Helping an ageing parent or loved one often begins with easy-to-field requests: Pick up a prescription. Drive them to a doctor’s appointment. Grab groceries.
However, light tasks – just “helping out” here and there – may eventually snowball into the avalanche of full-time caregiving, a phenomenon becoming known as “caregiver creep”. Like “caregiver burnout”, it’s not a formal term, but there is growing awareness about this slow build among healthcare providers and experts.
A 2025 research report from the AARP and the National Alliance for Caregiving found that 63 million Americans act as caregivers; one in every four adults is a caregiver and the majority (94%) are caring for an adult. As the population ages – the oldest baby boomers will turn 80 this year – the need for care will increase.
The US Bureau of Labor Statistics reports the majority (59%) of those providing this unpaid care are women. Many gen X and millennial women are feeling the sandwich-generation squeeze of caring for parents and children on top of their careers.
Recognizing when responsibilities increase, how to identify when support needs to level up, and where to find resources both for the person receiving care and the caregiver can help manage caregiver creep.
What is caregiver creep?
According to the Caregiver Alliance, a caregiver is an unpaid individual who helps another person with everyday activities of daily living or medical tasks. (Separately, paid care providers may assist at home or at a care facility.)
Caregiver creep is a slow build of tasks and increased responsibilities that may not be apparent at first. It can be distinguished from a more straightforward, sudden plunge into caregiving after an unexpected change in health or circumstances.
Kim Elliott, a 45-year-old director of software sales in Denver, Colorado, has experienced both. Elliott was close to her father-in-law. She, rather than his two sons, was the point person for his care. She ordered groceries for him, bought his clothes and made extra dinners to drop off.
“I took my father-in-law to a doctor’s appointment and they referred to me as the caregiver … At that moment, I recognized that I was the one caring for him and that there was a term for all of the years of care,” Elliott says.
By contrast to this slow creep, in late 2020 Elliott abruptly became the caregiver to her mother. Elliott’s mother was diagnosed with an aggressive form of leukemia that required an urgent stem cell transplant and round-the-clock care. Amid the pandemic, her mother relocated from California to Colorado to move in with Elliott, who became both her stem cell donor and caregiver.
“That was an absolute plunge,” Elliott says. “There were minutes between me realizing that she was in need of intense care and the decision to raise my hand to help.”
It is very common for people to not recognize the slide into caregiver status – when being a helpful child becomes something more. An estimated 53 million people provide over $870bn worth of unpaid care for loved ones in the US, according to the Johns Hopkins Bloomberg School of Public Health. Public health experts say that the tremendous strain on individuals, the grand scale and lack of resources constitutes a crisis.
Jackee de Lagarde’s caregiver creep began in 2010 when her father became ill. De Lagarde, a 49-year-old fashion and branding consultant in New Jersey, relocated from San Francisco to New York with her husband to help him. Caregiver roles are often temporary, but following her father’s death in 2012, his medical costs left her mom in need of financial support. When de Lagarde’s son was born in 2013, her mother moved in with them, resulting in a positive multigenerational arrangement – particularly as her mother helped with childcare.
In 2021, de Lagarde’s mom was diagnosed with progressive supranuclear palsy (PSP), a rare degenerative neurological disease. De Lagarde and her husband, who had already cared for his mother, stepped into full-time caregiver roles.
“That’s part of the creep. You are so in the moment. There’s so much that needs to be done that I wasn’t thinking about myself. I wasn’t thinking, how is this gonna affect me, my identity, my family, my career? – it was just go mode,” says de Lagarde.
How do you know when an ageing person needs more care?
Health shifts may be slow or sudden, but a person’s needs often increase with age-related changes.
“Ageing denial is the biggest disease we have,” says Rosanne M Leipzig, a professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai and author of Honest Aging. “You’ve got to be prepared. If you know what’s normal and what to expect, you can gear up for it and adapt,” she says.
There are two categories of tasks that are used to assess cognitive and physical health, says Leipzig: activities of daily living (ADL) and instrumental activities of daily living (IADL). These are the everyday tasks required to live independently. Healthcare providers rate the tasks on a scale to assess health and ability, and determine if support is needed. “These are clues that something’s going on … and also clues that people need more help than they currently have,” says Leipzig.
ADL include daily tasks such as bathing, personal hygiene, using the toilet, eating, getting dressed and moving around the house. Sometimes, people only need temporary assistance with ADL, such as after a surgery. IADL are more advanced skills, such as managing money, organizing a household, cooking, making a phone call, driving and shopping.
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If you notice that an older person needs help with ADL and IADL – for instance, they are wearing the same outfit or taking longer to answer the phone, or have an empty fridge – these are signs that support is needed, says Martin Hernandez, general manager of family sales at A Place for Mom, an agency that helps assess and find in-home support and senior living options for families.
Leipzig notes that the Medicare annual wellness visit can be a helpful assessment tool for ADL and IADL. She recommends someone dial in or be at a parent’s wellness visit to understand their overall health needs.
What should you do when older relatives or friends need more support?
First, start the conversation. “Dialogues are really important,” says Leipzig. Acknowledge that their needs have shifted, then “brainstorm together”, she says. “Make it a team effort. Collaborate if it’s possible.”
The best-case scenario is to get ahead of the creep and start the conversation before their needs grow. Invite other point people too, advises Hernandez. “Over half of the families that we speak to wish they would have started their planning sooner. It doesn’t mean that a decision needs to be made, but you need to be prepared for it,” says Hernandez.
As a caregiver, you cannot do it all, so knowing the options can be mutually beneficial. “No one task seems huge on its own. But over time, that mental load, that stress, that worry, that time commitment can become very real,” says Hernandez. Meet with a social worker or senior living adviser to discuss support and safety for ageing in place, whether a move is the right option, and budgeting.
For transportation, grocery shopping or socialization, connect with a social worker through a community agency or local senior center, or at a hospital.
Many caregivers find themselves financially responsible for covering costs or taking a step back from their careers to provide care. This can result in lost earnings. Advance planning can help minimize that impact. A Place for Mom’s 2026 Cost of Long-Term Care and Senior Living Report found that the national median costs were $34 per hour for home care, $3,200 per month for independent living, $5,419 per month for assisted living and $6,690 per month for skilled memory care.
What is the effect on caregivers?
Caring for loved ones can deepen relationships, but caregivers need outside support to avoid burnout and maintain their own health. Leipzig warns that caregivers are often unaware of how burdened they are. She recommends connecting with a social worker for services and support groups for caregivers or groups specific to care for Alzheimer’s, dementia or cancer.
Caregiving can be extremely isolating. Resources are scattered, research is often self-led and community can be hard to find. In 2025, Elliott founded Gray Monster, a newsletter dedicated to those supporting ageing parents that features practical resources, tools and interviews with experts.
Elliott wanted to help others feel less alone and normalize conversations about care. “The caregiving experience I walked into cannot be the one that 63 million people are also walking into. I can’t let that happen,” Elliott says.
De Lagarde also felt that isolation and launched the Who Cares About Me? podcast for caregivers. “Everybody’s going through it. We all have some of the same experiences, and sometimes you just want to be heard and acknowledged,” de Lagarde says.
