How 'high warmth' parenting works as shouting found to damage children's brains
But while raising your voice might feel effective in the moment, new research suggests it could have lasting effects on children's wellbeing. Brain scans from University College London reveal that regular exposure to shouting can 'reshape' developing brains, increasing the risk of poor mental health later in life.
These findings were recently presented to MPs in Westminster by a panel of child development experts, in an event organised by the charity Words Matter.
The researchers warned that children subjected to verbal aggression may also struggle to experience joy and build healthy friendships, especially if they're shouted at on a regular basis.
In the UK, shouting is a common behaviour in many households, with two in five children experiencing verbal abuse, and over half of kids exposed to it weekly.
Shouting can range from raised voices to more extreme scolding, threatening and insulting from parents. The World Health Organization classifies the latter as emotional abuse, categorising it as a key form of violence against young people.
Experts have previously warned that regular shouting can have long-term effects on kids, increasing the risk of anxiety, depression, eating disorders, sleep problems, addiction and self-harm.
Studies have even suggested that verbal abuse may be as damaging as physical or sexual abuse, with one 2023 research paper linking shouting at with a greater risk of self-harm, drug use and imprisonment later in life.
If you're a parent, you'll probably familiar with this scenario: your child ignores your last warning not to misbehave, and the next thing you know, you're yelling at the top of your voice.
But parenting coach Olivia Edwards says that disciplining kids in this way rarely works, as it models shouting as a conflict-resolution strategy, and can often escalate small issues into full blown family rows.
"When parents shout, it's usually because they've been triggered into a fight-or-flight state," she notes. "For many, this response is learned from their own childhood experiences, which can lead to default reactions when children misbehave.
"We often revert to what we experienced growing up - how our parents reacted when we misbehaved," she reveals. "That's why the gentle parenting movement is so important, as it encourages us to parent differently from how we were raised, requiring us to rewire old habits."
Edwards says the first step is for parents is to build awareness, recognising when shouting is happening. From here, they can try the following tips to get back on track with calm and effective communication:
Between school runs, homework, cooking and bedtimes routines, parents rarely get the time to rest and reset their nervous system - the body's ability to maintain balance and adapt to stress. In this state, small frictions can easily tip parents into losing their cool.
"We all have triggers, but on the flip side, there are glimmers too - habits or hobbies that can take us out of a fight and flight response and into a relaxed rest and digest state," Edwards note.
Glimmers could be anything from going for a walk in nature, stepping outside for a few restorative breaths or listening to calming music - any activity and ritual that helps you feel calm and in control.
Shouting might feel like the right thing to do in the moment, but it rarely achieves the right result.
'When a parent's old wounds are triggered, they tend to go into a state of needing to shout to gain control. Or they look at punishments, such as threats or removal of privileges," says Edwards.
"But we want to avoid using both of these tactics," she warns, "because it's not really teaching children the value in feeling and moving past their emotions."
Rather than shouting, Edwards encourages what she calls a 'high warmth' parenting style.
"Many parents think gentle parenting means being lenient, but children actually need clear limits," she explains. "Their nervous systems feel safer when they know where the boundaries are, and that you're confident in holding them as their parent."
The goal is to be consistent, but also compassionate. "When a child tests a limit, it's important to hold it while offering understanding," says Edwards.
For example, you might say there won't be ice cream at the park today because they've already had sugary treats. "If they get upset, that's okay," she says. "It's normal for children to have big emotions. and we don't want to shut those down with shouting."
Instead, parents should stay calm and confident. "You can say, 'I know you're disappointed,' while still sticking to the decision."
After setting the boundary and validating their feelings, Edwards advises against getting drawn into negotiation with kids. "Sometimes it helps to gently redirect their energy, shifting the focus to something else to move past the tantrum," she says.
"It's fine to distract or move on, but only after you've acknowledged how they feel, because that's how they build emotional resilience over time."
While calming practices can take the edge off a particularly testing day, parents who find themselves blowing up regularly may need therapy to tackle unhealed wounds, so they can show up for their children without easily getting upset.
"If the root causes of those triggers are inherent feelings like, 'my child isn't listening to me,' 'that felt really disrespectful,' or 'my voice isn't being heard,' a qualified therapist or coach can help you understand the root cause of these emotions," says Edwards.
No parent is perfect, and Edwards says it's important to recognise when things didn't go as planned.
"For example, you might feel annoyed after shouting, but if you say, 'I'm sorry I shouted, but if you'd just listened…' the apology isn't valid, because it's still blaming the child. An effective repair means owning your mistake genuinely and not passing the blame," she says.
"Instead, you might say, 'I'm really sorry I shouted at you earlier. I was angry, and it's okay for me to feel angry, but it's not okay that I let that anger come out as shouting.'
"It's important to frame it this way so that the child understands anger is a natural emotion, but it's how we handle it that counts."
She adds that it's helpful to check in with children's feelings after shouting, as even if the comments weren't aimed directly at them, it can still be unsettling for them to witness.
Read more on parenting:
How much sleep do teenagers actually need? An expert explains (Yahoo Life UK, 6-min read)
What being the youngest, oldest or middle child could mean for your personality (Yahoo Life UK, 4-min read)
My 4-year-old son was too anxious to go to school for a year (Yahoo Life UK, 5-min read)
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IRVINE, Calif.--(BUSINESS WIRE)--Edwards Lifesciences (NYSE: EW) today reported financial results for the quarter ended June 30, 2025. 2025 Outlook Increasing Edwards sales growth guidance to 9-10% from 8-10% Increasing TAVR sales guidance to 6-7% from 5-7%; reiterating TMTT and Surgical sales guidance Increasing adjusted 1 EPS guidance to the high-end of $2.40 to $2.50 Expected clinical presentations: 7-year PARTNER 3 low-risk, ENCIRCLE, TRISCEND II sub-analysis 'We are pleased to report strong second quarter results that delivered double-digit sales growth. Based on our better-than-expected first half performance and the many catalysts across our portfolio, we are confident in our full-year outlook and are raising our sales and EPS guidance,' said Bernard Zovighian, CEO. 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Surgical In Surgical, second quarter sales of $267 million increased 7.7% over the prior year, or 6.8% on a constant currency basis. The company continues to see positive procedure growth globally for the many patients best treated with its premium RESILIA tissue portfolio including the INSPIRIS, MITRIS and KONECT technologies. The company's KONECT aortic valved conduit received CE Mark approval in Europe during the quarter and the Surgical team made continued progress advancing important innovations around the world. Additional Financial Results For the quarter, the gross profit margin was 77.5%, in-line with the company's expectations, compared to 79.9% in the same period last year. This year-over-year change was driven by additional manufacturing expenses related to the expansion of new therapies as well as foreign exchange. 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Through breakthrough technologies, world-class evidence and partnerships with clinicians and healthcare stakeholders, our employees are inspired by our patient-focused culture to deliver life-changing innovations to those who need them most. Discover more at and follow us on LinkedIn, Facebook, Instagram and YouTube. Conference Call and Webcast Information The company will be hosting a conference call today at 2:00 p.m. PT to discuss its second quarter results. To participate in the conference call, dial (877) 704-2848 or (201) 389-0893. The call will also be available live and archived on the 'Investor Relations' section of the Edwards website at or This news release includes forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, and Section 21E of the Securities Exchange Act of 1934. These forward-looking statements can sometimes be identified by the use of words such as 'may,' 'will,' 'should,' 'anticipate,' 'believe,' 'plan,' 'project,' 'estimate,' 'forecast,' 'potential,' 'predict,' "early clinician feedback," 'expect,' 'intend,' 'guidance,' 'outlook,' 'optimistic,' 'aspire,' 'confident' or other forms of these words or similar expressions and include, but are not limited to, statements made by Mr. Zovighian and statements regarding the third quarter and fiscal year 2025 financial guidance, our expected growth and accelerating growth due to, among other things, asymptomatic TAVR approval; global adoption of, and differentiated features of, our devices; progress of the EVOQUE commercial launch; feedback on SAPIEN M3; our ability to deliver significant value to patients, healthcare ecosystem and shareholders; expansion of evidence, approvals, clinical trial outcomes and impacts; patient outcomes; the highlights in the Guidance and Outlook section and the information in the Outlook section. No inferences or assumptions should be made from statements of past performance, efforts, or results which may not be indicative of future performance or results. Forward-looking statements are based on estimates and assumptions made by management of the company and are believed to be reasonable, though they are inherently uncertain, difficult to predict, and may be outside of the company's control. The company's forward-looking statements speak only as of the date on which they are made and the company does not undertake any obligation to update any forward-looking statement to reflect events or circumstances after the date of the statement. If the company does update or correct one or more of these statements, investors and others should not conclude that the company will make additional updates or corrections. Edwards' guidance reflects the Company's current estimates of the impact from tariffs that are in effect or have been announced as of the time of this press release and assumes such tariffs remain in place for the remainder of 2025. Any modification to such tariffs, or any new tariffs, could have a material impact on the Company's future financial results and guidance. Forward-looking statements involve risks and uncertainties that could cause actual results or experience to differ materially from that expressed or implied by the forward-looking statements. Factors that could cause actual results or experience to differ materially from that expressed or implied by the forward-looking statements include risk and uncertainties associated with the risks detailed in the company's filings with the Securities and Exchange Commission (SEC), including its Annual Report on Form 10-K for the year ended December 31, 2024, and its other filings with the SEC. These filings, along with important safety information about our products, may be found at Edwards, Edwards Lifesciences, the stylized E logo, EARLY TAVR, ENCIRCLE, EVOQUE, INSPIRIS, KONECT, MITRIS, PARTNER, PARTNER II, PARTNER 3, PASCAL, RESILIA, SAPIEN, SAPIEN M3, SAPIEN 3, SAPIEN 3 Ultra, TRISCEND, and TRISCEND II are trademarks of Edwards Lifesciences Corporation or its affiliates. All other trademarks are the property of their respective owners. (in millions, except per share data) Three Months Ended June 30, Six Months Ended June 30, 2025 2024 2025 2024 Net sales $ 1,532.2 $ 1,369.4 $ 2,944.9 $ 2,699.3 Cost of sales 344.4 275.5 646.0 562.4 Gross profit 1,187.8 1,093.9 2,298.9 2,136.9 Selling, general, and administrative expenses 502.0 447.5 967.7 875.9 Research and development expenses 276.2 271.8 530.8 528.5 Certain litigation expenses 15.5 8.1 26.4 17.0 Separation costs 4.2 — 8.4 — Other operating income (21.3 ) — (40.4 ) — Operating income, net 411.2 366.5 806.0 715.5 Interest income, net (37.4 ) (15.5 ) (73.9 ) (32.0 ) Loss on impairment 47.1 — 47.1 — Other non-operating expense (income), net 1.3 (2.0 ) (1.3 ) (7.7 ) Income from continuing operations before provision for income taxes 400.2 384.0 834.1 755.2 Provision for income taxes 64.3 20.0 134.6 66.3 Net income from continuing operations 335.9 364.0 $ 699.5 $ 688.9 (Loss) income from discontinued operations, net of tax (4.4 ) 1.0 (11.6 ) 27.1 Net income 331.5 365.0 687.9 716.0 Net loss attributable to noncontrolling interest (1.7 ) (1.3 ) (3.3 ) (2.2 ) Net income attributable to Edwards Lifesciences Corporation $ 333.2 $ 366.3 $ 691.2 $ 718.2 Earnings (loss) per share: Basic: Continuing operations $ 0.58 $ 0.61 $ 1.20 $ 1.15 Discontinued operations $ (0.01 ) $ — $ (0.02 ) $ 0.04 Basic earnings per share $ 0.57 $ 0.61 $ 1.18 $ 1.19 Diluted: Continuing operations $ 0.57 $ 0.61 $ 1.20 $ 1.15 Discontinued operations $ (0.01 ) $ — $ (0.02 ) $ 0.04 Diluted earnings per share $ 0.56 $ 0.61 $ 1.18 $ 1.19 Weighted-average common shares outstanding: Basic 587.0 602.1 586.9 601.8 Diluted 587.9 604.3 587.9 604.2 Operating statistics from continuing operations As a percentage of net sales: Gross profit 77.5 % 79.9 % 78.1 % 79.2 % Selling, general, and administrative expenses 32.8 % 32.7 % 32.9 % 32.4 % Research and development expenses 18.0 % 19.8 % 18.0 % 19.6 % Operating income 26.8 % 26.8 % 27.4 % 26.5 % Income before provision for income taxes 26.1 % 28.0 % 28.3 % 28.0 % Net income from continuing operations 21.9 % 26.6 % 23.8 % 25.5 % Effective tax rate 16.1 % 5.2 % 16.1 % 8.8 % Expand ____________________ Note: Numbers may not calculate due to rounding. Expand EDWARDS LIFESCIENCES CORPORATION Non-GAAP Financial Information To supplement the consolidated financial results prepared in accordance with Generally Accepted Accounting Principles ('GAAP'), the Company uses non-GAAP historical financial measures. Management makes adjustments to the GAAP measures for items (both charges and gains) that (a) do not reflect the core operational activities of the Company, (b) are commonly adjusted within the Company's industry to enhance comparability of the Company's financial results with those of its peer group, or (c) are inconsistent in amount or frequency between periods (albeit such items are monitored and controlled with equal diligence relative to core operations). The Company uses the terms "adjusted" and 'constant currency" when referring to non-GAAP sales from continuing operations and sales growth information, respectively, which excludes currency exchange rate fluctuations and newly acquired products. The Company uses the term 'adjusted' to also exclude certain litigation expenses, amortization of intangible assets, loss on impairment, and separation costs. Management uses non-GAAP financial measures internally for strategic decision making, forecasting future results, and evaluating current performance. These non-GAAP financial measures are used in addition to, and in conjunction with, results presented in accordance with GAAP and reflect an additional way of viewing aspects of the Company's operations by investors that, when viewed with its GAAP results, provide a more complete understanding of factors and trends affecting the Company's business and facilitate comparability to historical periods. Non-GAAP financial measures are not prepared in accordance with GAAP; therefore, the information is not necessarily comparable to other companies and should be considered as a supplement to, and not as a substitute for, or superior to, the corresponding measures calculated in accordance with GAAP. A reconciliation of non-GAAP historical financial measures to the most comparable GAAP measure is provided in the tables below. Fluctuations in currency exchange rates impact the comparative results and sales growth rates of the Company's underlying business. Management believes that excluding the impact of currency exchange rate fluctuations from its sales growth provides investors a more useful comparison to historical financial results. The impact of the fluctuations has been detailed in the "Reconciliation of Sales by Product Group and Region." Guidance for sales and sales growth rates is provided on a "constant currency basis," and projections for diluted earnings per share, net income and growth, gross profit margin, and taxes are also provided on a non-GAAP basis, as adjusted, for the items identified above due to the inherent difficulty in forecasting such items without unreasonable efforts. The Company is not able to provide a reconciliation of the non-GAAP guidance to comparable GAAP measures due to the unknown effect, timing, and potential significance of special charges or gains, and management's inability to forecast charges associated with future transactions and initiatives. The items described below are adjustments to the GAAP financial results in the reconciliations that follow: Certain Litigation Expenses - The Company incurred certain litigation expenses of $10.9 million and $8.9 million in the first quarter of 2025 and 2024, respectively, and $15.5 million and $8.1 million for the second quarter of 2025 and 2024, respectively. Amortization of Intangible Assets - The Company recorded amortization expense related to developed technology and patents in the amount of $1.4 million and $0.5 million in the first quarter of 2025 and 2024, respectively, and $1.8 million and $1.2 million in the second quarter of 2025 and 2024, respectively. Separation Costs - The Company recorded expenses of $4.2 million in both the first and second quarter of 2025 related to consulting, legal, tax, and other professional advisory services related to the sale of Critical Care. Loss on Impairment - The Company recorded other-than-temporary loss on impairment of $47.1 million ($37.6 million net of tax) in the second quarter of 2025, related to the Company's determination to not exercise an option to acquire one of its cost method investments. Provision for Income Taxes - The income tax impacts of the expenses and gains discussed above are based upon the items' forecasted effect upon the Company's full year effective tax rate. Adjustments to forecasted items unrelated to the expenses and gains above, as well as impacts related to interim reporting, will have an effect on the income tax impact of these items in subsequent periods. Three Months Ended June 30, 2024 Net Sales Gross Profit Margin Operating Income, net Operating Profit Margin Net Income Diluted EPS Effective Tax Rate GAAP - Continuing Operations $ 1,369.4 79.9 % $ 366.5 26.8 % $ 364.0 $ 0.61 5.2 % Net loss attributable to noncontrolling interests — — — — 1.3 — — Total attributable to Edwards Lifesciences Corporation 1,369.4 79.9 % 366.5 26.8 % 365.3 0.61 5.2 % Non-GAAP adjustments: (A) (B) Certain litigation expenses — — 8.1 0.5 6.5 0.01 0.1 Amortization of intangible assets — 0.1 1.2 0.1 1.0 — — Prior period ongoing tax impacts — — — — 0.8 — — Adjusted $ 1,369.4 80.0 % $ 375.8 27.4 % $ 373.6 $ 0.62 5.3 % Expand Six Months Ended June 30, 2025 GAAP - Continuing Operations $ 2,944.9 78.1 % $ 806.0 27.4 % $ 699.5 $ 1.20 16.1 % Net loss attributable to noncontrolling interests — — — — 3.3 — — Total attributable to Edwards Lifesciences Corporation 2,944.9 78.1 % 806.0 27.4 % 702.8 1.20 16.1 % Non-GAAP adjustments: (A) (B) Certain litigation expenses — — 26.4 0.9 20.8 0.03 0.2 Amortization of intangible assets — 0.1 3.2 0.1 2.6 — — Separation costs — — 8.4 0.3 6.6 0.02 0.1 Loss on impairment — — — — 37.6 0.06 0.1 Adjusted $ 2,944.9 78.2 % $ 844.0 28.7 % $ 770.4 $ 1.31 16.5 % Expand Six Months Ended June 30, 2024 GAAP - Continuing Operations $ 2,699.3 79.2 % $ 715.5 26.5 % $ 688.9 $ 1.15 8.8 % Net loss attributable to noncontrolling interests — — — — 2.2 — — Total attributable to Edwards Lifesciences Corporation 2,699.3 79.2 % 715.5 26.5 % 691.1 1.15 8.8 % Non-GAAP adjustments: (A) (B) Certain litigation expenses — — 17.0 0.6 13.9 0.03 0.1 Amortization of intangible assets — — 1.7 0.1 1.4 — — Prior period ongoing tax impacts — — — 0.8 — — Adjusted $ 2,699.3 79.2 % $ 734.2 27.2 % $ 707.2 $ 1.18 8.9 % Expand ____________________ (A) See description of non-GAAP adjustments under "Non-GAAP Financial Information." (B) The tax effect on non-GAAP adjustments is calculated based upon the impact of the relevant tax jurisdictions' statutory tax rates on the Company's estimated annual effective tax rate, or discrete rate in the quarter, as applicable. The impact on the effective tax rate is reflected on each individual non-GAAP adjustment line item. Expand 2025 Adjusted 2024 Adjusted Sales by Product Group (QTD) - Continuing Operations 2Q 2025 2Q 2024 Change GAAP Growth Rate* Implantable Heart Failure Management 2Q 2025 Adjusted Sales FX Impact 2Q 2024 Adjusted Sales Constant Currency Growth Rate * Transcatheter Aortic Valve Replacement $ 1,130.9 $ 1,038.6 $ 92.3 8.9 % $ — $ 1,130.9 $ 11.3 $ 1,049.9 7.8 % Transcatheter Mitral and Tricuspid Therapies 134.5 83.0 51.5 61.9 % (1.5 ) 133.0 1.7 84.7 57.1 % Surgical Structural Heart 266.8 247.8 19.0 7.7 % — 266.8 2.4 250.2 6.8 % Total $ 1,532.2 $ 1,369.4 $ 162.8 11.9 % $ (1.5 ) $ 1,530.7 $ 15.4 $ 1,384.8 10.6 % Expand 2025 Adjusted 2024 Adjusted Sales by Product Group (YTD) - Continuing Operations YTD 2Q 2025 YTD 2Q 2024 Change GAAP Growth Rate* Implantable Heart Failure Management YTD 2Q 2025 Adjusted Sales FX Impact YTD 2Q 2024 Adjusted Sales Constant Currency Growth Rate * Transcatheter Aortic Valve Replacement $ 2,177.5 $ 2,046.5 $ 131.0 6.4 % $ — $ 2,177.5 $ (3.8 ) $ 2,042.7 6.6 % Transcatheter Mitral and Tricuspid Therapies 249.7 155.9 93.8 60.1 % (1.9 ) 247.8 (0.1 ) 155.8 59.1 % Surgical Structural Heart 517.7 496.9 20.8 4.2 % — 517.7 (2.2 ) 494.7 4.7 % Total $ 2,944.9 $ 2,699.3 $ 245.6 9.1 % $ (1.9 ) $ 2,943.0 $ (6.1 ) $ 2,693.2 9.3 % Expand 2025 Adjusted 2024 Adjusted Sales by Region (QTD) - Continuing Operations 2Q 2025 2Q 2024 Change GAAP Growth Rate* Implantable Heart Failure Management 2Q 2025 Adjusted Sales FX Impact 2Q 2024 Adjusted Sales Constant Currency Growth Rate * United States $ 889.7 $ 806.4 $ 83.3 10.3 % $ (1.5 ) $ 888.2 $ — $ 806.4 10.1 % Europe 378.2 332.2 46.0 13.8 % — 378.2 13.1 345.3 9.6 % Japan 95.3 86.5 8.8 10.2 % — 95.3 5.1 91.6 4.2 % Rest of World 169.0 144.3 24.7 17.1 % — 169.0 (2.8 ) 141.5 19.5 % Outside of the United States 642.5 563.0 79.5 14.1 % — 642.5 15.4 578.4 11.3 % Total $ 1,532.2 $ 1,369.4 $ 162.8 11.9 % $ (1.5 ) $ 1,530.7 $ 15.4 $ 1,384.8 10.6 % Expand ____________________ * Numbers may not calculate due to rounding. Expand


USA Today
17 hours ago
- USA Today
Revealing data shows number of caregivers in the US has skyrocketed
Caroline Edwards, 59, helps her mother sit up in bed every morning and hands her a glass of water. Then, she retells her mother's life story, pointing to family photos on the wall. Her mother, Ingrid Martinez, started showing signs of Alzheimer's disease in 2017, Edwards said. It started slowly, but now her mom needs 24/7 care. "One day you realize her entire life and everything it encompasses − her house, her shopping for groceries and her personal care, her dog, her yard, filing her taxes, paying her property taxes, all of her bills, everything − is, like, suddenly in your hands," Edwards, of Mission Viejo, California, said. Now, more than ever, millions of Americans are in Edwards' shoes. Nearly 1 in 4 American adults are caregivers, according to a report, "Caregiving in the US 2025," jointly published by AARP and the National Alliance for Caregiving on July 24. It estimates more than 63 million adults are family caregivers who have provided care to adults or children with a medical condition or disability at some point in the past year. That's a 45% increase − 20 million more caregivers − in the last decade. That number doesn't include people who take care of children without a medical condition or disability. The report, which was first conducted in 1997 and this year includes data from a national survey of nearly 7,000 family caregivers, estimates 91 million Americans care for children under 18 in their households. The Cost of Care recent feature: Her mom got sick, she moved in to help. Years later, they both feel trapped. 'Family caregivers are a backbone of our health and long-term care systems − often providing complex care with little or no training, sacrificing their financial future and their own health, and too often doing it alone,' AARP CEO Myechia Minter-Jordan said in a news release. 'As our population ages, we must act boldly to support people providing this crucial source of care.' People are providing care for longer, too. Nearly 30% of caregivers have provided care for 5 years or more, an increase of 24% since 2015, the report found. "Families are doing more. They're being asked to do more. They're taking on more. And it's affecting every member of the family," Rita Choula, senior director of caregiving at AARP, told USA TODAY. While several policies have increased financial support for family caregivers in recent years, the report says less than 1 in 5 family caregivers were paid for the care they provided. Financial struggles are common among caregivers, and most survey respondents said tax credits, paid leave and paid caregiving programs would help. Caregivers said they need help in other ways, too. Respite care, help with paperwork, better paid leave policies and emotional support were among the most sought-after services caregivers said they valued in the survey. Caregivers in America are diverse, but a lot of them are like Edwards: middle-aged women caring for an aging parent. The report found the average age of a caregiver is 51 years old, that 61% of caregivers are women and that 70% of caregivers ages 18-64 are employed while also providing care. A woman's retirement crisis: Between caregiving and gender wage gap, can they catch up? Approximately 16 million of today's caregivers are in the sandwich generation, balancing care for both adults and children. Edwards is one of those caregivers, with a 17-year-old daughter heading into her senior year of high school. "You can't be a great mom and a great daughter at the same time. It's impossible," Edwards said. "I have a tremendous amount of guilt from all the time I have not spent with my daughter." Dementia, Alzheimer's impact 11% of care recipients Old age is the most common main reason care recipients need assistance, survey respondents said. The second most-common condition, at 11%, is Alzheimer's or dementia. An additional 19% of respondents indicated their care recipient is living with a cognitive impairment, leaving more than 1 in 4 caregivers caring for someone with memory issues and/or dementia. Another 17% of caregivers said they are "not sure" if their care recipient has a memory issue. Caregiving for someone with dementia is an intense type of care that involves more complex tasks, Choula said. And many people with dementia develop other chronic conditions, too, like heart disease or cancer, which can further complicate their care. "You're essentially having to function for that individual," Choula said. "You're having to make difficult choices and life sustaining choices for that individual." For Edwards, caregiving means helping Martinez use the bathroom and shower. She makes her meals and takes her to doctor's appointments. They play games and do puzzles together, and go for walks and drives around town. It's "very isolating, very lonely" to be a full-time caregiver, Edwards said. Sometimes she sees her mother nod and start to remember some parts of her life. But other times, Edwards said, "there's nothing there." Caregivers want respite care, help finding affordable resources Most caregivers live with their care recipient or within 20 minutes of them, according to the report from AARP and the National Alliance for Caregiving. Caregivers average 27 hours of care work per week, and nearly 1 in 4 caregivers provide at least 40 hours of care weekly. This care work can be overwhelming, caregivers say, and only 11% of caregivers said they've received formal training. Caregiving duties can be intense as care recipients often need help with routine tasks like bathing, dressing, feeding, taking medications, using the bathroom, getting out of bed or a chair and moving from one room to another. Caregivers may also help with grocery shopping, cooking and housework. To help lessen the load, the survey from AARP and the National Alliance for Caregiving found 1 in 3 family caregivers have paid help. Others rely on friends and family members to help out, including children. The report estimates 4 million children help with caregiving duties. What would be most helpful, caregivers often say, is access to respite care so family caregivers can get a break. Nearly 4 in 10 caregivers reported that respite services would be helpful, but only 13% said they use respite services. Tell your story: The caregiving crisis is real. USA TODAY wants to hear from you about how to solve it. Neal Shah, CEO of CareYaya Health Technologies, a tech platform that connects people in need of care with health care students, said there are lots of reasons why family caregivers don't get the help they need. Caregivers are underpaid, there's a caregiver workforce shortage and care services are too expensive for many families. There can also be shame, guilt and questions about care quality, which he experienced firsthand when he cared for his wife who was sick with cancer. "I kept taking sabbaticals from my work to manage her care, because every time I tried to get care help, the quality was just so bad. The reliability, the interpersonal interactions," Shah said. "I felt very guilty." The survey also found more family caregivers have had difficulty finding affordable care services since 2015. Finding meal delivery programs, transportation services and in-home health help is a struggle for 28% of caregivers. Caregivers find purpose in caring for loved ones While caregiving can take a toll on mental health, the report also found half of caregivers say the responsibility provides a sense of purpose or meaning in life. Family caregivers often find they grow closer to their loved one in caring for them, Choula said. Caregiving can also be empowering for some family caregivers, and allows adult children especially a chance to return the care their parents once gave them. While caring for her mother has been challenging, Edwards said she wants her mom to be able to stay at home. They've always been close, she said. Just a look from Edwards can make Martinez smile. "I do this out of my love I have for her," Edwards said. Madeline Mitchell's role covering women and the caregiving economy at USA TODAY is supported by a partnership with Pivotal and Journalism Funding Partners. Funders do not provide editorial input. Reach Madeline at memitchell@ and @maddiemitch_ on X.