Opportunities for Nursing Leadership in Family Caregiver Policy: A Policy Analysis of the RAISE Family Caregivers Act Using the Health Policy Triangle and Multiple Streams Framework

Abstract

Family caregivers provide essential unpaid care to millions of older adults and individuals with chronic illness or disability in the United States, yet federal support policies have historically been fragmented and underdeveloped. The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act of 2018 (Pub. L. 115-119) established the first national framework to coordinate federal actions, disseminate evidence-based practices, and institutionalize caregiver recognition. This study analyzed the RAISE Act using Walt and Gilson's Health Policy Triangle and Kingdon's Multiple Streams Framework to understand how its structure, political origins, and implementation mechanisms institutionalize caregiving support and create opportunities for nursing leadership. Primary data included legislative text, congressional records, and federal implementation documents; secondary data comprised policy briefs, nursing literature, and grey reports from 2016–2024. Analysis revealed that the Act reframes family caregiving as a coordinated national responsibility through recurring strategy updates, multi-sector collaboration, and public transparency, ensuring sustainability without new appropriations. The convergence of social need, feasible policy alternatives, and bipartisan support created a durable policy window (an opportune moment when conditions align for policy enactment). Nursing has substantial opportunities to shape implementation through care coordination, caregiver education, evaluation, and advocacy. The RAISE Act demonstrates how modest, consensus-based policy can generate structural impact, creating expanded opportunities for nursing to lead caregiver integration, strengthen care transitions, and advance equitable aging policy.