Elderly patients often rely on caregivers—either family members or paid workers—to assist with important medical tasks such as taking medications and accompanying patients to appointments. This study found that more than one third of paid caregivers had inadequate health literacy, and a similar proportion had impaired numeracy (difficulty applying arithmetic operations to common tasks). As low health literacy has been linked to misunderstanding medication instructions, these findings imply that paid caregivers may themselves be a source of patient errors in the ambulatory setting.