About 15 years ago, Bradley Cooper, the famed actor known for his roles in blockbuster movies ranging from The Hangover to A Star Is Born, took a break from his storied career to take on very different role: That of a caregiver to his father, Charlie, who was battling lung cancer.

“My dad was somebody I idolized,” Cooper says in the opening of the PBS documentary, Caregiving, which premiered earlier this summer. "I used to dress up like him when I was a kid in kindergarten and get made fun of because I wanted to wear a little suit and tie.” In the film, which Cooper executive produced in partnership with WETA (Washington, D.C.) and Ark Media, he notes, “Like most people, I didn’t even think about caregiving until my dad was diagnosed. To go from [dressing up like him] to giving him a bath is quite a traumatic thing ... I was lucky enough that I was able to be there for him, and I certainly also benefited from the help we got.”

I recently had an opportunity to watch the 2-hour documentary, now streaming on PBS  (https://www.pbs.org/show/caregiving/). It’s a powerful, provocative and deeply personal film, which follows the stories of six caregivers from diverse walks of life, capturing both family and professional caregiving experiences. The film is narrated by Emmy-winning actress Uzo Aduba, who brings her own caregiving journey to the narrative—she lost her mother to pancreatic cancer in 2020.

As expected, the film highlights the huge need for eldercare, as the U. S. population continues to age dramatically. (By 2034 or 2035 the number of people over 65 is projected to outnumber those under age 18.) But it does much more than that. It underscores how essential and pervasive caregiving challenges for people of all ages: husbands and wives taking care of spouses with chronic conditions; a 14-year-old son taking care of his mother with multiple sclerosis; an adult daughter caring for her father with dementia; a young mother raising her daughter who lives with brain damage resulting from complications at birth.

The film interweaves these stories with an incisive and sometimes discouraging historical view of American caregiving—beginning in the New Deal era with Frances Perkins and the Social Security Act, through wartime societal shifts, up to the COVID-19 pandemic and present-day policy debates.  The filmmakers connect major political and economic events to the erratic evolution of caregiving narratives, often vacillating between promoting American self-reliance and creating a wider social safety net. Experts like Ai-jen Poo, the president of the National Domestic Workers Alliance and executive director of Caring Across Generations, point out how essential caregiving practices have been to maintaining a growing economy—and how precarious they continue to be.

Basically, America’s caregiving system, especially as it relates to long-term care, isn’t a system at all. It’s a patchwork of programs, services, payment rules, and eligibility cliffs that most families only discover in a crisis. As longevity increases and more people live with chronic conditions or disabilities, the gap between what families need and what the market and government provide is widening. There are many obstacles, but here are just a few of the core challenges:

•  Financing that fails most families
• Medicaid or bust: Medicaid is the nation’s de facto long-term care payer, but it’s available only after spending down assets or meeting strict income rules.
• Thin private options: Traditional LTC insurance covers a shrinking share of the market, with rising premiums and complex underwriting.
• High and unpredictable costs: Home care, adult day services, assisted living, and skilled nursing are priced differently across markets, with wide variation in quality.
• A strained direct-care workforce
• Low pay, high churn: Home health aides, personal care aides, and Certified Nursing Assistants often earn near-poverty wages with few benefits and limited advancement. Turnover drives instability for families and providers.
• Target immigration pathways for direct-care roles—immigrants make up about a third of the direct-care workforce.
•  System fragmentation that exhausts families
• No “front door”: Families don’t know where to start—Area Agencies on Aging, health plans, hospitals, disability organizations, or private care managers.
• Care coordination gaps: Medical, behavioral, and social services run on separate rails. Benefits and eligibility vary by state and payer; records don’t follow people across settings.
• Caregiver invisibility: Family caregivers provide the majority of care, often without training, respite, or workplace support.

At the same time, thankfully, there are lots of experts, organizations and caregiving coalitions working on proposed solutions. Here’s a sample of what government, nonprofits and the private sector, collectively, can do:

Government can:

Create a national “catastrophic” LTC benefit. A public backstop that kicks in after, say, one to two years of functional impairment would protect against the worst-case risk while encouraging private savings and insurance for the front end.

• Guarantee a core HCBS benefit in Medicaid (personal care, respite, adult day, caregiver training) with federal matching incentives.
• Stabilize the workforce by rate-setting, tying wages and benefits so Medicaid reimbursement supports a living wage and provides paid sick leave.
• Support family caregivers as part of the care team, providing paid family and medical leave with wage replacement, and a caregiver tax credit or refundable benefit to offset out-of-pocket costs.
• Expand respite, crisis support, and evidence-based caregiver training.

Nonprofits can:

• Be the front door. Operate or strengthen aging and disability resource centers that function like air-traffic control for families: benefits screening, options counseling, and care planning
• Train the trainers. Scale culturally appropriate caregiver education, skills bootcamps, and disease-specific coaching.
• Build reliable micro-volunteer respite networks for companionship, transportation, meal prep, and short-break coverage.

The Private Sector can:

• Offer insurance that people will buy. Provide front-end coverage (first 2–3 years) at affordable premiums paired with a public catastrophic layer; simplified underwriting, transparent pricing, and clear, flexible benefits.
• Offer auto-enrollment or workplace-based LTC benefits with employer contributions.
• Provide employer supports for the “sandwich generation,” such as paid caregiver leave, flexible schedules, backup eldercare, navigation services, and tax-advantaged accounts for LTC expenses.
• Offer home care models such as skilled nursing partnerships that blend clinical oversight with personal care, remote monitoring, and rapid response teams.

Getting to an effective, flexible caregiving system will require policy will, market redesign, and community muscle. The good news: every piece exists somewhere already. The job now is to make them universal, inter-operable, and affordable. So despite the sometimes heart-wrenching realities and challenges of caregiving, Bradley Cooper’s film ends on a note of resilience and hope.

“The story of caregiving in America is everyone’s story,” says advocate and labor activist Ai-jen Poo. “It’s profoundly unifying at a time when all we hear about is how divided we are, and the truth is that everyone benefits from a strong care infrastructure in this country—it doesn’t matter who you are, where you live, what you do, where you come from, who you call family. You need care. That unity is powerful.”

—Ron Roel             

Moving Forward

 Whether through sharing, supporting, or speaking up—you can help transform caregiving from a personal struggle into a collective movement. The Caregiving documentary is accompanied by a broader engagement initiative, a series of 18 short caregiving films released as part of Well Beings: (https://wellbeings.org/) and social media campaigns (#CaregivingPBS, #ShareYourCaregivingStory) inviting public participation.

Ther is also a wide ecosystem of organizations, from large national advocacy groups to local resource hubs, that support caregivers with information, navigation, training, respite, and policy advocacy.  Here are ten notable U.S. organizations focused on caregiving.

1. National Alliance for Caregiving
A national coalition representing 50 organizations dedicated to improving the lives of family caregivers through research, advocacy, and raising public awareness.

2. Family Caregiver Alliance (FCA)
Founded in 1977, FCA provides national programs and resources, education, advocacy, and caregiver materials. It also operates state-level support centers.

3. Caregiver Action Network (CAN)
Formerly the National Family Caregivers Association, CAN offers education, peer support, toolkits, and practical guidance for caregivers across the U.S.

4. ARCH National Respite Network
Focused on respite care, ARCH helps caregivers find local services and advocates for quality crisis care and policy improvements.

5. Rosalynn Carter Institute for Caregivers
Established by former First Lady Rosalynn Carter, this nonprofit promotes caregiver health, resilience, training, and community support.

6. Alzheimer's Association

Provides information, educational webinars, memory screenings, support groups, and resources specifically tailored for caregivers of those with Alzheimer’s or related dementias.

7. SAGE (Services & Advocacy for LGBTQ+ Elders)
Supports LGBTQ+ elders and their caregivers through advocacy, peer support, programs for homebound seniors, and national resource services.

8. Adult Children of Aging Parents
Supports caregiving adult children by offering information, referrals, public awareness, and respite care assistance.

9. National Volunteer Caregiving Network
Coordinates volunteer caregiving programs nationwide—providing advocacy, support services, and access to local volunteer resources.

10. Eldercare Locator (administered by USAging / Administration on Aging)
A federal service connecting caregivers to local support, services, and resources for older adults and people with disabilities.