Nextdoor Blog

America's Growing Caregiving Crisis—And Why Local Recommendations Matter More Than Ever

Written by #TeamNextdoor | Jan 22, 2026 1:27:35 PM

Caregiving in America has reached a critical inflection point. According to AARP's landmark 2025 report, 63 million Americans—nearly 1 in 4 adults—are now family caregivers, representing a staggering 45% increase since 2015. This surge reflects a demographic reality: as Baby Boomers age and the number of Americans 65 and older continues to climb, more families are navigating the complex responsibilities of providing care for aging parents, spouses, and relatives.

Against this backdrop, our latest Nextdoor research reveals that neighbors on the platform are significantly more likely to be caregivers and are actively using local recommendations to make critical care decisions. Understanding how these caregivers search for support, what drives their choices, and where they turn for trusted guidance offers essential insights for care providers looking to reach this high-intent audience.

Nextdoor Neighbors Are More Likely to Be Caregivers

The research shows that 41% of Nextdoor neighbors provide or manage adult care—46% higher than the general population. Of these caregivers:

  • 43% care for a parent or in-law, while 29% care for a spouse and 20% for another relative
  • 74% personally provide care, with 61% handling finances and legal matters and 42% actively finding and managing professional care (31% higher than the general population)
  • 76% coordinate appointments, 75% provide transportation, 73% communicate with medical professionals, and 71% handle finances, billing, and insurance

These numbers align with national trends showing caregiving has become increasingly complex and time-intensive. The 2025 AARP report found that 44% of caregivers provide high-intensity care, with many managing medical and nursing tasks that would once have been handled by healthcare providers. Nearly 1 in 4 caregivers spend 40 or more hours per week on caregiving—equivalent to a full-time job.

The Strong Preference for In-Home Care

When it comes to care settings, neighbors on Nextdoor show a decisive preference for keeping loved ones at home. 50% prefer in-home care over out-of-home options (21%), driven primarily by:

  • Greater independence for care recipients (75%)
  • More comfortable and less disruptive to daily life (60%)
  • More convenient to schedule (58%)
  • Care recipient's preference (56%)
  • More affordable (54%)

This preference reflects a broader national trend. Research shows that 87-90% of older adults prefer to age in place rather than move to institutional settings, and the U.S. home healthcare market—valued at $107 billion in 2025—is projected to grow by 64% over the next seven years.

Interestingly, in-home care on Nextdoor typically involves 2-8 hours of daily support (67% combined), suggesting that most neighbors are seeking partial assistance that allows care recipients to maintain independence rather than full-time institutional care.

What Caregivers Prioritize When Evaluating Care Options

Quality and trust dominate caregiver decision-making. When evaluating care providers, neighbors prioritize:

  • Quality of care (85%)
  • Reputation (77%)
  • Safety standards (74%)

However, significant information gaps remain. Caregivers report needing more transparency around:

  • Cost and pricing (21%)
  • Insurance coverage details (17%)
  • Staff qualifications and training (15%)

Among caregivers managing professional care, 61% manage paid caregivers—15% higher than the general population—highlighting the coordination burden many families face. Nationally, caregivers spend an average of $7,200 per year out-of-pocket on caregiving expenses, creating significant financial strain for many families.

The Power of Neighbor Recommendations

Perhaps most significantly for care providers, 65% of neighbors are likely to use Nextdoor for care recommendations—making peer influence a critical factor in care decisions.

The importance of local reputation is further reinforced by the fact that 75% of neighbors say having a locally-based provider is very important—underscoring the value of hyper-local targeting and community presence for care organizations.

Why Neighbors Provide Care Themselves

Understanding why families choose to provide care personally rather than hire professional help reveals important motivations and potential pain points:

  • Care recipient prefers family care (55%)
  • Desire to control the care provided (48%, 17% higher than general population)
  • Professional care costs too high (48%)
  • Care level not needed yet (38%)
  • Lack of good local options (33%)
  • Cultural or family expectations (28%)

When providing personal care, neighbors most commonly assist with:

  • Household tasks (75%)
  • Transportation (68%, 11% higher than general population)
  • Emotional support and companionship (65%)
  • Health and safety monitoring (63%)
  • Medication management (60%)
  • Daily activities like bathing and dressing (53%)

Despite these significant responsibilities, 65% feel very confident in their ability to provide care, driven primarily by prior experience (79%) and support networks (40%). This confidence, however, comes with trade-offs. The impact on caregivers' lives varies considerably:

  • Mental wellbeing: 59% report positive impact, 29% negative
  • Financial situation: 43% positive, 34% negative
  • Work and career: 41% positive, 25% negative
  • Social life: 39% positive, 35% negative

Nationally, the toll is significant: 1 in 5 caregivers report fair or poor health directly attributable to their caregiving responsibilities, and nearly half report at least one negative financial impact, including taking on debt or depleting savings.

When Families Consider Professional Care

Several triggers prompt caregivers to consider transitioning to professional care services:

  • Decline in care recipient's health (59%)
  • Care recipient requests professional help (48%)
  • Medical professional encouragement (41%)
  • More affordable professional options become available (36%)

These decision points represent critical moments when care providers can reach families actively seeking support.

Platform Insights: How Neighbors Discuss Caregiving on Nextdoor

Analysis of Nextdoor conversations reveals that caregiving mentions increased 21% year-over-year (January 2024 to December 2025), with discussions remaining consistent throughout the year—suggesting caregiving is a year-round concern rather than seasonal.

Top discussion topics include:

  • Out-of-home care (28%): Choosing facilities, especially post-hospitalization
  • Home care services (21%, up 11% year-over-year)
  • Memory care (4%): Alzheimer's and dementia support
  • Self-promotion (3%): Professional caregivers seeking clients
  • Paying for care (2%): Medicaid, Medicare, and insurance questions

Geographically, caregiving discussions are most concentrated in Wyoming, New Jersey, and New York—areas that may benefit from increased targeting and localized content strategies.

When asked why they use Nextdoor for care-related information, neighbors cite:

  • Real local experiences from trusted neighbors (66%)
  • More relevant local information (56%)
  • Easier to get personalized advice (54%)
  • More trustworthy recommendations (46%)
  • Less overwhelming than generic searches (41%)

What This Means for Care Providers

The convergence of national caregiving trends and Nextdoor-specific insights reveals several opportunities for care providers:

1. Lead with local trust and testimonials. With 65% of neighbors likely to use Nextdoor for recommendations and peer influence rivaling professional sales, featuring real stories from local families who've used your services can be more powerful than traditional marketing.

2. Emphasize independence and home-based options. The strong preference for in-home care (50% vs. 21% for facilities) suggests positioning services around preserving independence, maintaining daily routines, and supporting aging in place will resonate more than facility-focused messaging.

3. Address cost transparency proactively. With 21% of caregivers citing cost information gaps and 48% saying professional care costs are too high, clear pricing information and discussion of insurance coverage, payment options, and financial assistance can differentiate your organization.

4. Position as partners, not replacements, for family caregivers. Since 55% prefer family-provided care and 48% want to maintain control, framing professional services as supportive extensions that work alongside family members—rather than replacements—will be more effective.

5. Target high-intent moments. Focus outreach around key trigger points: health declines (59%), recipient requests (48%), and medical professional recommendations (41%). These moments represent when families are actively researching and making decisions.

6. Maintain year-round presence. Unlike seasonal services, caregiving discussions remain consistent throughout the year, suggesting the value of always-on campaigns that establish your organization as a trusted resource before crisis moments arise.

7. Provide resources for care coordination. With 76% of managing caregivers coordinating appointments, 71% handling finances, and 61% managing paid caregivers, offering tools, guides, and support for these coordination tasks can position your organization as a valuable partner beyond direct care provision.

The Bottom Line

As America's caregiving crisis intensifies—with 63 million family caregivers nationwide and growing—platforms like Nextdoor are becoming essential resources for families navigating care decisions. The combination of high caregiver concentration, strong preference for local recommendations, and active use of the platform for care-related discussions makes Nextdoor a uniquely valuable channel for reaching families at critical decision points.

For care providers, success lies in building local trust, providing transparent information, positioning services as supportive partners to family caregivers, and maintaining consistent presence in communities where neighbors are already turning to each other for guidance.

Want to explore the complete findings? This article highlights key insights from our caregiving research, but there's much more to discover. For the full report with detailed data, audience segments, targeting options, and strategic recommendations for reaching caregivers on Nextdoor, reach out to Jacob Chavis, Customer Analytics & Insights Manager, at jchavis@nextdoor.com.