ArcaMax

Just four days before she died, Dolly Parton said she was being treated for health problems that she "didn't pay attention to when I was watching over Carl." She was talking about the years she spent caring for her husband through a long illness. All the money in the world could not spare her from the enormous burdens that caregivers of sick loved ones suffer. In October 2025, when posting a video to calm fans who had begun to worry about her health, she acknowledged that while her husband was sick and after he died, "I didn't take care of myself," and had let things slide. A few months later in March 2026, opening the season at Dollywood, she admitted that she had gotten "worn down and worn out," a message she repeated only four days before she died. Caregiving is dangerous.

In his mid-30s, hedge fund manager Neal K. Shah suddenly became the primary caregiver for his wife, who was battling cancer. It opened his eyes to the burden caregivers face every day. He quit his hedge fund job and founded CareYaya, where he's worked to help thousands of caregivers who are caring for loved ones through serious illness, dementia or disability. More than 60 million Americans are going through such crises, a 45% increase over the past decade. And yet, we hardly talk about it.

The numbers Shah has collected should spur us to action. We have known for years about the costs of caregiving. In the Caregiver Health Effects Study, published in JAMA in 1999, elderly spousal caregivers who reported strain had a four-year mortality rate 63% higher than non-caregiving spouses. Give a caregiver and a matched non-caregiver an identical small wound, and the caregiver's wound takes about nine more days to close. Caregivers' immune cells show accelerated telomere erosion, the hallmark cellular signature of faster aging.

When Blue Cross Blue Shield went into its own claims database and identified 6.7 million members who were caregivers, it found that caregivers had 26% poorer overall health than a matched benchmark. They were 64% more likely to have high blood pressure, 37% more likely to have major depression, and 34% more likely to have anxiety. Among millennials, the so-called "sandwich generation" raising their children while managing an aging parent's illness, the rates of hypertension ran 82% higher and hospitalizations ran 59% higher. As Shah reports, "the health care system can already see clearly what caregiving does to someone's own health. It simply has not adjusted the way it responds to help caregivers."

I have spent the last few months watching one of my oldest and best friends decline. She is, in some respects, lucky. In addition to family and me, she gets great and loving care from dedicated paid caregivers. But it is still so hard. Watching someone you love decline is heartbreaking, no matter how much help you have. I shall be eternally grateful to Cheree and Timeka, the women who care for her every day. But I can see the toll it takes on them, as well as the family, not to mention my friend. Everyone knows the warning they give you on planes about putting your own oxygen mask on first, about how you can't help others if you don't help yourself first. But who can do that? Not Dolly. She did not put herself first. May her life, and her death, be an inspiration to all of us who do our best to provide the loving care that they deserve.

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To find out more about Susan Estrich and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.

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