Eldercare—the leadership crisis no one is talking about

As founder, chair, and CEO of the Exceptional Women Alliance, I am privileged to engage with extraordinary female leaders across industries. This month, I spoke with Shari Hofer about a workforce issue hiding in plain sight: eldercare.

For many organizations, caregiving is still viewed as something employees manage quietly outside of work. According to the 2025 Caregiving in the US report, released by AARP and the National Alliance for Caregiving, approximately 63 million Americans provide family care, with almost 48 million providing unpaid care to adults. The 2021 AARP report estimated that the economic value of care was over $600 billion annually. Today, these professionals are simultaneously leading teams, raising families, and caring for aging parents. The result is an invisible workforce dynamic that is already impacting performance, retention, and leadership effectiveness.

Hofer wrote With Love: A Practical Guide for Caregiving for Aging Parents Through End of Life with coauthor Shabnam Kazmi. Both built demanding global careers while raising families and caring for aging parents through dementia, Parkinson’s, and end-of-life decisions. Their new book reframes caregiving not as a private hardship, but as a leadership and organizational imperative.

Q: How did your caregiving journey begin, and when did it significantly intensify—both personally and professionally?

Hofer: It began when my siblings and I learned our father had macular degeneration and dementia. We had already lost our mother, and we were all living in different states. We knew the road ahead would be long and complex, and that we would need to step in, because our father wouldn’t make any changes or be able to care for himself without assistance.

The intensity escalated when we moved him closer to us. That was the turning point—when caregiving shifted from something we managed at a distance to an integral part of our daily lives.

Q: What was the moment caregiving shifted from a private responsibility to something that affected your work identity?

Hofer: In the final years, I relied heavily on my team and my manager. I shared just enough to get support, but kept most of it private. The reality was too painful. And there was always a risk that sharing more broadly could change how I was perceived—a sad but very real part of corporate culture.

When my father passed, everything surfaced. The physical effects of burnout and grief became impossible to ignore. I had powered through for years, but the cost showed up in my body and my ability to stay engaged.

That’s when I realized: The effects of caregiving last long after the role ends.

Q: Did caregiving change how you lead?

Hofer: Absolutely. It deepened my understanding of trust, delegation, and succession planning—I had to rely on others in ways I hadn’t before. And it made me realize that our existing leadership structures need to be rebuilt because they did not factor in the reality of caregiving.

More importantly, it changed how I view performance. High-performing employees are often carrying invisible weight. Leadership isn’t just about driving results—it’s about understanding context and creating systems that allow people to perform sustainably and consistently.

Q: How did you handle burnout, and what workplace lessons did you take from it?

Hofer: Burnout is not something you can outwork. Staying busy doesn’t fix it. When it surfaces, you have to listen and act. It’s a signal, not a weakness.

From a workplace perspective, leaders must normalize conversations around capacity. Ignoring burnout doesn’t protect performance—it erodes it over time.

Q: What do employers still misunderstand about employees who are caregivers?

Hofer: They’re only seeing part of the story. If someone’s performance or engagement shifts, there’s often more beneath the surface. Caregiving is unpredictable and rarely linear.

Leaders need to ask questions—with empathy—and create space for honest answers.

Q: How can companies move beyond talking about work-life balance to actually supporting eldercare challenges?

Hofer: It comes down to lived values. If organizations say they prioritize people, leaders have to model that. Flexibility cannot exist only in policy—it has to show up in daily behavior. Employees notice the gap between what’s said and what’s rewarded.

Q: What should leaders do now?

Hofer: Eldercare is not a future issue—it is a present reality. For organizations to effectively support a workforce increasingly shaped by caregiving responsibilities, leaders must move beyond awareness and into action.

Three shifts are critical:

1. Normalize transparency around capacity

2. Redefine performance through context, not just output

3. Align culture with practice, not just policy.

Organizations that continue to treat caregiving as an unspoken issue will face rising burnout, disengagement, and talent loss. Those that acknowledge it as a shared reality—and design cultures, expectations, and systems accordingly—will build stronger, more resilient, and more human organizations.

Caregiving does not just change individuals. It is reshaping the workforce. The leaders who understand and act on that will define the next era of leadership.

Larraine Segil is founder, chair, and CEO of The Exceptional Women Alliance.