The short version: Most employees carrying eldercare never tell their employer, and a large share don't even know the word "caregiver" applies to them. That's why engagement surveys come back clean while your most experienced people quietly resign. I missed it in my own employee after 25 years in aging services.

She was late to meetings. She stopped volunteering for work travel. Then the call-offs started, never egregious, never a pattern you'd write up, just enough that you noticed.

I noticed. And I decided it was the kids.

She was a single mom. That's a real, hard, entirely sufficient explanation, and I am a single mom, so I thought I understood how complicated her life was and I used that as my entire point of reference. I didn't ask anything further. Twenty-five years in aging services, a career built on understanding exactly this, and I looked straight at an employee in trouble and reached for the story I already had language for.

Her mother had early-onset dementia. She was living in the house. She had moved in originally to help with the grandkids, and along the way that arrangement had inverted — the woman who came to help had become the person needing help, and nobody in that family had said the word out loud. Including my employee. She didn't tell me for a long time. When she finally resigned, what she said was that everything in her life had just gotten too chaotic and she was done.

Her employer (me) wrote that down. It went in the file as personal reasons.

Why does eldercare go unreported when childcare doesn't?

Because there is no announcement.

A pregnancy has a beginning. There's a date, a shower, a leave plan, a coverage conversation. The organization has vocabulary for it, policy for it, and a socially rehearsed way of being decent about it. Eldercare has none of that. It arrives as a series of small unrelated favors — picking up a prescription, sitting on hold with an insurer, driving to one appointment, then two. Each one is nothing. There is no morning where a person wakes up and thinks: today I became a caregiver.

So they don't report it, because in their own minds there is nothing yet to report.

What did your employee engagement survey actually miss?

I built a short survey to test this, and I ran an early pilot with about forty people — friends, family, small business owners, most of them somewhere between their late forties and their sixties. Self-selected, not a scientific sample, and skewed exactly toward the years when this tends to land.

Seventy-five percent of them turned out to be doing some form of caregiving.

That number is interesting. This one is the finding: a meaningful share of them didn't know it counted until the questions asked. Not "I didn't want to say." Not "it's private." I hadn't thought of it that way. They finished the survey and came back with some version of: huh, I guess I am a caregiver.

This is not a small measurement problem. It's the entire problem. You cannot survey for a condition your people don't have a name for. Ask "are you a caregiver?" and the person managing their father's medications, his falls, and his insurance appeals will answer no, in good faith, because in their mind a caregiver is someone doing hands-on physical care and they're just... handling some things for Dad. Your data comes back clean. Your attrition doesn't.

And this isn't only my forty people. AARP and the National Alliance for Caregiving found in their Caregiving in the U.S. 2025 report that 63 million Americans, roughly one in four adults, are now family caregivers — a 45% increase in a decade. Part of that surge, by their own account, isn't more caregiving. It's more recognition of caregiving. The national number is moving partly because people are finally applying the word to what they were already doing.

Six in ten family caregivers are employed on top of the caregiving. Half of those employed caregivers say it interrupts the workday — arriving late, leaving early, stepping out. Those are your people, and that is your Tuesday.

Why won't employees tell you they're caregivers?

Three reasons, and none of them are the one HR usually assumes.

1. They don't have the category yet. This is the one I've described. You can't disclose something you haven't named.
2. When they do have it, disclosing feels like a confession. Telling your manager that your mother has dementia isn't a scheduling conversation — it's volunteering that a permanent, worsening, unpredictable thing now sits between you and the job. Employees read that as admitting they can't do the work. So they compensate silently, for months, sometimes years.
3. Family. Dementia in particular carries a quiet shame that families organize around. They keep it in the house, they cover for each other, they don't say it at Thanksgiving, and they certainly don't say it at work.

Now put those three together and look at what an employer actually sees: an employee who is late, declining travel, disengaging, occasionally calling off. No stated cause. And then a resignation that seems, from the outside, to arrive out of nowhere, followed by a manager asking the question everyone asks a beat too late. What can I do to help?

By then the answer is nothing.

What is hidden turnover?

Hidden turnover is the loss of a good employee to a cause that never appears anywhere in your data — because the person carrying it never named it, and you never asked. The exit interview says "personal reasons." The engagement survey says everything is fine. The cost lands in your replacement budget, your institutional knowledge, and your bench, and nothing in your reporting connects it back to eldercare.

It is not a soft problem. It is a measurement failure with a dollar figure attached, and the figure is usually bigger than leadership assumes because the category doesn't exist in the reporting.

What would you have done if it had been a child?

Here's the part that should bother you, because it bothers me.

If my employee's struggle had been childcare, the company had a playbook. Bring them in after school. Shift your hours. Take the meeting from the car. Let's figure something out. We've spent thirty years building accommodations for parenting, and most of us are pretty good at it now.

There is no version of bring your mother with dementia to the office.

Every tool in the accommodation kit assumes the dependent can be co-located, entertained, or briefly supervised. Cognitive decline in an adult breaks all three assumptions. So the entire apparatus we built for one kind of caregiving is structurally unavailable for the other, and nobody has built the replacement. That's not a sensitivity gap that a kinder manager fixes. It's a design gap.

What can HR leaders actually do about it this quarter?

Three things, none of which require you to ask an employee a single invasive question.

1. Change the word. Stop asking who's a caregiver. Ask what responsibilities outside of work are currently affecting people's schedules, and give eldercare its own explicit checkbox with examples attached — managing medications, coordinating appointments, handling insurance or facility communication, financial support for a parent. Naming the tasks is what lets people recognize themselves. The question does the teaching.
2. Put it in your next engagement survey as a named option. Not as a write-in. Anonymous, aggregate, with no manager anywhere near an individual answer. You'll get a prevalence number for your own workforce, and I'd bet real money it's higher than your assumptions.
3. Assume the resignation is a lagging indicator. By the time someone tells you, the decision is usually already made. The window for doing anything useful is the six months before that, which means your detection has to run on patterns — travel declines, schedule volatility, quiet disengagement in your most experienced people — rather than on disclosure.

I misread it, and I'm the person who should have caught it. The odds that it's being read correctly inside your organization right now are not good.

Want to see what this is costing you?

The Hidden Turnover Calculator takes about four minutes and gives you a defensible number for what caregiver-driven attrition is running you annually — the kind of figure you can bring into a budget conversation.

Frequently asked questions

How many working employees are family caregivers?

AARP and the National Alliance for Caregiving put the national total at 63 million family caregivers in 2025, roughly one in four U.S. adults, with six in ten of them employed. Inside a given workforce the real number is almost always higher than the reported number, because most employees never identify themselves as caregivers.

Why don't employees disclose eldercare responsibilities to HR?

Three reasons: they haven't recognized their own situation as caregiving yet, disclosing feels like admitting they can't do the job, and families — especially around dementia — keep it private by default. None of those are solved by a more sympathetic manager.

How do you measure caregiving in an employee engagement survey?

Don't ask "are you a caregiver?" Ask what outside responsibilities are affecting people's schedules and list the specific tasks — medications, appointments, insurance and facility calls, financial support for a parent. Keep it anonymous and aggregate. The specificity is what lets people recognize themselves in the question.

What's the difference between eldercare and childcare accommodations at work?

Childcare accommodations assume the dependent can be co-located, entertained, or briefly supervised. Adult cognitive decline breaks all three assumptions, which means the flexibility playbook most employers built for parents is structurally unavailable to employees caring for a parent.

What is the cost of caregiver turnover to an employer?

It varies by role and replacement cost, but it is systematically underestimated because caregiver-driven exits are recorded as "personal reasons" and never rolled up as a category. Modeling it against your own headcount, salary bands, and turnover rate is the only way to get a number a CFO will accept.

Jaime Roberts is the founder of The Help Project and the author of The Third Rail. She's spent 25 years in aging services — direct care, senior living operations, and statewide policy — and now works with employers on the eldercare pressures quietly reshaping their workforce.