近年来随着物价上涨，看护者的成本也水涨船高。美国退休人员协会周三发布的一项研究发现，家庭看护者——帮助残疾、慢性病或老年成年人的人——现在平均每年自付费用为11508美元。这比五年前增加了约60%，平均占看护者收入的31%。
As prices have ticked up in recent years, the cost to caregivers has skyrocketed. A study, released Wednesday by AARP, finds that family caregivers — people helping out disabled, chronically ill or elderly adults — now spend an average $11,508 out of pocket each year. That's roughly 60% more than just five years ago, and adds up to 31% of a caregiver's income, on average.
这些年看护成本的涨幅是美国联邦劳工统计局消费者物价指数所衡量的24%的整体通胀率的两倍多。
The increase during those years is more than twice the overall rate of inflation of 24%, as measured by the federal Bureau of Labor Statistics' Consumer Price Index.
是什么推动了成本上涨？这项研究调查了2538名家庭看护者，发现食品、住房和医疗费用是最大的部分。换言之，仅仅是基本开销。
What's driving the ramp-up? Food, housing and medical expenses are the biggest chunk, finds the study, which queried 2,538 family caregivers. In other words, just the basics.
美国退休人员协会政府事务副总裁梅根·奥莱利表示，看护成本上升之际，家庭看护者在家承担了更多护理和更复杂的医疗责任。“需要的护理越多，花费就越多。”而支出增加只是故事的一部分。调查发现，看护的要求往往需要人们减少工作时间或完全辞职。这是双重打击：成本增加加上收入损失。
The bump in costs comes as family caregivers take on more care and more complicated medical responsibilities at home, says Megan O'Reilly, vice president of governmental affairs at AARP. "The more care that's needed, the more it costs." And increased spending is only part of the story. The demands of caregiving often require people to reduce their working hours or quit work entirely, the survey finds. It's a double whammy: increased costs on top of lost income.
梅根·马赫亲眼目睹了这一点。在她的第一个孩子出生仅七周后，她的母亲被诊断出患有晚期癌症。突然间，马赫成了一名“三明治”看护者——父母和孩子同时需要她。
Meghan Maher has seen that first-hand. Just seven weeks after the birth of her first baby, her mother was diagnosed with advanced cancer. Suddenly, Maher was a "sandwich" caregiver — parent and child needing her at the same time.
起初，她试图把一切都处理好。休完产假后，她回到了癌症研究的职业岗位，但兼顾工作、母亲和刚出生的儿子的需求实在太多了。
At first, she tried to manage it all. She returned to her career in cancer research after maternity leave, but keeping up with the demands of work, her mom and her newborn son was too much.
她把工作时间缩减为兼职。但即使这样也难以应付。她无法参加母亲的所有预约、协调她的护理，同时还要赶工作上的重要截止日期。
She shrank her hours to part time. But even that wasn't manageable. There was no way to attend all her mother's appointments, coordinate her care, and also be available for big deadlines on the job.
她辞了职，家庭收入减少了一半。因为丈夫有一份不错的工作，他们日子还不算难过，但她现在说，“当时确实很害怕”。随着母亲病情加重，父母搬来同住，家庭开支也随之增加。
She quit, and the family's income fell by half. Because her husband had a good job, they weren't struggling, but "it was definitely scary," she says now. As her mom got sicker her parents moved in, increasing the household expenses.
2017年母亲去世后不久，父亲因腹部手术出现了一系列严重并发症，危重状态持续了数月。马希尔需要在他住院期间陪在身边，随时为他争取权益，因此家里现在还需要支付育儿费用。她估计这项开支每年约为1万美元。
Soon after her mother's death in 2017, her father had a series of major complications from abdominal surgery and was critically ill for months. Maher needed to be by his side during hospital stays, advocating for him on a moment's notice, so now the family also needed to pay for child care. She estimates the cost at about $10,000 a year.
父亲最终康复了，尽管困难重重，这个家庭还是撑了过来。许多人却没有这么幸运。
Her father eventually recovered, and the family was able to manage despite the difficulties. Many aren't so lucky.
根据AARP的报告，大约一半的家庭照护者表示他们做出了重大的经济牺牲：增加工作时间、削减储蓄，甚至动用为退休存下的钱。
About half of all family caregivers say they've made major financial sacrifices, according to the AARP report: Working more hours, cutting savings, or even drawing down on money put away for retirement.
许多美国人都在承担照护费用，未来还会有更多人如此。目前约有6300万人长期为家人或朋友提供帮助——大约每4个成年人中就有1人。这一需求很可能还会增长：据估计，今天年满65岁的人中，有70%在年老时需要某种形式的帮助。
Many Americans deal with the cost of care, and more will in the future. About 63 million people now provide ongoing help for a family member or friend — roughly 1 in 4 adults. The need will likely grow: An estimated 70 percent of the people turning 65 today will need some form of help as they age.
联邦医疗保险（Medicare）不支付居家或机构中的日常照护费用，而这类照护十分昂贵。根据每年开展照护成本调查的保险公司Genworth的数据，2025年，每周40小时的居家照护服务一年约需72792美元。专业护理机构合住房间的平均费用为每年11.5万美元。
Medicare does not pay for routine help either at home or in a facility, and that care is expensive. In 2025, 40 hours of in-home caregiving help a week ran about $72,792 a year, according to the insurance company Genworth, which conducts annual surveys of the cost of care. Skilled nursing costs an average of $115,000 per year for a shared room.
马希尔重返职场后，成了一名职业临终陪护师。这意味着她帮助客户应对生命末期的情感和现实难题。她是自雇人士，因此可以自己掌控日程，并限制服务的客户数量。这让她能够灵活地照顾年迈的父亲。但她的收入只有她从事旧职业时的一半。
When Maher returned to work, she became a professional death doula. That means she helps clients with the emotional and practical challenges at the end of life. She's self-employed, so she can control her own schedule and limit the number of clients she serves. It allows her the flexibility to help her father as he ages. But her income is half what it would have been in her old career.
在她所帮助的客户身上，她看到了护理费用累积的其他方式。在她居住的佛罗里达州，慢性病患者聘请律师以便符合医疗补助（Medicaid）资格是司空见惯的事——与联邦医疗保险（Medicare）不同，医疗补助确实会支付长期护理费用。尽管他们符合福利资格，但文书工作如此复杂，以至于他们最终要花钱请法律帮助来应对。她说，在佛罗里达州，这笔费用大约为6000美元。
With the clients she helps, she sees other ways that care costs pile up. In Florida where she lives, it's routine for chronically ill people to hire an attorney in order to qualify for Medicaid, which unlike Medicare does foot the bill for long-term care. Even though they are eligible for the benefits, the paperwork is so complex that they wind up paying for legal help to navigate it. In Florida, she says, that runs about $6,000.
她的所见所闻促使她呼吁人们关注护理危机。今年4月，马赫在国会参议院老龄问题特别委员会作证。“护理工作也重塑了我的职业生涯，”她在参议院发言时说。“自雇的灵活性伴随着实实在在的经济和职业代价。”她是应“女儿责任”（Daughterhood）组织的邀请出席的，该组织为护理者提供支持和资源。
What she has seen and experienced motivates her to call attention to the caregiving crunch. In April, Maher testified before Congress at a special Senate committee on aging. "Caregiving has also reshaped my professional life," she said on the Senate floor. "The flexibility of self-employment comes with real financial and professional tradeoffs." She was invited by Daughterhood, an organization that offers support and resources for caregivers.
家庭护理者可以根据居住地获得一些公共资金。所有州都通过医疗补助向某些类型的家庭护理者支付报酬。例如，在加利福尼亚州，超过80万名护理者从事居家护理工作，时薪在16.90美元至25美元之间。由于特朗普总统的大规模预算案将在未来十年削减近1万亿美元的医疗补助资金，这些项目的资金很可能会减少。
Family caregivers can access some public money, depending on where they live. All states pay some types of family caregivers through Medicaid. In California, for instance, more than 800,000 caregivers earn between $16.90 and $25 an hour for in-home work. Funds for these programs are likely to dwindle due to President Trump's big budget bill that cut nearly $1 trillion out of Medicaid funding over the next decade.
如果需要护理的人符合退伍军人事务部福利的资格，他们也可能有权获得经济帮助以支付护理费用。与医疗补助一样，规则很复杂，许多家庭护理者会聘请顾问来就资格和申请程序提供建议。
If the person who needs care is eligible for Veterans Administration benefits, they may also be entitled to financial help to cover the cost of caregiving. Like Medicaid, the rules are complex, and many family caregivers hire advocates to advise on eligibility and the application procedure.
美国退休人员协会执行副总裁南希·利蒙德表示，护理成本不像汽油、食品和医疗保健成本那样显而易见。她认为这种情况将会改变。“当你看到有这么多人在支付这种费用时，我认为这将成为立法领域采取行动的推动力。”过去几年，国会提出了各种提案，这些提案可能会让护理人员收回一些钱，比如允许护理人员从免税的健康储蓄账户中花钱支付父母的医疗费用。在一些州，新规定已经成为现实。
The cost of care hasn't been as visible as the cost of gasoline, food and healthcare, says AARP executive vice president Nancy LeaMond. She believes that will change. "When you see the number of people paying this kind of money, I think that'll be an impetus for action in the legislative arena." In the last few years, Congress has introduced various proposals that could put some money back into the pockets of caregivers, such as allowing caregivers to spend money from their tax-sheltered health savings accounts on their parents' medical expenses. In some states, new rules are already a reality.
目前有六个州为家庭护理人员提供税收抵免，用于改造房屋加装扶手或栏杆等费用，通常每年在1000美元到5000美元之间。另外两个州的计划较为有限。去年，两位美国参议员提出了一项两党法案，将在全国范围内建立类似的5000美元税收抵免。
Six states now offer tax credits to family caregivers for expenses like retrofitting a home with grab bars or railings, usually between $1,000 and $5,000 a year. Two other states have more limited programs. Last year, two U.S. Senators introduced a bipartisan bill that would establish a similar $5,000 tax credit nationwide.
在14个州和哥伦比亚特区，大多数雇主被要求提供带薪家庭和医疗假。这些政策包括为照顾家庭成员而休假。提交给国会的另一项法案将把它转变为国家政策，要求为一些工人提供最多12周的部分带薪休假。
In 14 states and the District of Columbia, most employers are required to offer paid family and medical leave. Those policies include time off for caregiving for a family member. Another bill introduced into Congress would convert that into a national policy that would require up to 12 weeks of partly paid leave for some workers.
第三项拟议的联邦法律将保护护理人员的社会保障福利。根据现行规定，一个人如果为了全职照顾家人而停止工作，其未来的社会保障支票将缩水，因为他们不再获得退休积分。这项法案将修改法律，继续给予全职护理人员积分。
A third proposed federal law would protect the Social Security benefits of caregivers. Under current rules, a person who stops working in order to care full-time for family sees their future Social Security check shrink, because they are no longer earning credits toward retirement. This bill would change the law to continue awarding points to full-time caregivers.
利蒙德说：“我们花了很多时间与国会议员交谈，你在会议上提出这个问题时，总会有人插话讲述自己的故事。我相信，随着时间的推移，这些力量将汇聚起来，支持家庭护理。”
"We spend a lot of time talking to members of Congress, and you can't raise this issue in a meeting without being interrupted by someone telling their own story," says LeaMond. "In time, I believe that will coalesce to support family caregiving."