The Cost of Family Caregiving: What You Spend and How to Offset It

In AARP's 2021 national study, family caregivers reported a typical annual out-of-pocket total of $7,242 and spent 26% of their income on caregiving.1 If you've been quietly adding up the co-pays, the groceries, the gas, and the shifts you've missed, you're not imagining the cost of family caregiving. It's real, it's measured, and some of it can come back to you through programs most families never hear about.

In This Guide

• Key Takeaways
• What Family Caregivers Spend Out of Pocket
• What Caregiving Costs You at Work
• What the Same Care Would Cost to Buy
• Can You Get Paid for the Care You Give?
• Tax Breaks That Offset the Cost of Family Caregiving
• Free Help That Lowers What You Spend
• Protecting Your Job and Your Paycheck
• If the Person You Care For Is a Veteran
• Where to Start This Week
• Frequently Asked Questions
• Learn More

What Family Caregivers Spend Out of Pocket

Most caregivers never set out to spend money. It happens a receipt at a time: a prescription you cover because it's easier than arguing, a grab bar for the shower, a tank of gas for the third drive of the week. Then one day you total it up and the number stops you cold.

The best national measure comes from the AARP 2021 Caregiving Out-of-Pocket Costs Study, a national study of nearly 2,400 caregivers conducted in the spring of 2021. The AARP 2021 study found that nearly eight in 10 family caregivers report routine out-of-pocket expenses for the person they look after, that the typical annual total was $7,242, and that on average family caregivers spent 26% of their income on caregiving activities.1

The U.S. Centers for Disease Control and Prevention relays the same 2021 AARP study on its caregiving public health page, and CDC lists caregiving services, meals, medical supplies, and other expenses among what family caregivers pay for out of pocket.1

If the person you care for has dementia, expect the bill to run higher. CDC, citing the AARP 2021 study, reports that annual out-of-pocket costs rose to nearly $9,000 per year for caregivers of someone with dementia.1

Two cautions keep these numbers honest. They're 2021 survey figures, so prices you pay today are likely different. And they're a typical total across many families, not a budget for yours. The value of the figure is permission: if your spending looks like this, it isn't a sign you're doing something wrong.

What Caregiving Costs You at Work

The out-of-pocket number leaves out the biggest cost for many families: the income you give up. That loss is quieter, because it shows up as a smaller paycheck, a skipped promotion, or a job you left, not as a receipt.

CDC's caregiving public health page states that many employed caregivers have had to take time away from work, resulting in lost wages, and CDC draws its work figures from the Rosalynn Carter Institute for Caregivers' 2021 national survey, Working While Caring, which surveyed 509 family caregivers ages 18 to 70 who were employed full-time.1 In the Rosalynn Carter Institute's 2021 survey, nearly two in ten employed family caregivers said they had to quit their job, and more than four in ten said they had to go part-time.1

If you're weighing cutting back, it's worth knowing that federal job-protection and some state paid-leave programs exist before you decide. Those are covered in Protecting Your Job and Your Paycheck below.

What the Same Care Would Cost to Buy

Here's another way to see what you're giving. If you stopped tomorrow, someone would have to be paid to do it. The CareScout Cost of Care Survey for 2025, released March 2, 2026, gives these U.S. national medians.5

These are medians from CareScout's 2025 national survey, not prices, and CareScout warns that actual long-term care costs vary with care needs, provider availability, and local market conditions.5 Still, the table makes one thing plain: at CareScout's 2025 U.S. median of $35 an hour for a non-medical in-home caregiver, even a few hours of your help each week is worth real money.5 For your state's figures, see Cost of Senior Care by State.

Can You Get Paid for the Care You Give?

For many families this is the single biggest offset, and it's the one people assume doesn't apply to them. Sometimes it does.

Medicaid self-direction. If the person you care for gets Medicaid home care, their state may run a self-directed program in which the participant or a representative chooses, hires, schedules, and supervises their own workers and helps decide what those workers are paid.2 Under federal Medicaid law, whether a relative, including a spouse, can be the paid worker in a Medicaid self-directed program is a state option: a state may allow it, and a state may decline.2 One federal limit trips families up. Under the federal Medicaid rules for Section 1915(j) self-directed personal assistance and for Community First Choice, a person serving as the participant's appointed representative can't also be the paid caregiver.2 Because the answer turns on your state's program rules, start with How to Get Paid as a Family Caregiver, which covers all 50 states, and Medicaid Self-Direction and Consumer-Directed Services. If the person you care for is your husband or wife, see How to Get Paid to Care for Your Spouse.

The federal income tax treatment of that pay. When you live with the person you care for and are paid through a state Medicaid home and community-based services waiver under section 1915(c), the IRS treats those qualified waiver payments as difficulty-of-care payments you can exclude from your federal gross income under IRS Notice 2014-7.6 The IRS Notice 2014-7 exclusion does not apply if you keep a separate home where you regularly live.6 State tax treatment is a separate question, so confirm it with a tax professional.

Private family pay. If your family pays you directly from a parent's savings, a written arrangement protects everyone, especially if Medicaid could be needed later. Personal Care Agreements explains how that works.

Tax Breaks That Offset the Cost of Family Caregiving

Taxes won't refund what you spent, but they can take a meaningful bite out of it if you meet the conditions. Each federal break below has a gate, and the gate is what decides whether you get anything.

The medical expense deduction. Under federal tax law, if you itemize on Schedule A, you can deduct unreimbursed medical expenses only to the extent they exceed 7.5% of your adjusted gross income; if you don't itemize, you get no medical deduction.3 For the federal medical expense deduction, qualifying costs can include wages paid for nursing services, and qualified long-term care services for a chronically ill person under a plan of care prescribed by a licensed health care practitioner.3 Even if a parent's income is too high for you to claim them as a dependent, you can still count the medical costs you paid for them toward your own federal medical expense deduction, as long as they would have been your dependent except for the gross-income, joint-return, or claimed-by-someone-else tests.3

Claiming a parent as a dependent. For 2026 under federal tax rules, a parent can be your qualifying-relative dependent only if their gross income is less than $5,300 and you provide over half of their support, and three further tests must also be met.3 Social Security that isn't taxable doesn't count toward the $5,300 federal gross-income limit for claiming a parent as a qualifying-relative dependent in 2026, and siblings who share the support can use a multiple support agreement so one of them claims the parent.3

The Child and Dependent Care Credit. Despite the name, the federal Child and Dependent Care Credit can apply to an adult who couldn't care for themselves, but only if that person lived with you for more than half the year and was (or nearly was) your dependent, and only if you had earned income and paid for the care so you could work.3 The federal Child and Dependent Care Credit is a percentage of your work-related care expenses, and the expenses used to figure it are capped at $3,000 for one qualifying person or $6,000 for two or more.3

For worked detail on each, see Tax Breaks for Family Caregivers and Tax Deductions and Credits for Senior Care Costs. If you hire help directly, How to Hire an In-Home Caregiver covers the household-employer tax side.

Free Help That Lowers What You Spend

Not every offset puts money in your hand. Some keep money from leaving it, by giving you services you'd otherwise pay for.

The National Family Caregiver Support Program. Authorized under Title III-E of the Older Americans Act, the National Family Caregiver Support Program funds five kinds of support through your local Area Agency on Aging: information about services, help getting access to them, individual counseling with support groups and caregiver training, respite care, and limited supplemental services.4 The National Family Caregiver Support Program serves adult family members and other informal caregivers of people 60 and older, caregivers of people of any age with Alzheimer's disease or a related disorder, and certain relatives 55 and older raising children or caring for adults ages 18 to 59 with disabilities.4 One limit to know before you call: under the federal Older Americans Act, National Family Caregiver Support Program respite care and supplemental services are available only when the person you care for is "frail," meaning they can't do at least two activities of daily living without substantial human assistance or, because of a cognitive or other mental impairment, need substantial supervision because their behavior poses a serious health or safety hazard.4 The Older Americans Act sets no fixed respite amount per caregiver, so what's available depends on your area.4 Find your local office through Area Agencies on Aging: How to Find and Use Yours, and read more in The National Family Caregiver Support Program.

Respite care. Respite is temporary care for the person you look after so you can rest, travel, or spend time with other people. Respite care can last a few hours or several weeks, at home, in a facility such as a nursing home, or at an adult day center.7 Respite from a friend, relative, or volunteer may cost nothing, while professional respite charges by the hour or by the number of days or weeks.7 Respite Care for Family Caregivers covers how to get a break and how to pay for it, and the Respite Care directory lists state options.

Protecting Your Job and Your Paycheck

Before you cut your hours or quit, find out what time off you're entitled to. Whether you have a right to protected leave, or to partial pay while you care for a relative, depends on federal and state leave laws with their own eligibility tests, and two dedicated guides walk through them: FMLA for Family Caregivers and Paid Family Leave for Caregivers. In the Rosalynn Carter Institute's 2021 national survey of full-time employed family caregivers, only four in ten reported access to paid leave or mental health coverage, so ask your employer's HR office directly what you have rather than assuming.1

If the Person You Care For Is a Veteran

Veterans' families have options that can pay a caregiver directly, and they're easy to miss.

The VA caregiver stipend. Through the Program of Comprehensive Assistance for Family Caregivers, the U.S. Department of Veterans Affairs pays an approved Primary Family Caregiver a tax-free monthly stipend.8 There's no single national dollar amount for the PCAFC stipend: VA sets it from the federal GS-4, step 1 pay rate for the veteran's locality, so it varies by where the veteran lives.8 VA's first screen for the veteran under the Program of Comprehensive Assistance for Family Caregivers has four parts that must all be true: a VA disability rating of 70% or higher, a discharge from the U.S. military or a date of medical discharge, a need for at least six months of continuous in-person personal care, and enrollment in VA health care. Meeting those four PCAFC criteria is necessary but not enough, because VA assesses further conditions during the application.8 Approval alone doesn't start the money: VA says a Primary Family Caregiver must enroll in direct deposit through the VA customer engagement portal to get the monthly stipend.8 The details are in VA Caregiver Stipend (PCAFC).

VA Veteran-Directed Care. VA's Veteran-Directed Care program gives an eligible veteran a flexible budget for home and community services, and the veteran can hire their own personal care aides, which VA says might include a family member or neighbor.9 VA Veteran-Directed Care is only available in certain locations and may carry a copay, so ask the veteran's VA social worker whether it's offered nearby.9 See VA Veteran-Directed Care. A lower-income wartime veteran or surviving spouse may also qualify for VA Aid and Attendance, an increased monthly VA pension payment that requires the veteran or survivor to already qualify for a VA pension.8 Our Aid and Attendance guide covers the rules.

Where to Start This Week

You don't have to tackle all of this at once. A few calls can change the math.

Learn More

Find personalized help cutting the cost of caring for a family member at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.