Georgia can become a leader in quality elder health by training caregivers

Georgia has an estimated 1.26 million unpaid family caregivers. Nationwide, nearly one in five adults provide unpaid care to aging relatives or friends. They’re managing medications, coordinating doctor visits, helping with mobility, and providing round-the-clock supervision for loved ones with dementia or chronic illness.

And we’re asking these caregivers to provide complex medical care they were never prepared to deliver.

I’ve watched this failure from every angle. As someone who cared for my wife through cancer after caring for my grandfather through dementia, I know the impossible math of caregiving.

As founder of one of America’s largest caregiving platforms and a researcher leading NIH-funded studies on caregiver training, I see how federal policy failures cascade into state-level chaos.

Caregiving time has soared especially for ‘sandwich generation’

The numbers are staggering and getting worse. A 2025 Columbia University study classifies Georgia as “CRITICAL” – one of only eight states requiring immediate action on its caregiving crisis.

Neal Shah

The numbers are staggering and getting worse. A 2025 Columbia University study classifies Georgia as “CRITICAL” – one of only eight states requiring immediate action on its caregiving crisis.

Average caregiving time has tripled since 2020, from nine hours to 26 hours per week, while nearly one in three caregivers are simultaneously raising children under 18. How do you work a job, raise kids, and provide 26 hours of medical care weekly? The answer is: You break yourself trying.

In rural Georgia, where 1.8 million people live with significantly less health care infrastructure than metropolitan areas, family caregivers must fill gaps that professional health care can’t reach. When your county has limited hospital access and higher uninsured rates, family members become de facto health care providers whether they’re ready or not.

Higher education institutions provide a great training pipeline

Research shows 86.7% of family caregivers need targeted training. When they receive support, health outcomes improve dramatically. When they don’t, the costs are staggering – depressed caregivers drive a 73% increase in emergency room visits and add nearly $2,000 per patient in preventable medical costs.

But here’s the opportunity: 56% of family caregivers want professional training to work in other households. That’s over 750,000 Georgians who already do caregiving work and want credentials to do it professionally.

Georgia could create the nation’s first comprehensive family-caregiver-to-healthcare-worker pipeline. Use the technical college system for training and certification. Leverage Georgia’s Medicaid waiver flexibility to reimburse trained family caregivers. Partner with Emory University and University of Georgia’s aging research programs to develop evidence-based curricula. Create tax credits for caregiving training expenses – far cheaper than the Credit for Caring Act that’s stalled in Congress.

This isn’t hypothetical. Through my own work in elder care, we’re proving the model works in Georgia cities. We connect pre-health students from Emory, Georgia State University and Georgia Tech with Atlanta-area seniors who need care. Students get clinical experience and income. Seniors get affordable, compassionate care delivered by trained caregivers they trust. Families get relief. Medicaid saves money.

But we’re reaching maybe 1% of the need. Scaling requires state policy and investment.

Georgia has the tools: the strong technical colleges in every region, the major research universities producing caregiving science and Medicaid waiver flexibility that other states lack. What the state is missing is recognition that Georgians already comprise the state’s largest health care workforce - and we’re destroying them through neglect.

State leaders must do more than show their thanks

This November, during National Family Caregivers Month, Georgia politicians will issue proclamations thanking caregivers for their service. They’ll host events in the Gold Dome. They’ll use words like “heroes” and “backbone.”

Then they’ll return to ignoring them for another year.

In 2034, when older adults outnumber children for the first time, Georgia has the power to decide: build a caregiving infrastructure now or face a humanitarian crisis that makes the nursing home COVID experience look like a preview.