exits, and how those costs fall unevenly on women, hourly workers, and mid-career talent. Five evidence-based responses are examined: making care visible, training family-supportive supervisors, redesigning work for schedule control, offering inclusive caregiving leave, and building equitable care infrastructure. Organizational examples from technology, financial services, energy, insurance, professional services, health care, and retail illustrate each response. The article closes with three pillars for long-term care readiness: measurement, equity by design, and a culture of shared care.
Ask a room of managers how many of their people are caregivers and most will guess low. They will think of new parents, perhaps a colleague whose mother recently moved into assisted living. They are unlikely to picture the analyst who drives across town at lunch to manage her father's medications, the warehouse supervisor who swaps shifts so he can take his son to physical therapy, or the senior engineer who has quietly declined a promotion because the new role would mean more travel and less control over his evenings. Yet those employees are everywhere. They are simply hard to see.
The scale is no longer in dispute. In July 2025, AARP and the National Alliance for Caregiving reported that 63 million Americans, nearly one in four adults, had provided ongoing care to a family member or friend in the past year, an increase of roughly 20 million since 2015 (AARP & National Alliance for Caregiving, 2025). Seven in ten caregivers of working age were employed while caregiving. The Bureau of Labor Statistics (2025), using a different method and a narrower definition focused on eldercare, estimated that 38.2 million people provided unpaid care to an older adult during 2023 and 2024, about 23.6 million of whom were employed. And in October 2026, the University of Kansas Care Board released updated estimates suggesting that unpaid care work continues to grow, with the paid care workforce alone approaching 48 million workers (Caine, 2026).
Those numbers describe something larger than a benefits niche. They describe a structural feature of the modern workforce. Most employees will move in and out of caregiving several times over a career, sometimes for a few weeks after a surgery, sometimes for a decade of progressive dementia, sometimes for both a toddler and a parent at once. Caregiving is not an exception to working life. For a very large share of the workforce, it is working life.
What makes this a leadership issue rather than only a policy one is the gap between what employees experience and what organizations notice. Harvard Business School researchers Joseph Fuller and Manjari Raman (2019) found that a majority of employers in their survey did not track employees' caregiving responsibilities and that only about a quarter believed caregiving affected performance, while more than 80% of employee caregivers said it did. Newer data point in the same direction. A 2026 survey sponsored by the insurer The Standard found that HR decision-makers widely assumed women were the main users of caregiving leave, while men in a separate employee sample reported taking leave to care for a loved one's physical health at least as often as women did (Rosanes, 2026; The Standard, 2026). The samples were modest and the findings are directional, but the pattern is familiar: organizations are managing a workforce they do not fully see.
The consequences of that blind spot are concrete. Caregivers arrive late and leave early. They shift to part-time schedules, take leaves of absence, turn down advancement, and sometimes leave altogether. The organization loses experience, institutional knowledge, and leadership pipeline, usually without ever recording caregiving as the cause. Meanwhile, the employees who carry the heaviest load, disproportionately women, hourly workers, and those in the so-called sandwich generation, absorb the financial and health costs largely on their own.
This article argues that leaders can do considerably better, and that the evidence base for doing so is stronger than many assume. Randomized and quasi-experimental studies show that changing how work is organized and how supervisors respond to family demands can reduce work-family conflict, burnout, and turnover. Meta-analyses show that work-family-specific support from supervisors and organizations matters more than generic goodwill. Employer examples across industries show a growing repertoire of practical tools, from paid caregiving leave and subsidized backup care to carer networks and care navigation.
The sections that follow define the key terms and map the current landscape, examine the organizational and individual consequences of unsupported caregiving, review five evidence-based organizational responses with examples, and close with three pillars for building long-term care readiness. The goal is practical: to help leaders move from a patchwork of well-meant benefits toward an organization that is designed, from the start, for people who care.
The Working Caregiver Landscape
Defining Working Caregivers and Care Readiness
A family caregiver, in the sense used by most national surveys, is someone who provides unpaid help to a relative or friend who needs assistance because of age, illness, disability, or another condition. AARP and the National Alliance for Caregiving (2025) define their population as adults who, within the past year, cared for an adult or for a child with a complex medical condition or disability. That definition deliberately excludes routine parenting of healthy children. The University of Kansas Care Board takes a broader view of unpaid care, counting parents caring for young children alongside adults helping older relatives with errands or medication, and treating both as part of the economy's care infrastructure (Caine, 2026).
For leaders, the distinction matters less than the overlap. A working caregiver is any employee who combines paid work with unpaid care for another person, whether that person is a child, a spouse, a parent, a neighbor, or a relative with a disability. The term sandwich generation describes caregivers responsible for both children and older adults at the same time. AARP and the National Alliance for Caregiving (2025) found that nearly one in three family caregivers was also raising a child under 18, and the share rose to 47% among caregivers under age 50.
Two further concepts help explain why caregiving affects work. Work-family conflict refers to a form of role conflict in which demands from work and family are incompatible, so that meeting one makes it harder to meet the other. Researchers distinguish work-to-family conflict (work interfering with family life) from family-to-work conflict (family demands interfering with work). Both are relevant to caregivers, and both have well-documented antecedents and consequences (Allen et al., 2000; Michel et al., 2011). Schedule control refers to an employee's latitude over when and where work is done, and it emerges repeatedly in the research as one of the most important resources for managing care.
Finally, this article uses the phrase care-ready organization to describe an employer whose policies, management practices, job designs, and culture assume that a substantial share of employees will be caregivers at any given time and are built to sustain both their performance and their care responsibilities. Fuller and Raman (2019) use the related term caring company. The emphasis here is on readiness: an organization that has anticipated care rather than one that reacts to each case as a surprise.
Prevalence, Drivers, and Distribution
The headline figure from Caregiving in the US 2025 is striking on its own: 63 million caregivers, up from roughly 43 million a decade earlier (AARP & National Alliance for Caregiving, 2025). The report's methodology is robust for this kind of research. Ipsos surveyed 6,858 caregivers drawn from a nationally representative, probability-based online panel. Within that population, 70% of caregivers between 18 and 64 were employed while caregiving, and 60% of all caregivers, including those over 65, were employed. Among working caregivers, 61% worked 40 or more hours a week, and the average was 35.6 hours. These are not people at the margins of the labor force. They are, in large part, the full-time core of it.
Federal time-use data tell a consistent story. The Bureau of Labor Statistics (2025) estimated that 14% of the civilian noninstitutional population aged 15 and over provided unpaid eldercare during 2023 and 2024. Of the 38.2 million eldercare providers, about 23.6 million were employed and 18.4 million worked full-time. Caregiving peaked in late career: 24% of people aged 55 to 64 provided eldercare, compared with 19% of those aged 45 to 54. Roughly 7.6 million eldercare providers were also parents of children living at home, and 86% of those parents were employed.
The University of Kansas Care Board's October 2026 release adds a household lens. Mothers in the data provided about 43.6 hours of care per week compared with about 28.6 for fathers, and their labor force participation was 74.5% compared with 94.6% for fathers, a gap that widened in households with children aged five and under (Caine, 2026). The release also estimated that nearly 5 million adults were simultaneously caring for children and older adults. Principal investigator Misty Heggeness has argued that care work has historically been nearly invisible in economic measurement and that better data are needed to treat it as critical infrastructure (Caine, 2026).
Several forces are driving the trend. Population aging is the most obvious. People are living longer with chronic conditions, and the number of older adults relative to working-age adults is rising. AARP's Public Policy Institute has noted that by 2034 adults aged 65 and older are projected to outnumber children under 18 for the first time in U.S. history (Reinhard et al., 2023). Household structures have also changed. Fuller and Raman (2019) document the decline of large, multigenerational households and the growth of single-person and single-parent households, which means fewer people inside the home to share care. And care itself has become more complex. AARP and the National Alliance for Caregiving (2025) found that more than half of caregivers performed medical or nursing tasks, yet only about one in five had received formal training for them.
The economic value of this work is enormous. AARP's Valuing the Invaluable series estimated that family caregivers provided about 36 billion hours of unpaid care in 2021, worth roughly $600 billion, an increase of $130 billion over the prior estimate (Reinhard et al., 2023). That value does not appear on any employer's balance sheet, but its side effects do: in absence patterns, in turnover, in the slow attrition of mid-career talent.
Caregiving is not evenly distributed, and neither is support for it. AARP and the National Alliance for Caregiving (2025) found that more employed caregivers were paid hourly (53%) than salaried (40%), and that female working caregivers were more likely to be hourly than male working caregivers. The report also found that the share of all family caregivers who work was higher among Black caregivers (66%) and LGBTQ+ caregivers (66%) than among caregivers overall. Financial strain was greatest for younger, lower-income, Black, Latino, and LGBTQ+ caregivers. In other words, the employees most likely to need flexibility and paid time are often in the jobs least likely to offer them, a pattern examined in more detail below.
Finally, much caregiving remains hidden at work. Only 49% of employed caregivers in the 2025 survey said their supervisor knew about their caregiving responsibilities (AARP & National Alliance for Caregiving, 2025). Fuller and Raman (2019) found that many employees feared that admitting to caregiving would harm their career prospects. Concealment protects the individual in the short run, but it makes the problem invisible to the organization and guarantees that support arrives late, if it arrives at all.
Organizational and Individual Consequences
Organizational Performance Impacts
The most immediate organizational effect of caregiving is schedule disruption. In the 2025 national survey, 56% of working caregivers who were not self-employed reported going in late, leaving early, or taking time off to provide care (AARP & National Alliance for Caregiving, 2025). Eighteen percent had cut from full-time to part-time or otherwise reduced their hours, 16% had taken a leave of absence, and 9% had received a warning about performance or attendance. Working caregivers were also more likely than nonworking caregivers to handle tasks such as communicating and advocating with health care providers, activities that typically must happen during standard business hours.
These disruptions compound. A missed morning becomes a pattern of late arrivals, which becomes an attendance warning, which may become a resignation. Fuller and Raman (2019) found that employers in their survey identified unplanned absences, late arrivals, and early departures as the behaviors most likely to undermine career progression. Those are precisely the behaviors that caregiving produces. The result is a quiet but systematic penalty: employees are judged on visible availability, and caregivers lose ground for reasons the organization does not recognize.
The talent costs are significant. In the Harvard Business School employee survey, 32% of respondents said they had voluntarily left a job at some point because of caregiving responsibilities (Fuller & Raman, 2019). The figure was 50% among employees aged 26 to 35. Notably, the share who had left rose with seniority within age groups; among 26- to 35-year-olds, 61% of senior leaders reported having left a position because of caregiving compared with 23% of individual contributors. While the employee survey was funded in part by a care services company and relied on an online panel, the direction of the finding is consistent with the national data: 9% of working caregivers in the 2025 AARP survey had given up working entirely, 8% had turned down a promotion, and 7% had retired early (AARP & National Alliance for Caregiving, 2025).
Lost promotions deserve particular attention because they are almost never counted. An employee who declines a stretch role to preserve schedule predictability stays on payroll, so the organization records no loss. But the leadership pipeline thins, and it thins selectively, removing people who are often experienced, mid-career, and well networked. Fuller and Raman (2019) also found that only a minority of employees who were offered caregiving-related benefits actually used them, in part because many benefits were poorly matched to need and in part because employees worried about how use would be perceived. Spending on benefits that go unused is a second hidden cost.
There is also a productivity dimension. A major review of the research on work-to-family conflict links it to lower job satisfaction, weaker organizational commitment, higher turnover intentions, and greater stress (Allen et al., 2000). Michel et al. (2011), in a meta-analysis of 178 samples, found that work role stressors and work social support were among the strongest antecedents of work-family conflict, which matters because both are within an employer's control. Organizations cannot eliminate an employee's caregiving demands, but they can shape the job demands and support that determine whether those caregiving demands spill into conflict.
Individual Wellbeing and Stakeholder Impacts
For caregivers themselves, the costs are financial, physical, and psychological. AARP and the National Alliance for Caregiving (2025) found that nearly half of caregivers had experienced at least one major financial impact, such as taking on debt or being unable to afford food, and AARP's chief executive estimated that caregivers spend about $7,200 a year out of pocket on average. Working caregivers reported higher rates of using up short-term savings (31% versus 20%) and taking on debt (22% versus 17%) than nonworking caregivers. That may seem counterintuitive, but working caregivers are often purchasing help precisely so they can keep working, and they are often doing so on modest wages.
Health effects are real but uneven. A widely cited meta-analysis found that caregivers reported more depression and stress and somewhat worse physical health than noncaregivers, with larger gaps in clinical samples than in representative community samples (Pinquart & Sörensen, 2003). Later population-based work suggests that the most serious harms are concentrated among highly strained caregivers, while many caregivers also report meaning and pride in the role. Bauer and Sousa-Poza (2015), reviewing the international literature, concluded that caregiving tends to lower psychological health, which in turn affects physical health, and that women, spousal caregivers, and those providing intensive care are most affected. In the 2025 U.S. survey, one in five caregivers rated their health as fair or poor, and nearly one in four said caregiving made it hard to take care of their own health (AARP & National Alliance for Caregiving, 2025).
Isolation is a further concern. A quarter of working caregivers reported feeling alone, a higher share than among nonworking caregivers (AARP & National Alliance for Caregiving, 2025). Work can be a source of connection and identity for caregivers, but it can also be a place where they feel unable to speak about what is happening at home.
The gender dimension cuts in two directions. Women still provide more care on average and pay a larger labor market price for it, as the Care Board's participation gap illustrates (Caine, 2026). At the same time, men's caregiving is frequently underestimated. The Standard's 2026 surveys suggest that HR leaders may systematically underestimate how often men take leave to care for family members (Rosanes, 2026; The Standard, 2026). Experimental research helps explain why men may be reluctant to make that caregiving visible: Rudman and Mescher (2013) found that men who requested family leave were viewed as poorer organizational citizens and as weaker and less agentic, perceptions that predicted recommendations for penalties such as demotion or downsizing. When either gender's caregiving is misperceived, policies are designed for the wrong people and stigma flourishes.
Other stakeholders are affected as well. Care recipients depend on caregivers' ability to stay employed, because employment often provides the income and health coverage that sustain the household. Coworkers absorb the work that shifts when a colleague is suddenly absent, and if coverage is unplanned, resentment can build. Communities and public programs absorb the costs when caregivers leave the workforce, deplete savings, or reach retirement with less security. The care squeeze, in short, is not a private problem that happens to surface at work. It is a shared problem that employers are unusually well positioned to ease.
Evidence-Based Organizational Responses
The research and practice evidence points toward five mutually reinforcing responses. None is sufficient on its own, and the strongest results come when organizations combine visible policy with changes in everyday management. Table 1 summarizes the evidence base, key practices, and illustrative examples for each response, which are then discussed in turn.
Table 1. Evidence-Based Organizational Responses to Working Caregiving
Response | Evidence Base | Key Practices | Illustrative Examples |
Make care visible | Employer-employee perception gaps; low supervisor awareness; benefit underuse (Fuller & Raman, 2019; AARP & National Alliance for Caregiving, 2025) | Care census, disclosure-safe norms, carer networks, leave data by group | Centrica carers network; Aviva carer policy pilot |
Train family-supportive supervisors | FSSB measurement and training studies; meta-analysis of work-family-specific support (Hammer et al., 2009, 2011; Kossek et al., 2011) | Brief supervisor training, behavior tracking, creative work-family problem solving | Grocery chain and health care field trials |
Redesign work for schedule control | Group-randomized STAR trial (Kelly et al., 2014; Moen et al., 2016, 2017) | Team-level control over time and place, results focus, low-value work cut | IT firm STAR trial |
Offer inclusive caregiving leave | Policy availability linked to attitudes (Butts et al., 2013); stigma research (Rudman & Mescher, 2013) | Paid leave covering elders, partners, disability; leaders model use | Deloitte, Microsoft, Google, Johnson & Johnson |
Build equitable care infrastructure | Benefit access gaps by pay type (AARP & National Alliance for Caregiving, 2025) | Backup care, care navigation, EAP, coverage for hourly and part-time staff | Bank of America, Starbucks |
Make Care Visible
Every other response depends on this one. Organizations cannot design for caregivers they cannot see, and the evidence suggests that most do not see them clearly. Fuller and Raman (2019) found that 52% of employers in their survey did not track data on employees' caregiving responsibilities, while 73% of employees in a separate survey reported some current caregiving responsibility. The same research documented a wide gap between how employers and employees viewed caregiving's effects on productivity. In the 2025 national data, only about half of employed caregivers said their supervisor knew they were caregivers (AARP & National Alliance for Caregiving, 2025). The Standard's 2026 surveys add a further caution: even HR leaders' beliefs about who takes caregiving leave may be badly miscalibrated (The Standard, 2026).
Visibility is not the same as surveillance. The goal is aggregate understanding and a culture in which disclosure is safe, not a registry of who is caring for whom. Fuller and Raman (2019) recommend a regular care census, an anonymous assessment of the scale and nature of care responsibilities across the workforce, combined with tracking benefit utilization. Butts et al. (2013) found in their meta-analysis that the availability of work-family policies was more strongly related to job satisfaction, commitment, and intentions to stay than actual use, partly through employees' perceptions that the organization supports families. Signaling matters. When employees see that the organization knows caregiving is common and has planned for it, they are more likely to believe support is genuine.
Effective approaches:
Run an anonymous care census: Ask about current and anticipated care for children, older adults, partners, and relatives with disability or illness, and repeat it every one to two years so trends are visible.
Disaggregate leave and benefit data: Examine use by gender, age, pay type, and location to test assumptions such as who takes caregiving leave.
Create carer networks: Employee resource groups for caregivers provide peer support and a channel for feedback without requiring individual disclosure to managers.
Name caregiving explicitly in policy: Policies that mention eldercare, disability, and serious illness, not only parenthood, signal that all forms of care count.
Normalize conversation from the top: Senior leaders who talk about their own caregiving reduce the perceived risk of disclosure.
Centrica, the UK energy company, has built visibility into its carer support over many years. In 2019 the company described a partnership with the charity Carers UK spanning roughly 15 years and noted that it offered flexible working from the day an employee becomes a carer, along with a carers network providing peer support (Centrica, 2019). That same year Centrica's chief executive co-signed a letter with Carers UK's chief executive to the UK's 100 largest employers urging greater support for carers, a public step that helped frame caregiving as a mainstream business concern rather than a private matter.
Aviva, the insurer, took a more incremental route. Before launching a formal carer policy for UK employees in October 2017, the company piloted it at its Bristol site and then rolled it out as part of a broader wellbeing program (Aviva, 2017). The launch was accompanied by the company's own research on carers and by data from Carers Trust indicating that roughly one in eight UK workers was a carer. Piloting allowed the organization to learn what employees actually needed before committing companywide.
A common pitfall is treating visibility as a one-time survey that produces a slide deck and nothing else. Employees who disclose caregiving in a census and then see no change learn that disclosure is pointless. Visibility only builds trust when it is visibly connected to decisions about policy, staffing, and management practice.
Train Family-Supportive Supervisors
Formal policies are filtered through supervisors. A manager decides whether a schedule change is approved, whether a late arrival is noted, whether an employee feels able to mention a parent's hospitalization at all. Research on family-supportive supervisor behaviors (FSSB) has made that influence measurable. Hammer et al. (2009) developed and validated a measure of FSSB with four dimensions: emotional support, instrumental support, role modeling, and creative work-family management, meaning proactive changes to how work is organized to help employees meet both sets of demands. In two samples of lower-wage workers, FSSB predicted work-family conflict, positive spillover, job satisfaction, and turnover intentions over and above general supervisor support.
Meta-analytic evidence confirms that specificity matters. Kossek et al. (2011), drawing on 115 samples and more than 72,000 employees, found that work-family-specific support from supervisors and organizations was more strongly related to work-family conflict than general supervisor or organizational support. Being a generally decent manager helps, but being a manager who understands and responds to family demands helps more.
Importantly, these behaviors can be trained. In a field study across 12 grocery stores, Hammer et al. (2011) randomly assigned six stores to an intervention in which supervisors completed roughly an hour of computer-based training and an hour of face-to-face group training, followed by voluntary self-monitoring of their supportive behaviors. Supervisors' knowledge improved substantially. Among employees with high family-to-work conflict, the training was associated with higher job satisfaction, better physical health, and lower turnover intentions. Among employees with low conflict, the effects were not positive, a useful reminder that support should be targeted to need rather than imposed uniformly. A later quasi-experiment in a health care organization extended the approach: supervisor training improved employees' perceptions of FSSB, which in turn were linked to higher job performance, engagement, commitment, and satisfaction and lower turnover intentions, with effects driven mainly by creative work-family management (Odle-Dusseau et al., 2016).
Effective approaches:
Teach the four FSSB dimensions explicitly: Emotional support, practical help, role modeling, and creative problem solving are distinct skills that can be described and practiced.
Keep training brief and behavioral: The grocery trial used about two hours of training plus self-monitoring, which is feasible even in lean frontline operations.
Prioritize creative work-family management: Help supervisors redesign coverage, sequencing, and handoffs rather than only granting individual exceptions.
Track behavior, not just attendance: Short self-monitoring or pulse measures help supervisors notice whether they are actually doing what they learned.
Target support to need: Focus first on teams and individuals experiencing high family-to-work conflict, where effects were strongest.
The grocery chain in the Hammer et al. (2011) study offers a useful frontline example. Thirty-nine supervisors in the intervention stores were trained, and 32 voluntarily took part in tracking their supportive behaviors over several weeks. The intervention was inexpensive and designed for a retail environment with hourly staff and tight schedules, which addresses the common objection that family-supportive management is a luxury for professional workplaces.
The health care organization studied by Odle-Dusseau et al. (2016) offered the training to its supervisors, and 71% took part. Ten months later, employees whose supervisors were perceived as more family-supportive showed better performance ratings and attitudes. The finding matters because it links supportive supervision to outcomes leaders care about, including supervisor-rated performance, not only to employee wellbeing.
A common pitfall is assuming that a supportive policy will be applied supportively. When supervisors are not trained, policies become discretionary favors, applied generously to some and grudgingly to others. That inconsistency undermines fairness and pushes caregivers back into concealment.
Redesign Work for Schedule Control
The most rigorous evidence on caregiving-friendly work comes from the Work, Family and Health Network, a multi-institution research collaboration that tested an intervention called STAR (Support. Transform. Achieve. Results.) in a group-randomized field trial at an information technology firm. STAR combined supervisor training on supporting employees' personal lives with team-based sessions that prompted employees to rethink when and where they worked, shifting attention from face time toward results. Kelly et al. (2014) found that STAR produced statistically significant, though modest, reductions in work-family conflict and improvements in family time adequacy, along with larger increases in schedule control and supervisor support. Crucially, the intervention did not increase work hours or perceived job demands, a common worry about flexibility. The benefits were greater for employees more vulnerable to work-family conflict.
Follow-up studies extended the findings. Moen et al. (2016) reported that over 12 months STAR reduced burnout, perceived stress, and psychological distress and increased job satisfaction among employees surveyed before a corporate merger announcement disrupted the study. Moen et al. (2017) found that employees on STAR teams reported lower turnover intentions and had a reduced risk of voluntary turnover over nearly three years. These effects were partly explained by reductions in work-family conflict, burnout, and stress.
The STAR results are important for caregivers because caregiving is often unpredictable. A parent falls, a school closes, a care aide cancels. Individual flexibility arrangements negotiated one at a time are poorly suited to that reality. Team-level schedule control, in contrast, builds coverage and flexibility into normal operations. Kossek et al. (2015) warn that flexibility implemented as an individual accommodation can backfire by creating fairness concerns and weakening culture, and that it works best as a systemic organizational change that empowers teams.
Effective approaches:
Shift the unit of flexibility to the team: Teams agree on core collaboration hours, coverage rules, and response expectations, so individuals can flex without negotiating each case.
Measure results, not presence: Define outcomes clearly so that schedule variation does not become a proxy for commitment.
Cut low-value work: STAR sessions encouraged teams to identify meetings and tasks that could be eliminated, freeing time rather than simply rearranging it.
Build cross-training and coverage: Redundancy lets caregivers step away for an appointment or emergency without leaving work stranded.
Adapt for shift-based roles: In frontline settings, schedule control may mean advance notice, shift-swapping tools, and employee input into rotas rather than remote work.
The IT firm in the Work, Family and Health Network trial is the clearest documented example. Some 867 employees participated in the well-being analyses, and the firm's teams were randomly assigned to STAR or usual practice (Moen et al., 2016). That randomization is rare in organizational research and gives leaders unusual confidence that the changes, rather than preexisting differences between teams, produced the results. The trial also weathered a real-world shock, a merger announcement, which dampened effects for employees surveyed afterward, a reminder that broader organizational turbulence can overwhelm even well-designed interventions.
A common pitfall is treating remote work as a complete answer. Remote and hybrid arrangements help many caregivers, but they are unavailable to large parts of the workforce and can blur boundaries so that work expands into every hour. Schedule control is the underlying resource; location flexibility is only one way to provide it.
Offer Inclusive Caregiving Leave
Leave policies have historically centered on the birth or adoption of a child. Caregiving, however, spans the life course, and a growing number of employers have extended paid leave to cover spouses, aging parents, and relatives with serious illness. Research on policy effects supports doing so. Butts et al. (2013) found that work-family policy availability had modest but consistent positive relationships with job satisfaction, affective commitment, and intentions to stay. At the same time, leave only helps if people feel able to use it. Rudman and Mescher (2013) showed that men who request family leave face penalties rooted in perceptions of weakness, which means that a policy on paper can be undermined by norms in practice.
Public policy is also moving. In the UK, the Carer's Leave Act 2023 took effect in April 2024, giving employees a day-one right to up to one week of unpaid leave per year to care for a dependant with a long-term care need (Carers UK, n.d.). Employers cannot require proof of caring and can postpone but not refuse the leave. In the United States, AARP and the National Alliance for Caregiving (2025) noted that 13 states and the District of Columbia offered paid family leave programs. Employer-provided leave remains essential, however, because statutory provisions are often unpaid, short, or limited to certain workers.
Effective approaches:
Define care broadly: Cover spouses and partners, parents and in-laws, adult children, and chosen family, and include disability and serious illness as well as end-of-life care.
Pay for at least part of it: Unpaid leave is often unaffordable for lower-wage caregivers, who most need it.
Allow intermittent use: Caregiving often requires days or half days rather than continuous blocks.
Make it gender-neutral in practice: Encourage and publicize men's use, and have senior leaders of all genders model it.
Pair leave with return planning: Agree on coverage before leave and check in on workload and schedules afterward.
Deloitte was an early mover among large professional services firms. In September 2016, it announced up to 16 weeks of fully paid family leave for U.S. professionals that could be used not only for a new child but also to care for a spouse or partner, an aging parent, or children beyond the birth stage (Deloitte, 2016). The firm cited its own survey finding that 88% of respondents would value a broader paid leave policy that included family care beyond parental leave.
Technology companies followed. In 2017, Microsoft introduced four weeks of paid leave, alongside existing unpaid leave, to care for a seriously ill family member, offering it first in 22 countries with plans to extend it worldwide (Bolden-Barrett, 2017). Google in 2022 doubled its carer's leave for employees caring for seriously ill loved ones to eight weeks, alongside expanded parental leave (Corrigan, 2022). Johnson & Johnson, as part of global paid leave enhancements, offers 10 days of paid time off per year to care for an immediate family member with a critical illness or injury; the company has highlighted an employee who used caregiver support while caring for her husband through organ failure and a transplant while raising three children (Johnson & Johnson, 2023).
In the UK, both Centrica and Aviva developed paid carer leave before the statutory right existed. Centrica offers 10 days of paid carers leave that do not come from annual leave, with a further 10 days available if matched with annual leave (Centrica, 2019). Aviva's 2017 policy provided up to 35 hours of paid leave per year for planned caring needs and up to 35 hours for emergencies, plus extended unpaid leave and the right to request a permanent change in working pattern (Aviva, 2017).
A common pitfall is offering generous leave that few people take. If employees believe using caregiving leave will brand them as less committed, or if their workloads simply wait for them, the policy will mostly serve as public relations. Leaders should track take-up by group and treat low use as a signal to investigate culture, not as evidence that the need is small.
Build Equitable Care Infrastructure
Leave covers time away. Much of caregiving, however, is about keeping a fragile arrangement running day to day: finding a reliable home aide, filling a gap when a child care center closes, navigating Medicare or disability benefits, arranging care for a parent in another city. Employers can help by providing care infrastructure, including subsidized backup care, care navigation and referral services, and employee assistance programs with caregiving expertise. Fuller and Raman (2019) found that the leading reasons caregivers gave for leaving a job included the unaffordable cost of paid help and the difficulty of finding trustworthy, qualified help, both areas where employers can make a difference.
Access to such supports is deeply unequal. Salaried working caregivers in the 2025 national survey were far more likely than hourly caregivers to report that their employer offered paid sick leave (78% versus 55%), paid family leave (60% versus 35%), telecommuting (58% versus 23%), and caregiver information, referral, counseling, or an employee assistance program (43% versus 27%) (AARP & National Alliance for Caregiving, 2025). Overall access to every measured benefit improved between 2020 and 2025, but the gap by pay type remains stark. Because hourly workers are a majority of employed caregivers and are disproportionately women, an infrastructure strategy that reaches only salaried staff misses most of the need.
Effective approaches:
Offer subsidized backup care for children and adults: Backup care addresses the unpredictable breakdowns that cause absences.
Provide care navigation: Expert guidance on eldercare options, benefits, and legal and financial planning saves caregivers hours of searching.
Extend eligibility to hourly and part-time staff: Design benefits so that frontline workers can actually use them, including low copays and easy enrollment.
Strengthen the EAP for caregivers: Ensure counseling and referral services include caregiving specialists rather than generic stress support.
Measure use and outcomes: Track uptake by pay type and connect usage data to absence and retention patterns.
Bank of America provides an example of a broad infrastructure approach in financial services. The company states that it offers up to 50 days of backup care per year for children and adult dependents when regular arrangements fall through, along with a Life Event Services team of more than 140 specialists that supported nearly 49,000 cases in 2025, and an employee assistance program offering up to 12 free in-person counseling sessions per issue each year (Bank of America, n.d.).
Starbucks extended backup care to a largely hourly retail workforce. In October 2018, the company announced that full- and part-time U.S. employees could use up to 10 days a year of subsidized backup care, paying $1 an hour for in-home care or $5 a day at a child care center, with the days usable for a parent or grandparent as well as a child (The Seattle Times, 2018). All U.S. employees also received a membership with a care marketplace that included help with senior care planning. The example matters because it shows that infrastructure benefits can be designed for part-time and frontline workers, not only professionals.
A common pitfall is equating the number of benefits with the quality of support. A long menu of services that employees do not know about, cannot afford, or cannot access from a store or plant floor does little. Fuller and Raman (2019) found that benefit usage was often very low across the 16 benefits they examined, even as users tended to report that the benefits helped. The work is in fit, communication, and access.
Building Long-Term Care Readiness
The five responses above are most effective when they are embedded in the way an organization operates rather than bolted on as programs. Three pillars support that kind of durable care readiness.
Care readiness can be understood as moving from hidden care demand through three organizational levers, seeing it, resourcing it, and redesigning work around it, toward outcomes such as lower conflict and burnout, fewer exits, and retained expertise. The pillars below describe what sustains that movement over time.
Measurement and Accountability
What gets measured gets managed, and caregiving has rarely been measured inside organizations. Long-term readiness begins with routine data: a periodic care census, utilization rates for leave and infrastructure benefits broken down by gender, age, pay type, and location, and exit interview questions that ask directly about caregiving. Fuller and Raman (2019) argue that employers should redo the math on the costs of care, combining turnover, absence, and presenteeism costs into a fuller picture that most management teams never see. National data from the University of Kansas Care Board and AARP can serve as external benchmarks, but internal data are what drive decisions (Caine, 2026; AARP & National Alliance for Caregiving, 2025).
Accountability means assigning ownership. Someone in the organization should be responsible for the caregiving strategy, with regular reporting to senior leadership on prevalence, use, and outcomes. Supervisors' family-supportive behaviors can be included in leadership development and, carefully, in performance conversations, given the evidence that those behaviors predict retention and performance (Hammer et al., 2009; Odle-Dusseau et al., 2016). Measurement also guards against the kind of misperception The Standard's research highlighted: assumptions about who takes leave are testable, and organizations should test them (The Standard, 2026).
Equity by Design
Caregiving support has too often been designed for salaried professionals and then extended, partially, to everyone else. The 2025 national data make clear that this approach misses most working caregivers, who are paid hourly and less likely to have access to paid leave, telecommuting, or caregiver services (AARP & National Alliance for Caregiving, 2025). Equity by design means starting with the employees who have the least slack, often frontline, hourly, and part-time workers, and building policies they can actually use.
In practice, this means paying for at least part of caregiving leave, offering predictable schedules and advance notice of shifts, creating shift-swap mechanisms, and ensuring infrastructure benefits are affordable and accessible without a desk or laptop. It also means attending to gender. Women continue to carry more care and pay a larger career penalty, while men's caregiving is often invisible and stigmatized (Caine, 2026; Rudman & Mescher, 2013). Policies that are formally gender-neutral but culturally coded as maternal will reproduce both problems. Equity also has a life-course dimension. Caregiving peaks for many employees in their fifties and early sixties, just as they reach their most experienced years (Bureau of Labor Statistics, 2025). Retaining those employees requires support that recognizes eldercare as central, not peripheral.
A Culture of Shared Care
Culture determines whether policies live or die. A care-ready culture treats caregiving as a normal, expected part of working life rather than a private failing to be hidden. Leaders who speak openly about their own caregiving, managers who respond to a family emergency with problem-solving rather than suspicion, and teams that plan coverage collectively all send the same message: care is shared here.
The STAR research demonstrates that culture can be changed deliberately. By shifting norms about when and where work happens and by training supervisors in supportive behaviors, STAR changed both employees' experiences and their decisions to stay (Kelly et al., 2014; Moen et al., 2017). Kossek et al. (2015) emphasize that flexibility works best when it is part of a systemic culture change rather than an individual accommodation. A culture of shared care also extends beyond the organization's walls. Centrica's public advocacy for paid carers leave alongside Carers UK shows how employers can help shift broader norms and policy (Centrica, 2019). Organizations that take this stance are not only supporting their own people; they are helping to build the care infrastructure that the whole economy depends on.
Conclusion
The care squeeze is not coming. It is here. With 63 million family caregivers in the United States, most of them working, and with care demands rising as the population ages and households shrink, caregiving has become a defining feature of the workforce (AARP & National Alliance for Caregiving, 2025). The costs show up in schedule disruptions, reduced hours, declined promotions, and exits, yet organizations rarely see caregiving as the cause, and many still misjudge who their caregivers are.
The good news is that leaders are not working without evidence. Randomized and quasi-experimental studies show that supervisor training and team-level schedule control reduce work-family conflict, burnout, and turnover (Hammer et al., 2011; Kelly et al., 2014; Moen et al., 2017). Meta-analyses show that work-family-specific support matters more than general goodwill (Kossek et al., 2011). Employers across industries have developed practical models, from paid caregiving leave and backup care to carer networks and navigation services. What distinguishes care-ready organizations is not any single program but the combination: they see care, resource it equitably, and redesign work around it.
For leaders deciding where to begin, the path is clearer than it may seem. Start by finding out what is actually happening in the workforce. Train supervisors, because they are where policy becomes practice. Give teams real control over time. Offer leave and infrastructure that cover the full range of care and reach the people who need them most. And build the measurement, equity, and culture that keep those commitments alive.
Assume caregivers are everywhere: Roughly one in four U.S. adults provides ongoing family care, and 70% of working-age caregivers are employed.
Close the visibility gap: Only 49% of employed caregivers say their supervisor knows about their caregiving, so run a care census and make disclosure safe.
Invest in supervisors: Brief, behavioral training in family-supportive supervision has improved satisfaction, health, performance, and retention outcomes in field studies.
Give teams control over time: The STAR trial showed that schedule control and supervisor support reduced conflict, burnout, and turnover without increasing hours.
Define care broadly in leave policy: Cover elders, partners, and relatives with illness or disability, pay for at least part of it, and encourage men to use it.
Design for hourly workers first: The largest benefit gaps fall on hourly caregivers, who are the majority of employed caregivers.
Measure what matters: Track prevalence, use by group, and caregiving-related exits so that assumptions can be tested and progress demonstrated.
Research Infographic
References
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Jonathan H. Westover, PhD, Chief Research Officer (Nexus Institute for Work and AI); Co-Founder & Chief Workforce and Learning Officer (Future State University); Founder & CEO (Human Capital Innovations); Professor of Organizational Leadership & Change (UVU). Read Jonathan Westover's executive profile here.
Suggested Citation: Westover, J. H. (2026). The Care Squeeze: Why Working Caregivers Are the Workforce's Hidden Majority, and How Leaders Can Build Care-Ready Organizations. Human Capital Leadership Review, 40(3). doi.org/10.70175/hclreview.2020.40.3.2
