Lori Gonzalez never trained to be a nurse. But at 75, she is her husband’s full-time caregiver — helping him bathe, dress and move about their Phoenix home. She makes sure he eats, and she knows not to argue when he’s agitated or confused. And she hasn’t left him home alone in three years.
Gonzalez knows that his dementia will only worsen and that she’ll be tending to him as her own health challenges mount, including the severe stenosis that leaves her back stiff and in pain.
“I don’t know when, I don’t know exactly what it’ll look like,” said Gonzalez, a former grade school librarian. But “I will be the primary caregiver.”
While caring for an aging person can be financially and emotionally draining for adult children, the undertaking raises a separate set of challenges for spouses. These partners are typically seniors themselves — close to half are 75 or older — and they are more likely to be caring for someone with long-term health challenges, according to a 2025 report from the National Alliance for Caregiving and the advocacy group AARP.
Those factors put them at risk of burning through savings they might need for their own care, and at greater risk of suffering injuries from the physical demands of caretaking, experts in elder care said.
The ranks of older adults caring for fellow older adults are only expected to increase as lifespans lengthen and family sizes shrink: Adults 65 and older are projected to account for about 1 in 4 Americans by 2050, up more than 30 percent from 2024. That compares with 1 in 10 in the 1980s.
Today’s smaller families may also factor into the rise of spousal caregivers, said Amy Goyer, an AARP family and caregiving expert who spent years caring for her parents and other family members. About 15 percent of family caregivers were spouses or partners last year, compared with 10 percent a decade prior, according to the National Alliance for Caregiving and AARP surveys.
“There may not be children to step in,” she said. Plus, “spouses have a tendency to feel like, ‘In sickness and in health, this is my job.’”
Spouses, siblings, children and other family members are the “cornerstone” of the United States’ long-term care system, backfilling for a dearth of affordable professional care, said Jennifer Ailshire, a professor of gerontology and sociology at the University of Southern California.
The responsibility can be isolating and all-consuming for spouses, who are more likely to be out of the workforce, experts in elder care said. These caregivers tend to live with their partner, making them vulnerable to disrupted sleep, and provide such intimate care as bathing, dressing and toileting that their spouse may be uncomfortable receiving from strangers or children.
“You are locked in — in a 24-hour, 365 sense — in a way that other caregivers may not be,” Ailshire said.
Caring for an aging spouse is akin to running a marathon, with no option to pass the baton, said Robin Shultz, a vice president with the National Partnership for Healthcare and Hospice Innovation, which represents nonprofit providers of hospice and advanced illness care.
By comparison, tending to an aging parent is more often a juggling act that can be done from afar — with spreadsheets and airline miles, and coordinating care “from a minivan in the parking lot of your kids’ soccer game,” Shultz said.
It’s similarly painful, she said, but “it hurts in a different way.”
Michele Riedel was 61 when her husband, Chuck, a Marine Corps veteran who was briefly stationed at Camp Lejeune in North Carolina, was diagnosed with Parkinson’s disease in 2014. She retired early, knowing they had limited time together.
He took 15 pills a day and underwent physical therapy, occupational therapy and speech therapy, sometimes multiple times a week. He lost a significant amount of weight and became so frail, Riedel said, that she had to stabilize him in the shower and cut his food so he wouldn’t choke. After he declined significantly in December, she found a spot for him in an assisted-living facility, where he will stay as she recovers from a planned shoulder surgery this month.
Still, Riedel considers herself lucky: The couple had enough savings to pay for in-home caregivers, who watched her husband about 12 hours a week. He also gets disability benefits from the U.S. Department of Veterans Affairs, she said.
Spousal caregivers often are living through a kind of “pre-bereavement” as they watch their partner fade and relationship change, especially if dementia is involved, said Katherine Ornstein, the director of Johns Hopkins University’s Center for Equity in Aging. Some find refuge in online support groups, where they can ask about the logistics of caring for an aging spouse and advice about navigating the fraught emotional terrain that accompanies it.
“People are talking about the best kind of diapers. I’m writing that down,” Gonzalez said. “There’s no real training.”
Katalin Warmkessel of Florida said she struggles between being the caregiver — the confident leader of the family — and showing respect for the man her husband was. It’s been difficult for her to see the 6-foot-2 Army veteran and former football coach grow weaker; he has dementia and is 91.
“One day, they wake up and they’re themselves, and you’re like, ‘Oh, my god. There he is,’” said Warmkessel, 78. “Then all of a sudden it just goes away … and he says things like, ‘Is this our house? Where is the bathroom?’”
Judith Nagle, who lives in Virginia, has tried to explain the complicated emotions that come with being a caregiver to others. She believes her husband had Parkinson’s dementia before he died in 2023.
“Be prepared to be angry,” Nagle said she told one friend. “Be prepared to feel guilty because you’re angry. Be prepared to be sad.”
“You’re sad for your husband,” she said. “And you feel guilty that you’re feeling sad for yourself.”
Financial sinkhole
Years of caregiving can decimate household finances.
Medicaid, the public insurance program for people with low incomes, is the primary payer for 6 in 10 nursing home residents, according to KFF. Some people will spend down their savings and investments to qualify for the aid; in fact, about 16 percent of people who entered a nursing home in 2018 and were not covered by Medicaid did just that, according to one study published last year.
Gonzalez said that the cost of elder care is a huge concern but that Medicaid isn’t an option because she and her husband have savings.
She might spend them all caring for him. But that raises a question: Will money be left over for her?
Others purchase long-term care insurance, though those policies have limits on how much they’ll pay.
Brian Haaser, 69, is unsure what he’ll do once he runs through his wife’s coverage. After his wife, Rita Felices, was diagnosed with Alzheimer’s in 2023, he said that her behavior became increasingly risky. She tried microwaving metal pots, and she once turned on all the gas burners in the house. He moved her into a long-term care facility in Maryland in July 2024, and he now pays about $8,485 a month for room, board and other care.
By his estimates, his wife’s insurance payout will run out in 16 months. He’s been working with a financial planner for seven years, and he expects his investments will cover his wife’s care for another eight. But that will leave far less for him to live on, or for his children’s inheritance.
“I’m going to be in a quandary in 2027,” he said.
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