Purpose of Review <p>To review the current and future roles of the caregiver in the management of hepatic encephalopathy (HE), associated caregiver burdens, and future roles caregivers may be expected to fulfill.</p> Recent Findings <p>Caregivers assist patients with medication management and can assist with monitoring adherence. Home based testing may provide enhanced caregiver administered confusion monitoring and HE detection. Wearable smart technology is being studied in HE and will impact caregivers as the healthcare system integrates this new data in routine clinical practice. The toll of serving as caregivers for patients with HE is high. The field awaits additional understanding of the impact of new tasks and related technology on caregivers and HE care.</p> Summary <p>Caregivers provide a vital role in the care of patients with HE. Caregiver integration must be considered as we implement new technologies for HE management and treatment.</p>