It’s National Family Caregivers Month, and the country is finally talking about the people holding up its care system. Some of them are caring for the person who hurt them.
Caregiving has become a policy story. This summer The American Journal of Managed Care tracked more than half a dozen federal caregiving bills, from a tax credit for caregiving costs to Social Security credit for years spent out of the workforce. AARP put the value of unpaid care for adults at $1.01 trillion in 2024, more than federal, state and local governments spent on Medicaid that year. Studies mentioning “family caregiving” rose 27% from 2024 to 2025. Sixty-three million Americans are doing this work, and 42% of women who voluntarily left their jobs in 2025 cited caregiving, mostly childcare, as the reason.
“Family caregivers are really holding up our long-term care system,” AARP’s Megan O’Reilly told AJMC. The numbers say she is being modest.
Caregiver Action Network’s theme for this year’s National Family Caregivers Month is “Care Connects Us.” Rosalynn Carter put it more plainly years ago: “There are only four kinds of people in the world: those who have been caregivers, those who are currently caregivers, those who will be caregivers and those who will need caregivers.”
Who ends up doing it
A study published last year in the Journal of Child and Family Studies asked a question the policy conversation hasn’t: which adults become the ones providing care. Researchers led by Erin Maher at the University of Oklahoma looked at nearly 19,000 adults. People with three or more adverse childhood experiences were somewhat more likely than their peers to be giving a parent nine or more hours of care a week.
The detail underneath that finding matters. The link ran through what researchers call parental challenges (a parent’s substance use, mental illness, incarceration or divorce), and not through direct childhood abuse. The children who grew up managing an unwell or unavailable parent are, statistically, somewhat more likely to be managing that parent again decades later.
For a lot of STARs, that reads like a description of their own family.
The question the conversation skips
Every article about the caregiving crisis assumes a particular caregiver: worn out and caring for someone who was good to them. That caregiver is real and deserves every bit of help.
There is another one. She is bathing a father who terrified her. He is managing the medications of a mother who told him for twenty years that he was the problem. The clinical literature has a name for this. Clinical Gerontologist published a review in 2021 called “Caregiving for Parents Who Harmed You,” yet the subject has almost no presence in the public conversation and none in the bills.
The hard part sits underneath the tasks. Caregiving asks a survivor to do, on purpose and for months or years, the exact thing recovery asked them to stop doing: put the other person’s needs ahead of their own reading of reality. Add the family pressure that usually comes with it (relatives who want the past dropped, a sibling far away with opinions) and a person can find themselves back inside a dynamic they spent a decade climbing out of, this time with everyone applauding.
STAR Network won’t tell you what to do here
This is where most advice fails, so let’s be plain: there is no correct answer, and anyone who offers you one is not being careful with you.
Some STARs provide care and find something in it they needed. Some provide care and are worn down by it. Some decline, and carry that. Some find a middle version, like money but not presence, or a paid aide instead of their own hands. Each is a legitimate choice made by an adult with the right to make it. Nobody else gets to make it for you, including out of love.
Dr. Jamie Huysman, STAR Network’s founder, spent years on this before STAR existed. He co-wrote Take Your Oxygen First with Leeza Gibbons and Dr. Rosemary DeAngelis Laird, a book for caregivers built on the airline instruction everyone has heard and almost nobody follows. The oxygen rule is harder when the person in the next seat is the reason you learned to hold your breath. In that case it is also more necessary.
What helps
Practical support exists and is worth using: respite programs, your local Area Agency on Aging, and the resources Caregiver Action Network gathers each November.
What is harder to find is a room where you can say the true sentence out loud, “I am taking care of the person who hurt me, and I don’t know what I feel,” without someone flinching or telling you how lucky your parent is to have you.
That room now exists. Caregiver Connections is a free, trauma-informed peer fellowship for family caregivers, created by the STAR Network Foundation with support from the WellMed Charitable Foundation and PACEs Connection. Meetings are anonymous (camera off, any name, nothing recorded) and run Mondays at 10 AM, Wednesdays at 1 PM and Fridays at 8 PM ET. The first one is Monday, November 9, and you can register here. Organizations that want to join the mission can reach Dr. Jamie at drjamie@starnetwork.org.
And if you need a door open today, TAR Anon® is one: a free, anonymous, worldwide peer fellowship for people healing from Toxic Abusive Relationships™. No referral or diagnosis is required, and nobody in the room will ask you to explain your choice. If you are caring for someone who harmed you, or deciding whether to, you can bring that to either room exactly as it is.
