Caregivers are essential for meeting the needs of aging Americans, but a growing caregiver shortage is reaching a crisis point, in services from long-term care facilities to home care services. Who will care for our seniors? Seniors Guide writer Kari Smith looks at the reasons and some individual solutions.
According to the U.S. Census Bureau, one in five Americans will be over age 65 by 2030. As the population ages, one question is growing in urgency: who will care for them?
The caregiver crisis has been building for years, and experts warn that it is now reaching a crisis point. From long-term care facilities to home care services, there are not enough workers to meet the growing demand. This shifting demographic means millions more Americans will soon need assistance with activities of daily living such as cooking, bathing, or managing medications – but will be unable to get help.
Reasons behind the shortage
While the need has grown, the supply of caregivers has not kept pace. The COVID-19 pandemic made a difficult job even harder. Workers in nursing homes and home care faced some of the highest infection rates, often without adequate protective equipment or paid sick leave. Many left the field altogether, and those who remained often took on longer hours and heavier workloads.
Even before the pandemic, low pay and demanding working conditions made it difficult to attract and retain caregivers. The U.S. Bureau of Labor Statistics reports that the median wage for a home health aide is about $15 an hour. For a job that involves both physical and emotional labor, one that demands skill and empathy, many find it unsustainable. Job turnover is high, averaging between 40% to 60% each year in some parts of the country.
Cuts to Medicaid compounding the problems
When the One Big, Beautiful Bill” goes into effect, the issue will likely become worse, due to cuts to Medicaid. This federal program provides important support to caregivers and those they care for, including older adults.
Immigrant workers fill a critical role
About 28% of the caregiving population are immigrants, according to a recent study by the Harvard Health Care Policy group. Many are drawn to the field because it is a steady employment opportunity and because it is a chance to serve others. Caring for elders comes as a more culturally normal opportunity for many. They work as certified nursing assistants, home health aides, and personal care attendants, supporting the backbone of the industry.
A recent study by the Center for Retirement Research at Boston College highlights the fact that immigrant caregivers are not easily replaced, potentially exacerbating the growing caregiver shortage. “Without immigrants, the shortage would be even more severe, particularly in home-based care,” researchers wrote. “They play an essential role in supporting aging Americans who wish to remain in their homes.”
Recent changes in immigration policy are compounding the shortage. Stricter immigration enforcement and reduced visa opportunities make it harder for new workers to enter the country and for current workers to remain. With fewer immigrant workers available, facilities and families are struggling to find steady help.
As a result, the caregiving system is under incredible strain. Senior facilities often must turn new residents away because they lack the staff to care for them. Home care agencies turn away clients or add them to long waiting lists. Family members must fill in the gaps while they juggle their own health needs, jobs, and children while caring for aging relatives.
How to prepare for the growing caregiver shortage
Whether it’s yourself, an aging parent, or a partner, there are practical steps we can take to prepare for the growing caregiver shortage.
1. Learn new skills
Families or loved ones may need to take on some caregiving skills as professional help becomes harder to find. Learning basic skills (such as safe transfer techniques and medication management) can make the process safer and less stressful – both physically and mentally. Look for local support groups and resources from the Family Caregiver Alliance.
2. Bolster family communication
When possible, discuss caregiving preferences and expectations before a crisis hits. Knowing your loved one’s wishes ahead of time may help prevent confusion later.
3. Create community connections
Check for resources in your area that may help ease the burden. Adult day programs, respite services, and volunteer-based initiatives provide relief for family caregivers. Your local Area Agencies on Aging (AAA) is an excellent starting point to look for information about programs, training, and financial aid available for caregivers in your area.
4. Pay attention to financial planning
As supply and demand dictates, the cost of care is likely to rise as the number of caregivers falls. If possible, begin saving now, whether those funds will be for in-home aid, assisted living, or nursing home care.
5. Contact your state and federal representatives.
Addressing this crisis in the U.S. will require changes in governmental policies.
Improving pay and working conditions for caregivers is essential to retain workers and attract new ones to a vital field that can be physically and mentally draining. Benefits could include paid time off, health benefits, and opportunities for growth and professional development.
Immigration policies also play a crucial role, and some health care leaders have called for policies that recognize that these workers are essential contributors to the nation’s well-being, including to the care of its elderly. Supporting those leaders who advocate for pathways for qualified immigrant caregivers to work legally in the United States could help to stabilize this sector of the workforce.
It may also be helpful to expand access to training programs and to actively promote caregiving as a respected profession. Some states have begun offering tuition-free certification programs for home health aides and nursing assistants. Others are using technology to ease caregiver workload using tools such as remote patient monitoring or even robotics that assist with mobility.
Ensuring care for senior adults will require a collective effort from all of us. The growing caregiver shortage isn’t a distant concern – it’s already upon us. As family members or simply advocates, we play a role in shaping a future where quality care is accessible for all.
