The hidden, lifelong price of showing up for someone you love — and where California caregivers can find real support.
Family caregivers are one of the largest workforces in the country, and almost none of them are counted, or paid, as workers. Every day, parents, spouses, adult children, and other relatives across the country provide care that would otherwise fall to hospitals, home care agencies, residential programs, or government-funded services. They manage medications, prevent falls, sit through medical appointments, coordinate services, and stay available in ways no job description would ever ask for.
In 2024, family caregivers in the United States provided an estimated 49.5 billion hours of unpaid care to adult family members and friends, according to the AARP Public Policy Institute’s most recent “Valuing the Invaluable” report, released in March 2026. Valued at what that labor would cost on the open market, it comes to $1.01 trillion — more than the entire country spent on Medicaid that year, and more than private businesses spent on health care.
Policymakers talk about that number often. What gets discussed far less is what caregiving costs the caregiver. The price isn’t paid only in hours. It’s paid in careers interrupted, retirement accounts left underfunded, Social Security benefits quietly reduced, and financial ground that, for many families, is never fully recovered.
The Paycheck That Never Arrives
Most people understand, in a general way, that stepping back from paid work to provide care costs money. What’s harder to see is how much that cost compounds over time. A caregiver who leaves a job doesn’t just lose a salary — they also lose employer retirement contributions, the raises and promotions they would have earned, and the professional momentum that turns one job into a better one.
A 2025 Urban Institute analysis, drawing on research highlighted by the U.S. Department of Labor’s Women’s Bureau, found that mothers who provide unpaid care over their lifetimes — to children, to aging parents, or to both — earn about 15 percent less than they would have otherwise, an average loss of roughly $237,000 in wages and retirement income. That figure is specific to mothers, and it blends the earnings effects of caring for kids with the effects of caring for adults, so it isn’t a stand-in for what every caregiver loses. But it illustrates the same basic mechanism at work for anyone who scales back paid employment to provide care: less time in the labor force compounds into a smaller paycheck, smaller employer contributions, and a lower ceiling on everything that comes after.
Retirement savings are especially sensitive to this kind of interruption, because they depend on time as much as money. Consider a simplified example: a caregiver who stops contributing $6,000 a year to a retirement account for ten years doesn’t just lose $60,000. Assuming a modest 7 percent average annual return, that decade of missed contributions can add up to more than $100,000 in lost retirement assets by the time the caregiver reaches retirement age, once compounding is factored in — and that estimate doesn’t even include employer matching, pension accrual, or the raises that would have increased future contributions. It’s an illustration, not a study finding, but it’s a useful one: a pause that feels temporary in the moment can leave a permanent dent decades later.
The Social Security Penalty Few People See Coming
Social Security benefits are calculated from a worker’s 35 highest-earning years. When a caregiver leaves the workforce, or drops to part-time, those years don’t simply vanish from a paycheck — they can be replaced with zeros in the benefit formula, or with years of far lower earnings than the caregiver would otherwise have posted.
The effect doesn’t show up right away, which is part of what makes it dangerous. It shows up decades later, in a monthly retirement benefit that’s smaller than it should be, a disability benefit that’s smaller if the caregiver later becomes unable to work themselves, and potentially a smaller survivor benefit for a spouse. Many caregivers don’t learn the size of the gap until retirement is close enough that there’s little left to do about it.
$303,880
That's the average lifetime loss in wages, pension income, and Social Security benefits for caregivers 50 and older who left the workforce to care for a parent, according to a MetLife Mature Market Institute study. Women lost more than men — $324,044 versus $283,716.
Figures are from a 2011 study, the most recent of its kind. A caregiver making the same decision today would likely lose more in absolute terms.
A frequently cited 2011 study by the MetLife Mature Market Institute — dated now, but still one of the few studies to try to quantify this specific loss — found that caregivers age 50 and older who left the workforce to care for a parent lost an average of $303,880 in wages, pension income, and Social Security benefits over their lifetimes, with women losing more than men. Those are 2011 dollars, so a caregiver making the same decision today would likely lose more in absolute terms; no comparably rigorous study has updated the calculation since.
The Career That Doesn't Fully Come Back
The financial toll isn’t limited to the years someone is actively providing care. Caregivers who step away from full-time work often find that returning is harder than leaving was. Employment gaps raise questions in interviews. Professional licenses can lapse. Industry knowledge moves on without them. Promotions that would have happened on a normal timeline simply don’t, because the caregiver wasn’t there to be considered for them.
Researchers sometimes call this the “caregiving penalty” — the compounding effect of reduced hours, missed advancement, and skill erosion that persists long after caregiving duties change or end. It tends to fall hardest on people who step back during what would otherwise be their highest-earning years, because that’s when the gap between where a career was headed and where it actually ends up is widest.
The Costs That Never Show Up on a Tax Return
None of the above accounts for what caregivers spend out of their own pockets while doing the work. In AARP’s most recent national survey on the subject, 78 percent of family caregivers reported regular out-of-pocket costs, averaging $7,242 a year — about a quarter of the typical caregiver’s income. Housing-related costs, such as rent, mortgage payments, and home modifications, made up more than half of that spending; medical costs like equipment, supplies, and copays accounted for another significant share.
Nearly half of caregivers surveyed said they’d experienced a financial setback as a direct result — dipping into savings, taking on debt, or cutting back on their own retirement contributions to keep up. These are recurring, everyday expenses, layered on top of the wage and retirement losses described above, not instead of them.
A System Built on Sacrifice
None of this happens in a vacuum. America’s long-term care system is built, in large part, on the assumption that families will absorb the difference. Every hour a family caregiver spends helping a parent bathe, a spouse manage medication, or a family member with a disability get through the day is an hour a hospital, a residential facility, or a paid home care worker doesn’t have to spend instead — and a cost the public system doesn’t have to pay.
That’s part of why the aggregate value of unpaid family care is worth naming plainly: it isn’t a rounding error. Caregiving has real, sustained economic value, and the people creating that value are, more often than not, the ones quietly paying for it out of their own future.
Where California Caregivers Can Find Support
None of this is a reason to feel guilty for providing care, and it isn’t a reason to stop. It’s a reason to know what support actually exists, so the sacrifice isn’t bigger than it has to be. In California, In-Home Supportive Services (IHSS) is the state’s program for paying eligible caregivers — including many family members — for a portion of the hands-on care they’re already providing to someone who qualifies. It won’t erase a lifetime of lost wages or restore Social Security credits that were never earned, but for many families it turns at least part of an unpaid full-time job into one that shows up in a paycheck, with real hours and real pay attached to it.
If you’re not sure whether you or the person you care for qualifies, or you just want a clear, current explanation of how the program actually works in California, that’s what IHSS Connect is here for.
Not sure where you stand with IHSS?
Whether you're already caregiving or just starting to look into support, IHSS Connect can help you figure out the next step.
The years spent showing up for someone else don’t disappear once the caregiving ends. They show up later — in a bank account, a retirement statement, a Social Security estimate — long after the daily urgency that caused them has passed. Caregivers deserve to go into that decision with their eyes open, and with as much real support behind them as they can find.
