Americans who have taken on the responsibilities of caring for children or adults are paying a steep price in terms of their emotional and financial well-being, according to a new survey by Fidelity Investments.

The national survey of 1,008 U.S. adults found that 79% of caregivers reported financial, social, mental or professional setbacks as a result of their responsibilities, Fidelity said.

For example, 37% of caregivers earned less after they returned to work, with respondents reporting a median 40% pay cut.

Respondents reported leaving their jobs for an average of 20 months to become a caregiver, with 53% saying their time away turned out to be longer than expected.

“Unless you’re in the thick of providing care, you may not realize the impact the experience can have,” Stacey Watson, senior vice president of life event planning at Fidelity Investments, said in a prepared statement. “When a member of the family takes on caregiving responsibilities, others may not realize the true toll it takes. Awareness and communication are critical elements to a successful support system that benefits both the cared-for and the caregiver.”

Caregivers said emotional stress was one of the consequences of their responsibilities, especially with the onset of the pandemic. But the survey revealed that caregivers perhaps had the most difficulty dealing with the impact on their careers.

The survey found that, on average, caregivers are providing 61 hours of care per week for children and 28 hours per week for adults. More than one-quarter of caregivers for adults (28%) left a job, took a leave of absence or shifted to part-time work in order to provide care, Fidelity said.

Among caregivers who took short-term leave or didn’t leave at all, 20% said they turned down or elected to not pursue opportunities at work because it would have interfered with their caregiving responsibilities.

Fidelity also noted there were other “hidden” costs that caregivers had to contend with, including lost promotions or raises, reduced contributions to their retirement savings, lower Social Security credits, and potential loss of employer contributions to retirement and health savings accounts. Only 32% of respondents tried to calculate such costs before stepping into their caregiver roles, Fidelity said.

"Perhaps as a result, 62% indicate they sometimes felt overwhelmed by the financial stress," the Fidelity report said.

Survey respondents said those who decide to care for a child or an adult should set aside time to care for themselves, ask for help when they need it and attempt to find emotional and social support.

“Caregiving can be a tremendously rewarding experience, but to lessen the emotional burden, having a good support system in place is essential.” said Watson. “Although selflessness comes with the territory, the problem with neglecting one’s own needs can be disastrous, creating a sense of helplessness and burnout. That’s why it’s important to take time to plan for as many contingencies as you possibly can—and don’t be afraid to ask for help when you need it.”