The Invisible Backbone: Recognizing and Supporting Family Caregivers
Family caregiving happens quietly. It occurs before sunrise and long after everyone else has gone to bed. Most of the time, it is women who take on this work, and very often it is Black women in Caribbean families. I saw this growing up in Trinidad, and I continue to see it in my clinical work. Caregivers are the ones who keep life moving when illness, aging, or crisis enters a home. They are the steady hands behind the scenes, holding up people who feel too tired to stand on their own.
Dr. LaToya Lewis (Contributed Image)A report that AARP released in 2023, titled “Valuing the Invaluable,” estimated that unpaid family caregivers in the United States provided 36 billion hours of care in 2021. Additionally, the report valued the unpaid caregiver work at over $600 billion, which is a significant figure. It shows that the entire healthcare system is supported by people who receive no pay for the labor that keeps their loved ones alive. I often remind my students of simple truth. Caregivers hold up the world, but the world seldom pauses long enough to see them.
A 2020 report by the American Association of Retired Persons (AARP) and the National Alliance for Caregiving found that caregivers are taking on more responsibilities while balancing work, children, and their own health. For Black caregivers, especially those shaped by Caribbean traditions, the load is even heavier. Many support parents, grandparents, relatives overseas, and their own children. Many of us have lived this reality or watched it unfold in our own families.
Caribbean families have a long tradition of caring for each other. When someone fell ill, the entire neighborhood stepped in. The soup arrived before you asked. Someone picked up a prescription. Someone else stayed with your loved one so you could rest. We never called it an official care plan. It was simply how our community moved. Someone cooked. Someone watched the children. Someone sat with the elder who needed company. It happened naturally, without titles or formal roles.
Life feels different now. Medical care has become more complicated, and the cost of staying healthy rises faster than most families can keep up. Currently many family members live far apart, spread across different islands, states, and countries. The tight community circle we once depended on is harder to come together. What used to feel effortless now rests on the same shoulders, and those shoulders are often already tired and burned out.
The 2020 Centers for Disease Control and Prevention (CDC) report stated that caregivers experience more mental distress, greater exhaustion, and more delays in receiving their own medical care. This can be seen with women apologizing for being late
because they spent the night bathing, lifting, or calming someone they love. They are generous with their care, even when they have nothing left to give. You cannot pour from an empty vessel. You cannot carry a family on an empty spirit. Caregiving is considered one of the ultimate ways to show love.
These realities make one point unmistakable. Culture alone cannot carry what the healthcare system refuses to hold. Policies that support caregivers are not optional; they are essential. The inclusion of caregiver stipends or tax credits would bring relief to those in need. Additionally, flexible schedules and paid leave would prevent families from falling behind financially. Community services that support daily care would help keep people safe at home. Creating sustainable culturally relevant programs that honor Caribbean families' unique identity and needs would help caregivers navigate the complex healthcare system with dignity. AARP (2023) mentioned that the strong support for caregivers leads to fewer preventable hospital visits, greater stability at home, and healthier families.
Communities can rise alongside policy changes through purposeful engagement with different Caribbean associations, churches, and neighborhood groups to revive the cultural norms of support. For example, a pot of soup, a few hours of rest for a tired caregiver, a ride to the store, or a check-in that reminds someone they are not alone. The Caribbean community is strongest when every person carries a little, rather than one person bearing the heavy physical, emotional, financial, and psychological burden alone.
Caregivers deserve more than gratitude. They deserve real help, policies that honor their sacrifices, and communities that understand the weight they carry. As someone shaped by Caribbean culture and the science of healthcare, I know that unpaid caregivers are the quiet heroes of our time, and the future depends on how well we care for the people who care for us. This is the time for all of us to shoulder a share of the responsibility because our caregivers have been carrying far too much for far too long.
