EDITOR’S NOTE: This article was prepared with the assistance of ChatGPT. It was then edited by a human being.
In one of her final interviews, Dolly Parton made a comment that easily could have been overlooked at the time. Speaking about the years she spent caring for her husband, Carl Dean, during his illness, she said she was being treated for health problems that she “didn’t pay attention to when I was watching over Carl.”
Earlier, she had similarly acknowledged that while her husband was ill, and continuing after his death, she had not taken care of herself and had allowed her own health needs to slide. Neal K. Shah recently argued in Time that Parton’s experience should serve as a warning about an enormous but often largely invisible population: family caregivers.
The issue is becoming increasingly important. AARP and the National Alliance for Caregiving estimate that 63 million U.S. adults, nearly one in four, are family caregivers: an increase of about 20 million, or 45 percent, since 2015. Caregiving is also becoming more demanding: 44 percent provide high-intensity care, nearly one-fourth provide 40 or more hours of care each week, and about one-third have been caregivers for five years or longer.
Many are performing tasks once associated primarily with trained healthcare workers, including medication management, wound care, injections, and other medical or nursing activities.
The evidence that caregivers themselves face increased health risks is substantial. A 2024 Centers for Disease Control and Prevention (CDC) analysis comparing caregivers with non-caregivers found that 13 of 19 health indicators were worse among caregivers. In 2021–2022, a total of 25.6 percent of caregivers reported having been diagnosed with depression, compared with 18.6 percent of non-caregivers.
Caregivers also had higher rates of frequent mental distress, obesity, asthma, COPD, arthritis, smoking, and multiple chronic physical conditions. Another CDC analysis of more than 109,000 baby boomers found that caregivers were 39 percent more likely to report frequent mental distress and were more likely to have at least one chronic health condition than non-caregivers.
The newest AARP data illustrates how caregiving may interfere with self-care. One in five caregivers reports being in fair or poor health; nearly one in four says caregiving makes it difficult to take care of their own health; and 39 percent report high emotional stress. Almost one-fourth also report social isolation. Federal health guidance similarly warns that prolonged caregiver stress is associated with greater risk of illness, depression and anxiety, sleep problems, and chronic conditions.
There is biological evidence as well. In a small but influential Lancet study, women caring for relatives with dementia who had a standardized wound took 48.7 days to heal, compared with 39.3 days among matched non-caregivers – roughly nine days longer. Researchers also detected differences in immune response.
Subsequent research comparing Alzheimer’s caregivers with matched controls found greater depressive symptoms, impaired measures of immune function, and shorter telomeres among caregivers, consistent with the physiological consequences of chronic stress.
Perhaps most concerning is the possibility of premature mortality among highly stressed caregivers. A frequently cited 1999 Journal of the American Medical Association (JAMA) study found that older spouses who were providing care and experiencing emotional or mental strain had a 63-percent higher four-year mortality risk than spouses whose partners were not disabled. Importantly, the finding did not apply to every caregiver: those who were not experiencing strain did not have a statistically significant increase in mortality. That distinction is important when presenting the study.
Pardon’s experience therefore illustrates something statistics can obscure. A caregiver may accompany a loved one to appointment after appointment, monitor medications, arrange treatments, communicate with clinicians, and watch vigilantly for changes in the other person – all while postponing a mammogram, ignoring fatigue, missing a physician visit, tolerating worsening symptoms, sleeping poorly, or telling themselves that their own problem can wait.
Yet the caregiver frequently remains almost invisible to the healthcare system. The 2025 AARP/National Alliance for Caregiving research found that only 15 percent of caregivers nationally reported being asked by a healthcare professional about their own needs.
That may be the most important warning, in Parton’s own words: “while we are caring for the patient, we may be overlooking another person at risk – the caregiver standing beside the patient.”
Sources:
TIME: Neal K. Shah, “What Dolly Parton Said in Her Last Interview Should Terrify Us”. Accessed 9/8/26. https://time.com/article/2026/09/03/what-dolly-parton-said-in-her-last-interview-should-terrify-us/
AARP and National Alliance for Caregiving. Caregiving in the US 2025. Washington, DC: AARP. July 24, 2025. https://doi.org/10.26419/ppi.00373. Accessed 9/8/26. https://www.aarp.org/pri/topics/ltss/family-caregiving/caregiving-in-the-us-2025/
Damjanovic AK, Yang Y, Glaser R, Kiecolt-Glaser JK, Nguyen H, Laskowski B, Zou Y, Beversdorf DQ, Weng NP. Accelerated telomere erosion is associated with a declining immune function of caregivers of Alzheimer’s disease patients. J Immunol. 2007 Sep 15;179(6):4249-54. doi: 10.4049/jimmunol.179.6.4249. PMID: 17785865; PMCID: PMC2262924. Accessed 9/8/26. https://pubmed.ncbi.nlm.nih.gov/17785865/
HHS-OASH – Office of Disease Prevention and Health Promotion. “Get Support If You’re a Caregiver.” March 31, 2026. Accessed 9/8/26. https://odphp.health.gov/myhealthfinder/healthy-living/mental-health-and-relationships/get-support-if-youre-caregiver
Kilmer G, Omura JD, Bouldin ED, et al. Changes in Health Indicators Among Caregivers — United States, 2015–2016 to 2021–2022. MMWR Morb Mortal Wkly Rep 2024;73:740–746. Accessed 9/8/26. https://www.cdc.gov/mmwr/volumes/73/wr/mm7334a2.htm
Schulz R, Beach SR. Caregiving as a Risk Factor for Mortality: The Caregiver Health Effects Study. JAMA. 1999;282(23):2215–2219. doi:10.1001/jama.282.23.2215. Accessed 9/8/26. https://jamanetwork.com/journals/jama/fullarticle/192209
