Thursday, March 19, 2026

 

Caregiving without a net: Poll shows who needs help most



Many older caregivers face financial stress and aren’t aware of or don’t use programs designed for them, especially if they don’t have friends or family to help them out




Michigan Medicine - University of Michigan

Caregiver awareness and use of support services 

image: 

National Poll on Healthy Aging findings about caregivers over 50 and their awareness of and use of services to support the adults they care for, such as adult day care and respite care.

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Credit: University of Michigan - Emily Smith





Nearly a third of Americans over age 50 provide regular care to an adult relative or friend with a health issue or disability, a new poll finds. But many of them don’t know about, or use, local resources that could help them with caregiving.

And about 20% of these caregivers are like highwire acrobats working without a net, the poll reveals. They’re taking care of someone else with health needs, but without close friends or family members to pitch in if they needed help with their own health concerns.

The new findings from the University of Michigan National Poll on Healthy Aging could inform caregiver-related policy discussions at state and national levels.

It also suggests a need for increased awareness of existing programs such as adult day programs and respite care, and local organizations like Area Agencies on Aging, that address the needs of adults aged 60 and older and their caregivers. Such programs can connect caregivers to services, support, and resources that can reduce their burden and improve the day-to-day care they provide.

The poll is based at the U-M Institute for Healthcare Policy and Innovation and supported by Michigan Medicine, U-M's academic medical center, with additional support for Michigan-specific polling from the Michigan Health Endowment Fund.

Caregiving and caregiver support

In all, the poll finds 22% of people over 50 served as caregivers in the last year for an adult with health or disability needs who they don’t live with, and 12% did so for someone they live with. Taken together, 32% of all people over 50 served as caregivers for at least one adult with health or disability needs.

In all, 17% of all caregivers say they do not have the support they need to manage their caregiving responsibilities.

But the percentage saying this was much higher — 41%— among the caregivers who also reported they did not have close friends or family to depend on for help with their own needs.

That’s compared with a much lower percentage saying they don’t have support for caregiving responsibilities — just 11% — among caregivers who do have friends and family to depend on for their own health needs.

“This is an issue we need to keep our eyes on as our nation continues to grapple with the growing demand for unpaid, untrained caregiving for older adults and for people with disabilities and serious health needs,” said Florence Johnson, Ph.D., M.S.N., M.H.A., an Assistant Professor in the U-M School of Nursing and member of IHPI. “Our poll shows that 23% of all people over 50, including many who are already caregivers for one or more adults, may lack family or friends to help them if they needed support with health needs. But they may not know where or how to find services.”

Financial impacts of caregiving

The poll asked about the financial impact of caregiving for a relative or friend with health issues or a disability.

Caregivers often take time away from work if they’re employed or spend money on transportation and other expenses to provide care. But most family or friend caregivers cannot receive pay from insurance or government sources for their efforts, except in rare circumstances.

In all, 34% of caregivers said caregiving resulted in financial challenges for them. The percentage was higher (40%) among those aged 50 to 64 than those over age 65 (27%). It was also higher among caregivers whose own physical or mental health is fair or poor, or who have a disability themselves.

The percentage citing a financial challenge from caregiving was also higher, at 47%, among caregivers who say they don’t have family or friends to help with their own health needs.

Among all caregivers who feel they don’t have enough support to manage their caregiving responsibilities, the poll team asked what would help them most.

The top answer by far, mentioned by 69%, was financial assistance or subsidies for caregiving expenses.

Day programs and respite care: Lack of awareness and use

The poll also asked caregivers about their awareness of, and use of, programs that many communities have made available for people with disabilities and older adults.

The first was adult day programs, where a caregiver can bring their relative or friend to take part in supervised, structured activities for a few hours to a full day, together with other people in their age group or with similar conditions or disabilities. Such programs can give a caregiver a chance to take time for themselves or catch up on work, or just relieve stress.

Only 9% of caregivers said the person they care for had used such programs, while 60% said they hadn’t used one but the caregivers had heard of them. That left 21% of caregivers who haven’t ever heard of adult day programs and 10% who didn’t know if the person they care for had ever attended an adult day program.

The poll also suggests communities could use many channels to get the word out about adult day programs, and any costs or sliding-scale fees involved. Among caregivers who had heard of adult day programs, there was no one way that people most frequently reported using to hear about them.

Another option for caregivers and the people they care for is respite care, which provides a “break” from caregiving through a paid or unpaid helper coming to the home, a short-term stay in a residential facility, or an emergency respite (for example if a caregiver has a sudden health issue).

Among caregivers who felt they don’t have the support they need, 39% said that respite care or temporary relief from caregiving was a service that could help them the most with their caregiving responsibilities.

Yet only 11% of all caregivers had used any form of respite, while 57% hadn’t used it but had heard of it, and 32% had never heard of it. Male caregivers were much more likely to say they had never heard of it.

Of those caregivers who had used respite care, 33% said it was to take time for themselves, and 33% said it was to relieve stress and prevent burnout.

Poll director Jeffrey Kullgren, M.D., M.P.H., M.S., said it’s important for health care providers to be attuned to their patients’ roles as caregivers, as well as to the family or friend caregivers who may be taking care of them.

“We see a real awareness gap here, and health care providers can help by making sure that information about local resources is available in waiting areas, patient education packets and more,” he said. Kullgren is an Associate Professor of Internal Medicine at the U-M Medical School who provides primary care to veterans at the VA Ann Arbor Healthcare System

“If our patients are feeling unsupported or stressed as caregivers, it can affect their own mental and physical health, and their ability to keep up with healthy habits that are important for long-term healthy aging,” he added. “Making sure they know about adult day programs and respite care could be a way to help them make caregiving sustainable.”

Michigan findings

In addition to the national poll findings, the poll team analyzed data from Michigan residents over age 50 via the Michigan Poll on Healthy Aging with support from the Michigan Health Endowment Fund. Overall, Michigan results were in line with the national findings.

In all, 31% of Michiganders over 50 serve as caregivers to one or more adult family members or friends who have a health issue or disability. And 33% of these Michigan caregivers say that caregiving has resulted in financial challenges for them. Meanwhile, 17% say they don’t have the support they need to manage their caregiving responsibilities, and this percentage was higher among caregivers without close friends or family to depend on for help with their own needs.

In all, 19% of Michigan caregivers over 50, and 23% of all Michiganders over 50, say they do not have family members or close friends that they could depend on if they needed support with their daily needs.  

But the poll shows that most of these Michigan caregivers don’t use or aren’t aware of programs designed to help with caregiving.

When asked about adult day programs, only 10% of Michigan caregivers said the person they care for had used such programs, while 50% said they hadn’t used one but the caregivers had heard of them. That left 26% of Michigan caregivers who hadn’t ever heard of adult day programs and 14% who didn’t know if the person they care for had ever attended an adult day program.

And only 15% of all Michigan caregivers had used any form of respite care, while 55% hadn’t used it but had heard of it, and 30% had never heard of it.

At the same time, among Michigan caregivers who felt they don’t have the support they need, 35% said that respite care or temporary relief from caregiving was a service that could help them the most with their caregiving responsibilities.

About the poll

The National Poll on Healthy Aging is a nationally representative survey conducted by NORC at the University of Chicago for the U-M Institute for Healthcare Policy and Innovation. The survey was administered online and via phone in September 2025 to 2,698 U.S. adults age 50 to 95 from the AmeriSpeak panel. The Michigan Poll on Healthy Aging includes data from 1,270 Michigan adults age 50 to 93 from the AmeriSpeak panel, which were compared to 2,334 non-Michigan adults age 50 to 95. All poll data are weighted to reflect the 50+ populations nationally and in Michigan.

Read past National Poll on Healthy Aging reports and Michigan Poll on Healthy Aging reports, and learn about the poll methodology.

 

Abalone shells could help trace seafood origins




Adelaide University
Abalone shells could help trace seafood origins 

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Abalone shells from southern Australia have chemical fingerprints that can help trace the origin of seafood.

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Credit: Louise Hosking, Adelaide University





The rocks beneath our feet are leaving a hidden signature in the shells of marine snails along Australia’s ancient coastline, according to new research led by Adelaide University scientists.

study published in Proceedings of the Royal Society B reveals that neodymium (Nd) isotope ratios in abalone shells reflect the age and type of continental rocks along southern Australia, providing new possibilities for tracking marine animal movement and verifying the origin of seafood.

The research team, led by marine ecologist Associate Professor Zoe Doubleday, analysed neodymium isotope ratios (expressed as ƐNd) in more than 100 abalone shells collected from 11 sites spanning Western Australia to NSW.

The results showed striking geographic differences, with shells from Western Australia recording far more negative ƐNd values than those from eastern Australia.

“These isotope ratios are effectively geological fingerprints,” said Assoc Prof Doubleday.

“What’s remarkable is that the chemical data in the shells reflect the age of the continental crust or land adjacent to where the abalone lived.”

Western Australia’s coastline is dominated by some of the oldest rocks on Earth – dating back billions of years to the Archean eon – while eastern Australia is largely composed of younger geological formations. The team found that ƐNd values in shells shifted predictably from west to east, mirroring this geological transition.

Radiogenic isotopes are widely used to track the movement of terrestrial and freshwater animals. However, their application in marine systems has been limited because commonly used isotope systems, like strontium, are too uniform in the ocean to distinguish regions.

“Unlike strontium, neodymium has a much shorter residence time in seawater,” Assoc Prof Doubleday said. “That means it varies geographically in the ocean, making it far more useful for marine biological applications.”

The study represents the largest analysis to date of neodymium isotopes in modern animal tissues, and the first conducted outside northeast Asia.

Compared with previously published shell data from Japan and China, the same broad pattern emerged: coastlines dominated by ancient geology produced more negative ƐNd values, while younger geological provinces produced fewer negative values.

“This consistency across continents gives suggests that neodymium isotopes can be used as a reliable tracer. It opens exciting possibilities for understanding where marine animals have lived, fed or migrated.”

Beyond ecological research, the findings could have practical applications for fisheries management and seafood authentication.

 “If we can link a shell or tissue sample back to a specific geological region, that gives us a powerful tool for verifying provenance. Geology is about the most permanent and stable driver of isotope variation that you can get in this field, which makes it a beautiful thing to work with” Assoc Prof Doubleday said.

“It could help regulators, industry and consumers ensure products are genuinely sourced from where they claim to be.”

The researchers note that neodymium occurs in very low concentrations in biological tissues, making analysis technically challenging. However, advances in mass spectrometry now allow highly precise measurements from smaller samples.

While further work is needed to better understand how different marine species incorporate neodymium, the study demonstrates that ƐNd offers a predictable, geology-driven chemical marker with minimal biological distortion.

“Radiogenic isotopes have transformed research on land, and we believe that neodymium could become just as indispensable in the marine realm – helping us to trace movement, protect vulnerable species, and safeguard the authenticity of valuable marine products.”

‘The geological imprint of neodymium isotopes in marine gastropods’ is published in Proceedings of the Royal Society B. DOI: https://doi.org/10.1098/rspb.2025.1652


Abalone shells could help trace seafood origins 

The abalone shells are some of the oldest rocks on Earth.

Credit

Zoe Doubleday, Adelaide University

 

Blood test may improve survival of childhood cancer in Africa




University of Oxford






  • Burkitt lymphoma is an aggressive cancer affecting children in sub-Saharan Africa
  • If treated early, over 90% survive but currently, slow diagnosis results in fewer than 50% of children surviving
  • A new, highly accurate blood test has been shown to cut diagnosis time from 46.8 days (using current methods) to 6.5 days and increases detection rate from 40% to 93.3%
  • This approach could help ensure that children with Burkitt lymphoma begin life-saving treatment sooner
  • This research is an output of the National Institute for Health and Care Research (NIHR)-funded AI-REAL consortium

In a study published today in Nature Medicine, researchers from the University of Oxford and the Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es salaam, Tanzania have shown that a minimally invasive “liquid biopsy” test can diagnose Burkitt lymphoma rapidly and accurately in sub-Saharan Africa, where delays in traditional testing often prove fatal.

Despite its aggressive nature, Burkitt lymphoma is often curable when treated quickly, with survival rates over 90%. Treatment is widely available and free-of-charge in most sub-Saharan countries, however current diagnostic tests demand specialist expertise and laboratory equipment that are often unavailable in resource-limited settings. Due to this, most children either remain undiagnosed or are diagnosed too late. In much of the region, survival rates can fall below 50%.

“There is an urgent need for new diagnostic methods that are practical and effective in the under-resourced settings where Burkitt lymphoma is most common”, said Anna Schuh, Professor of Molecular Diagnostics at the University of Oxford and lead researcher on the study. “This is a highly treatable cancer, yet too many children and young adults are not diagnosed in time. As a minimally invasive and precise approach, liquid biopsy tests have enormous potential to transform diagnosis in sub-Saharan Africa and significantly improve outcomes.”

Liquid biopsies detect tiny amounts of DNA released by cancer cells into the blood. Using a simple blood sample, scientists can identify specific genetic changes that are characteristic of Burkitt lymphoma and distinguish them from DNA from healthy cells or other tumour types.

Prof. Anna Schuh and her team in Oxford, working in collaboration with researchers at MUHAS in Tanzania, the Central Public Health Laboratory in Kampala, Uganda and 4 study sites in these countries have developed a minimally invasive liquid biopsy test for the rapid and precise detection of Burkitt lymphoma. This is the first indication that liquid biopsies might play a big role in diagnosing other cancers in sub-Saharan Africa.

The international research team evaluated the liquid biopsy test in a large group of children and young adults who presented with clinical signs of lymphoma across four hospitals in Uganda and Tanzania. Its performance was compared to a tissue biopsy-based approach that used diagnostic tests accessible in limited-resource settings.

High accuracy and faster results

The blood test demonstrated strong ability to distinguish Burkitt lymphoma from other conditions, achieving an overall accuracy of 98%. Among 81 patients with a confirmed tissue-based diagnosis of Burkitt lymphoma, 86.4% were correctly identified via liquid biopsy.

Importantly, the blood test dramatically reduced the time needed to reach a diagnosis. A liquid biopsy diagnosis was 40.3 days faster on average, compared to tissue biopsy diagnosis.

To understand how the test would perform in real-world clinical practice, the team held weekly multidisciplinary team (MDT) meetings to review cases in real time.

Clara Chamba, Head of Haematology at MUHAS and study author said:

“Introducing liquid biopsy into our multidisciplinary meetings transformed how quickly we could start treating our patients. With liquid biopsy, 93% of cases were diagnosed within the first week of sample collection, compared to just 40% when we relied on tissue biopsy alone. For a cancer that progresses as quickly as Burkitt lymphoma, that time can be life-saving.”

While further work is needed to understand how to scale the test for clinical use, this study shows that liquid biopsy could serve as a complementary and timely diagnostic tool, especially where tissue biopsy access is limited or delayed. By increasing diagnostic yield and dramatically shortening time to diagnosis, this approach could help ensure that children with Burkitt lymphoma begin life-saving treatment sooner.

Prof. Bruno Sunguya, Deputy Vice Chancellor, Research and Consultancy, MUHAS, Tanzania, said:

“The successful implementation and analytical work conducted in Tanzania and Uganda demonstrates that precision medicine research can and should be led from within low- and middle-income countries. Beyond lymphoma, this work opens new opportunities to apply genomic and liquid biopsy technologies to strengthen cancer diagnosis and improve outcomes more broadly across the region. This collaboration reaffirms our commitment to advancing innovation, accelerating timely diagnosis, and improving survival for children and adults affected by cancer.”

 

ENDS

 

Notes to Editors

This project (NIHR200133) was funded through the NIHR Research on Interventions for Global Health Transformation (RIGHT) programme. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK government.

 

For further information or interviews with the researchers, please contact:

Chris McIntyre
Communications Manager (Research & Innovation)
University of Oxford 
tel (direct): 01865 270 046
tel (News Office): 01865 280528
Christopher.mcintyre@admin.ox.ac.uk

About The AI-REAL consortium

Funded by the National Institute for Health and Care Research (NIHR), AI-REAL (Aggressive Infection-Related East Africa Lymphoma) aims to improve the early detection and outcomes of childhood lymphoma in Uganda and Tanzania by increasing the speed and precision of diagnosis. The programme is led by Professor Anna Schuh (University of Oxford), with research teams in Tanzania and Uganda. The AI-REAL study developed and tested two simple, low-cost tools that can operate outside traditional laboratory environments:

  • a liquid biopsy test that detects cancer DNA from a blood sample
  • mobile whole-slide imaging which involves scanning entire histological tissue slides using a mobile camera that can be attached to any microscope, to enable remote pathology review.

The study paired these innovations with bioinformatics training, health economic evaluation and policy engagement to assess technical feasibility, affordability and pathways for scale-up. By combining research with local capacity strengthening, it sought to demonstrate how molecular and digital tools can transform cancer care in low- and middle-income countries.

 

About Burkitt lymphoma

Burkitt lymphoma is a highly aggressive cancer that grows very quickly. It can affect the jaw, central nervous system, bowel, kidneys, ovaries, and other organs. In sub-Saharan Africa, 95% of cases are associated with infection by the Epstein-Barr virus (EBV).

An accurate diagnosis of Burkitt lymphoma is made by identifying specific genetic and molecular changes in tumour samples. These tests demand specialist expertise and laboratory equipment that are often unavailable in resource-limited settings. As a result, many hospitals struggle with delays, misdiagnoses, and limited access to specialist pathology services.

 

About the NIHR

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research.

We do this by:

  • funding high quality, timely research that benefits the NHS, public health and social care
  • investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services
  • partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research
  • attracting, training and supporting the best researchers to tackle complex health and social care challenges
  • collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system
  • funding applied global health research and training to meet the needs of the poorest people in low and middle income countries

 

NIHR is funded by the Department of Health and Social Care. Our work in low and middle income countries is principally funded through UK international development funding from the UK government.

 

About the University of Oxford

Oxford University has been placed number 1 in the Times Higher Education World University Rankings for the ninth year running, and number 3 in the QS World Rankings 2024. At the heart of this success are the twin-pillars of our ground-breaking research and innovation and our distinctive educational offer.

Oxford is world-famous for research and teaching excellence and home to some of the most talented people from across the globe. Our work helps the lives of millions, solving real-world problems through a huge network of partnerships and collaborations. The breadth and interdisciplinary nature of our research alongside our personalised approach to teaching sparks imaginative and inventive insights and solutions.

Through its research commercialisation arm, Oxford University Innovation, Oxford is the highest university patent filer in the UK and is ranked first in the UK for university spinouts, having created more than 300 new companies since 1988. Over a third of these companies have been created in the past five years. The university is a catalyst for prosperity in Oxfordshire and the United Kingdom, contributing £15.7 billion to the UK economy in 2018/19, and supports more than 28,000 full time jobs.