A new study has found that family caregivers are performing an estimated value of $873 billion worth of labor each year, most of which goes unpaid.

The research from Columbia University found the crisis is a result of the healthcare workforce shortages and rising dementia cases. Liz O’Donnell, founder of caregiver advocate organization Working Daughter, says that has a significant impact on many families.

“I also cared for my husband at 51 who had cancer, but it was caring for my dad with dementia where I really felt helpless and I really felt this 24-7 intensity,” O’Donnell said.

O’Donnell says now more than ever is the time to establish a standard of support for family caregivers.