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Caregiving Across the Word: Same Crisis, Different Choices

April 29, 2026

Hi there!

I’m Erna, the author of Care Fully.

My caregiver journey started over 20 years ago, when I was 21 years old. As a newly minted college graduate, my life was just beginning. I had no idea how to deal with the ups, downs, and in-betweens of caregiving for my Mother.

Care Fully is a play on words. The questions I am asked and the ones I still have drive each issue of this newsletter.

We “care fully” by balancing our needs as a caregivers with those we provide care for. My goal is to offer up experiences and information to support your caregiving journey.

The caregiving crisis is not American. It knows no geographic boundaries and is global and structural. A key difference is the degree to which policy acknowledges and supports it.

For this of Care Fully, we look outside the US to Japan and Australia. I’ll note similarities and differences, and what we can learn from one another.

Keep reading this edition of Care Fully for:

  • A glimpse into Japan and Australia caregiving policy.

  • Updates on future topics, thanks to your feedback.

  • News you can use. This week, one story maps back to our main feature.

If this edition was forwarded to you, please sign up for your own copy here. To spotlight or support caregiving in your company, email [email protected].

🌏 GLOBAL CAREGIVING EXPERIENCES IN JAPAN AND AUSTRALIA

We are familiar with caregiving across our country, but how does our experience compare to that of other nations?

This question can be analyzed a multitude of ways. To answer this question, I wanted to start with two countries: Japan, a country with a rapidly aging population, and Australia, a country with similar caregiving statistics as the US.

🇯🇵 Japan’s Journey

There is a reason for that expression.

Births in Japan fell below 705,809 in 2025, the lowest on record since 1899. The country has more people over 65 than under 15. And, the majority of the population in many rural communities is elderly.

To respond to this accelerating crisis, Japan moved aggressively on workplace policy supporting caregiving.

Amendments to the Act on Childcare Leave and Caregiver Leave, effective in 2025, expanded flexible work options, required employers to proactively inform employees about caregiving support, and extended leave eligibility to newer workers. Employers who fail to comply risk public disclosure of violations.

 🇦🇺Australia’s Journey 

Australia's 2024 National Carer Survey found 58.6% of caregivers reporting financial stress. Psychological distress, social isolation, and loss of income and career opportunity were pervasive across all age groups. These are similar themes to the US.

However, policy is where the similarities end.

Australia launched its Support at Home program in November 2025. This program replaced previous Home Care Packages with a single framework of eight funding classifications to align funding with individual need.

Also, the government announced a $3 billion aged care investment this month. Updates include:

  • $1 billion to reclassify personal care (showering, dressing, continence management as clinical care), fully government-funded from October 1, 2026

  • 5,000 additional aged care beds annually from July 2027

  • And over $200 million for dementia care expansion.

These changes signal significant progress, but serious mistakes have happened.

Over 3,100 patients were stranded in hospitals awaiting care placements as of February 2026, and more than 120,000 people remained on the home care waiting list. Care workers and clinicians raised serious concerns about the assessment algorithm at the center of the new system.

🇺🇸The Work Is Not Done

As of April 29, 2026, the US still has no federal paid family leave, national long-term care insurance, or caregiver benefit. However,

  • Fourteen states and the District of Columbia offer paid leave. We don’t have national long-term care insurance. However,

  • The Credit for Caring Act could provide a federal tax credit of up to $5K for eligible working family caregivers. It remains an open issue.

  • Several states are actively studying or advancing long-term care insurance proposals inspired by Washington State’s WA Cares Fund.

  • Medicaid continues to be the primary support for care at home, chronically underfunded and increasingly under threat. See the news below.

Japan and Australia show us inaction has a price. We are aware of this price. It gets billed to caregivers instead of governments.

Change is constant, but many times its speed is not.

😀THANK YOU FOR YOUR POLL RESPONSES

I appreciate the time you spend reading Care Fully and answering the polls. Everything you write and share, I read. My goal is to continue sharing information that is most helpful to you. The topic of long term care needs and balancing caregiving and work resonate with many of you. Stay tuned, I’ll incorporate both of those into future editions.

🗞️ NEWS YOU CAN USE

 🫶 BEFORE YOU GO . . .

The caregiving crisis is not unique to the US. Every country that has extended life expectancy without building the infrastructure to support it feels this burden.

The question was never whether the crisis would arrive, it was whether the systems would be ready when it did.

They weren't. They aren't. But they're being built.

In the US, our systems are being built. Slowly, state by state, bill by bill, benefit by benefit. The caregiving crisis is not uniquely American. But the urgency to act is ours to claim.

If you know someone who could use Care Fully, please forward this newsletter. They could be a fellow caregiver, colleague in HR, policymaker in your network, or someone who wants to know more about caregivers. The more folks who understand what is at stake and what is possible, the faster we can make change happen.

Until next time,