1. Kaiser EDU, 2008 figures; 2. Projected U.S. Budget, 2011; 3. AARP Public Policy Institute, 2009 figures; 4. Bureau of Labor Statistics, 2010 figures; 5. IMS Institute, 2010 figures

En español | Family caregivers provided the equivalent of $450 billion worth of care to their adult parents and other loved ones in 2009, an amount that makes caregivers one of the largest and most overlooked pillars of the U.S. health care system, according to a new report by the AARP Public Policy Institute, "Valuing the Invaluable: The Growing Contributions and Costs of Family Caregiving, 2011 Update."

See also: Are you overwhelmed caring for someone else?

This figure, which puts a dollar value on every meal prepared, every call made to an insurance company and every time a caregiver helped an older adult bathe or dress, is nearly as much as the government spent on Medicare in 2009 and nearly four times what Medicaid itself paid for long-term care services. It's an estimate that explains why caregivers are so overwhelmed and in dire need of support, says Lynn Feinberg, senior strategic policy adviser at the AARP Public Policy Institute.

"It's difficult to find paid help to supplement the care family provides at home," Feinberg says. "There's a shortage of quality home care aides; with the economic downturn, people are having a harder time paying for the extra care; and public programs are shrinking — many states now have waiting lists."

"We have to recognize that in the United States, caregiving comes at a cost. We need to provide better support to families in their caregiving roles. Because otherwise, our whole long-term care and health care systems will almost collapse."

Significant findings include:

• People who take care of others are devoting nearly 20 hours per week on average to caregiving duties, often while still working a full-time job.

• Caregiving costs have increased 20 percent over the last estimate of $375 million two years ago.

• Caregivers provide 1.4 billion trips per year for older adults who no longer drive.

• Caregivers are using their own personal savings — or diverting money for their own health care needs — to help cover the $5,000 annual average out-of-pocket cost for caregiving.

• Caregivers are also leaving the workforce earlier than they would, losing an average of $115,900 in wages, $137,980 in Social Security benefits and $50,000 in pension benefits.

Next: What about the physical strain on the caregiver? >>