Spouses and partners lose pay when dementia care demands cut hours, force job exits, and reduce lifetime earnings. People with dementia and their care partners together forgo $23 billion in annual earnings.
Care partners are unpaid spouses, partners, and family members who provide daily help. The NIA-funded U.S. Cost of Dementia Project estimated total 2026 dementia costs at $818 billion for 5.7 million adults age 51 and older supported by 5.2 million care partners, according to the USC Schaeffer Center in its Schaeffer Center cost study.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- How do working spouses lose income?
- What happens to retirement security?
- Who pays the medical and care bills?
- Why is paid help harder to arrange?
How do working spouses lose income?
Many care partners provide help during prime working years. About 5.2 million care partners provide 6.8 billion hours of unpaid dementia care each year.
That time has a direct job-loss channel. Reduced schedules, unpaid leave, and early exits lower household pay now and shrink future raises, benefits, and savings.
What happens to retirement security?
Spousal caregivers enter later life with smaller reserves. They held about 50 percent less in IRA assets, 39 percent less in non-IRA assets, and 11 percent less in Social Security income than non-caregivers, according to the federal accountability office in its GAO retirement and caregiving report. The gap matters for partners who live long after care ends.
Lower account balances mean less cushion for rent, medical bills, and long-term needs. Caregiving may not cause the full shortfall. The same federal office cautions that isolating caregiving from other factors affecting assets and income is difficult.
Who pays the medical and care bills?
Medical and long-term dementia care totals $222 billion. Medicare and Medicaid cover about 70 percent, or $154 billion, while families pay about 20 percent, or $46 billion, out of pocket, according to USC Schaeffer researchers in the MedicalXpress summary of the findings. The wider burden falls even more on households.
About 80 percent of total costs fall on families when unpaid care, earnings losses, out-of-pocket costs, and quality-of-life losses are counted. That pattern leaves spouses and partners with limited policy protection. Paid coverage helps with clinical care, but daily supervision and lost work time remain largely family responsibilities.
Why is paid help harder to arrange?
Spouses and partners face scarcer affordable paid-care alternatives. AARP and the National Alliance for Caregiving counted 63 million U.S.
family caregivers in 2025, up 45 percent since 2015. Demand strains home aides, adult day programs, and residential options. Partners may wait longer, pay more, or cover gaps themselves.
- List weekly care tasks, work conflicts, and hours lost from sleep or employment
- Ask the care team about respite hours, adult day options, and home aide referrals
- Review earnings records, retirement accounts, and survivor benefit rules together
- Meet with a benefits counselor or elder-law attorney before quitting a job
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