1 in 5 Adults Needs Ongoing Support for Activities of Daily Living

Vice President Kamala Harris and Sen. Tammy Duckworth (D-Ill.) are the latest U.S. leaders to go to bat for home- and community-based services (HCBS), with the pair highlighting caregiving investments in the Biden administration’s Build Back Better plan during a Thursday town hall.

Negotiations over Build Back Better, a package which includes multiple types of caregiving investments aimed at improving jobs and bolstering access to services, have dragged on for weeks. The administration originally hoped to carve out upwards of $400 billion for HCBS, but it’s looking increasingly likely that number will be cut in half, if funding is included at all.

“There’s so much at stake in terms of our real ability to actually leapfrog over where we’ve been,” Vice President Harris said during the town hall. “To really just take on these issues that we have known even before the pandemic represent the failures, the fissures and the fractures in our system.”


In the U.S., care is often too expensive and too difficult to find, Harris noted.

In turn, many seniors and individuals with disabilities are forced to forgo much-needed services or turn to unpaid caregivers for support.

“[Build Back Better] will improve options for seniors and people with disabilities, so that they don’t need to leave their home or leave their community to get the care they need,” Harris continued. “And on that point, this is essentially about allowing people the dignity with which they deserve and want to live.”


About one in five adults in the U.S. say they receive ongoing support for daily activities such as bathing, dressing or remembering medications, according to the October Kaiser Family Foundation (KFF) Health Tracking Poll. A similar share says they are providing those types of services for a close friend or family member.

About 27% of adults 65 and older say they receive ongoing support with everyday activities from either a family member, a friend or paid caregiver, such as a nurse or an aide.

“Medicaid home- and community-based services are essential to assisting older Americans and people with disabilities,” Sen. Duckworth said. “And ensuring that this program has sufficient resources is as important as it has ever been in our nation’s history.”

About one in five adults in the KFF poll also say they or a family member need either new or additional support from paid nurses or aides beyond what they are currently getting. Yet more than three-fourths of those individuals are unable to arrange for more services due to the cost of care.

At 44 hours per week, the median monthly cost for homemaker services was $4,481 in 2020, according to the most recent Genworth Cost of Care Survey.

The median monthly cost for a home health aide at the same level was $4,576.

“Our nation is deep in a caregiving crisis for both patients and for care workers,” Duckworth added. “Seniors and people with disabilities who have already been disproportionately impacted by the deadly pandemic should not be forced to abandon their home services for group settings.”

The KFF poll featured a nationally representative sample of 1,146 U.S. adults aged 18 or older, including an oversample of 474 adults ages 65 and older. The poll was conducted online and via phone from Sept. 23 to Oct. 4.

Companies featured in this article: