As the nation reflects upon the service of nearly 22 million veterans this Veterans Day, Americans are reminded of their strength, sacrifice, and commitment, which continue long after they take off the uniform and reintegrate into their communities.

Today we especially honor the millions of veterans living with service-related illnesses and injuries—but it is also important to recognize the sacrifices of those helping them to recover and thrive. A RAND study found that there are approximately 5.5 million individuals providing informal care and support to the nation’s military veterans. These wives, husbands, siblings, parents, children, and friends devote significant time caring for veterans. Whether it be helping them to dress and bathe, administering medications, arranging care appointments, or preparing meals, caring for a wounded, ill, or injured loved one is a demanding task, and often doubly so for those juggling care duties with family life and work. These caregivers provide an estimated $3 billion in care annually, saving the United States substantial sums in avoided long-term care costs.

Caregiving also imposes a non-monetary burden: military caregivers consistently experience worse health outcomes, greater strains in family relationships, and more workplace problems than non-caregivers. Caregiving contributes to an increased risk for depression, lower levels of relationship quality with care recipients, decreased time spent with children, increased financial strain, and lower work productivity.

Caregivers for post-9/11 veterans face particularly acute challenges. They tend to be young (many are under 30), caring for a younger individual with a mental health or substance use problem, juggling work and caregiving duties, and disconnected from a support network. These caregivers are four times more likely than non-caregivers to be depressed. In addition, more than 30 percent of these caregivers lacked health care coverage at the time of the RAND study, suggesting they face added barriers to receiving help for their own health needs.

Approximately 5.5 million Americans provide informal care and support to the nation’s military veterans.

Many programs exist to support wounded, ill, and injured veterans; however, few specifically target the needs of military caregivers. The United States needs to enhance and expand efforts to ensure better support for military caregivers. We offer four broad recommendations for how to do this:

  1. Empower caregivers by offering them high-quality training in providing care, facilitating access to health care coverage, and boosting public awareness of their contributions and sacrifices.
  2. Create caregiver-friendly environments in health care settings and in the workplace that acknowledge and support the unique needs of military caregivers by helping them balance the demands of caregiving with their other responsibilities.
  3. Fill gaps in programs by aligning eligibility criteria with the characteristics of caregiver populations and expanding opportunities for respite care.
  4. Plan for the future to ensure caregiving continuity and the sustainability of programs. Families will require financial and legal planning to ensure continuous support for loved ones, particularly among those relying upon aging parents. In addition, to improve policies for caregivers and their families, further research must assess how veteran support needs change over time.

Just as military caregivers provide a wide range of assistance to wounded, ill, and injured service members and veterans—as well as a tremendous benefit to America as a whole—the steps we’ve outlined are widespread in scope and can promote the long-term well-being of these hidden heroes and their families.

Terri Tanielian is a senior research analyst at the nonprofit, nonpartisan RAND Corporation.