Founded by Melinda French Gates, Pivotal Ventures accelerates social progress in the United States by removing barriers that hold people back.

An aging woman kisses her daughter's cheek.

Photo by Mikaela Martin for Pivotal Ventures

Ramona Peña, who is in her 90s, kisses her daughter, Johana Vallejos, who is also her primary caregiver, as Johana pulls her mother close. 

Caring for Each Other: Caregiving in America and the Need for Change 

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As the matriarch of her family, Ramona Peña was used to being the one taking care of others, opening her Florida home to anyone who needed it. Now, in her mid-nineties, as she copes with Alzheimer’s and lack of mobility, Ramona finds herself opening her home once more — this time, to receive care. Struggling to find a qualified, live-in caretaker they could afford and trust, Ramona’s daughter Johana, a retired teacher, made a critical decision: to dedicate her life to becoming her mother’s primary caregiver. 


Shining a Light on the Caregiving Experience


Across the United States, family members and loved ones, much like Johana, must make a similar choice. Millions are forced unexpectedly to step away from work and into caregiving roles that demand immense time, determination, and resilience. And often, this sacrifice is made in silence and in isolation.  


The Covid-19 pandemic has only exacerbated the challenges that families have been dealing with for decades, exposing the many cracks within our nation’s caregiving system. Once considered a private family matter, the complicated, intimate, and exhausting work of family caregiving is finally making it into the public discussion. The caregiving crisis can’t be ignored any longer. Americans have an opportunity to improve a system for over 53 million caregivers in this country and push their voices, realities, and needs to the forefront.  


Pivotal Ventures and Women Photograph partnered to shine a light on the experiences of family caregivers who often go unseen as they navigate one of the most complex jobs of all. Invited into the homes of families across the country, a selection of female and non-binary photographers documented the intimate and personal moments of everyday life, from hair washing and playing in the yard to balancing finances and administering medication. These photographs show the many forms that caregiving can take, the different sacrifices made, the responsibilities assumed, and the joy of caring for another. Most of all, they show the urgent need for progress and change.  

Creating a Better Future for America’s Caregivers 

Every single one of us will care for a loved one or be cared for at some point in our lives. It’s a universal act of love and immense responsibility. But caregivers across the country—like Chrystalle and Song Cho and Johana Vallejos—often receive very little support to make the experience less challenging and more fulfilling.  

So what can be done? Together with our partners, we are working to support the creation of a modern caregiving system for U.S. families. We can’t afford to wait for transformative solutions when millions of people currently must choose between making a living and caring for themselves and their loved ones.  

And in our homes, we can help our friends and family members feel seen and appreciated for their valiant acts of selflessness. We can stress the importance of caregivers and caregiving—and recognize that being invaluable does not mean without value.    

Most importantly, we can put people at the center. When we do that, when we reconsider the caregiving system based on the realities of people’s lives today, change just makes sense.  

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