Military caregivers need more tailored support that reflects their needs, according to a new Rand Corp. report.

“We call [caregivers] hidden heroes,” Rajeev Ramchand, co-director of the Rand Epstein Family Veterans Policy Research Institute, said during the Elizabeth Dole Foundation’s National Convening on Military Caregiving on Sept. 24. “We call them this because we truly believe that they're really the backbone of our national security, but oftentimes their service is hidden, unrecognized and undervalued.”

The report, “America’s Military and Veteran Caregivers: Hidden Heroes Emerging from the Shadows,” was commissioned by the Elizabeth Dole Foundation, a nonprofit organization that supports and empowers military and veteran caregivers. It defines military and veteran caregivers as someone “who … car[es] for a wounded, ill, or injured adult … who is currently serving or had formerly served in the U.S. military.”

Across the country, there are 14.3 million military and veteran caregivers, according to the report. Of the service members and veterans receiving care, the majority served in the Army, according to the report.

Caregivers reported helping their service member or veteran through a wide range of tasks.

“[I provide assistance with] basically everything,” a partner caregiver of an Army veteran said in Rand’s qualitative data report. “I have to [take care of] the house. I have to help him get a shower, get his shoes on, his pants. He puts his shirt on, but I have to help him with his pants, and I make his bed, do the dishes, stuff like that. I transport him to the store. I go to the store for him.” 

Caregiving can have an adverse impact on caregivers’ mental health, the report found.

“The authors found that 43 percent of military and veteran caregivers to those 60 and under met probable criteria for depression; this is almost four times the rate of non-caregivers,” the report found. “About 20 percent of military and veteran caregivers in this group had thoughts in the past year about taking their own lives. This is also four times the rate of non-caregivers.” 

Though caregiving “generates economic value,” caregivers may forgo potential earnings to prioritize unpaid aspects of caregiving, opt out of or not be selected for promotions and may incur costs from the stresses of caregiving on their own health, the report found.

The report recommends increasing mental health resources to caregivers and their families, boosting financial support for caregivers and tailoring caregiver support programs to meet their needs, among others.

Though caregiving is done “out of love and obligation,” there is a cost to it, Ramchand said.

“Military and veteran caregivers are family members who do this out of love and obligation, but they are also friends and neighbors who are taking on these duties out of caring and kindness,” he said. “Care recipients benefit from the work these caregivers do, and caregivers benefit as well. But caregiving is not without its costs, both financial and emotional.”

Read the full report here.