Some of the strongest women we know do their most important work where no one sees it: before the first client call, after the last order ships, on a lunch break spent on hold with the insurance company.
November is National Family Caregivers Month. Caregiver Action Network has led the observance since 1997, and this year’s theme is “Care Connects Us.” It’s a fitting phrase for work that can feel so solitary.
You are not the only one
Caregiving in the US 2025, from AARP and the National Alliance for Caregiving, found that 63 million Americans, nearly 1 in 4 adults, provided ongoing care to someone with a complex medical condition or disability. Nearly 1 in 4 of those caregivers give 40 or more hours a week, and six in 10 also hold a job. AARP values the unpaid care families gave in 2021 at about $600 billion, across 36 billion hours.
When the care is physical, every day
The National Spinal Cord Injury Statistical Center estimates that about 305,000 Americans live with a traumatic spinal cord injury, with about 18,000 new injuries a year. Since 2015, nearly 40% of those injuries have resulted in paraplegia.
For families, that can mean wheelchair transfers and bowel and bladder routines. It means helping with pressure relief and checking the skin at least twice a day. It means managing medications, getting to appointments, and advocating in rooms full of professionals. Dana Reeve once wrote to caregivers: “Please know that you are not alone, that you are extremely valuable…”
In Texas, you may be able to get paid
AARP counts 11.2 million family caregivers who now receive some compensation, though most still go unpaid. If your loved one lives in Texas and qualifies for Medicaid, these programs may open a door:
- STAR+PLUS is Texas Medicaid managed care for adults 65 and older and adults with disabilities. It includes help at home with daily activities.
- Community First Choice (CFC) provides personal attendant services to eligible members who need an institutional level of care but live at home.
- Consumer Directed Services (CDS) makes your loved one, or their legal representative, the employer, who hires and sets pay for their own attendant while a state-contracted agency handles payroll.
Who can be hired? Under Texas HHSC rules, a relative such as an adult child or sibling may serve as the paid attendant if they meet program requirements. A spouse generally cannot. Neither can a legal guardian, the parent of a minor, or the person’s designated representative. (A small state program, CMPAS, does allow spouses. Ask HHSC whether it applies to you.)
Next steps:
- Apply for Medicaid at YourTexasBenefits.com or call 2-1-1.
- Already in STAR+PLUS? Ask the health plan’s service coordinator about CFC and the CDS option.
- Not sure where to start? Call the Aging and Disability Resource Center at 855-937-2372, or the Area Agency on Aging at 1-800-252-9240 for adults 60 and older.
- Caring for a veteran? The VA’s family caregiver program (PCAFC) is separate, with its own stipend and rules.
Being seen
If this is your season, hear us: being tired is not failing, and asking for help is not weakness. The quiet work of care, done with grace and dignity, is seen.
For general information only. Program rules change, so confirm eligibility with Texas HHSC or your health plan.
