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In November 2022, Beth Pinsker’s 76-year-old mother started getting sick.
Ann Pinsker, an otherwise healthy woman, suffered from lower back pain and chose to undergo spinal surgery to preserve her ability to walk. Anne and Beth thought they would make an easy recovery, but instead developed complications and infections, and Anne ended up in one nursing home after another while her daughter cared for her.
Eventually, by July of the following year, Anne died.
“We thought she would be back to normal after a few weeks of hospitalization, rehab, and home care, but she had complications and it all turned out to be much harder than she expected,” Beth Pinsker, a certified financial planner, MarketWatch financial planning columnist, and author of books on caregiving, told CNBC.
This wasn’t Pinsker’s first time working in the elderly care field. Five years before her mother died, she cared for her father and before that, her grandparents.
But through each of these processes, Ms Pinsker said she noticed major changes in the aged care sector.
“From the level of care my grandparents received to the level of care my mother received, prices have skyrocketed and services have declined,” she said.
This is a reminder of a larger trend across the industry, as America’s elderly population continues to grow rapidly and the workforce struggles to keep up.
Recent data from the U.S. Census Bureau shows that the nation’s population aged 65 and older will increase from 12.4% in 2004 to 18% in 2024, and older adults outnumber children in 11 states, up from just three in 2020.
As the population changed, other changes also occurred, such as an increase in demand for elderly care.
According to the U.S. Bureau of Labor Statistics, the price of senior care services is increasing faster than the price of inflation. The consumer price index rose at an annual rate of 3% in September, and prices for nursing homes and adult day services rose more than 4% over the same period.
However, the labor force has not necessarily kept up with the increase.
Demand for home care workers is skyrocketing as inequality widens, with 4.6 million jobs projected to be unfilled by 2032, according to the Harvard School of Public Health. McKnight’s Senior Living, a trade publication for senior care companies, also found that the workforce gap in long-term care is worse than in other healthcare fields, having declined by more than 7% since 2020.
“Severe labor shortage”
Experts say the shortage is mainly caused by a combination of low wages, poor quality of work and difficulty in getting promoted.
“This is coming for us, and this is going to create a huge need for long-term care,” Jonathan Gruber, an economist at the Massachusetts Institute of Technology, told CNBC.
Gruber said the country is experiencing a period of “peak demand” for the aging baby boomer generation, creating a situation where rising demand is not fully matched by wages, leading to a “severe labor shortage.”
What’s more, nursing home jobs are often strenuous and require more training, as skills vary depending on each senior’s specific needs, yet nursing assistants are placed in difficult jobs that pay only slightly more than retail jobs, he said.
According to the latest BLS wage data for May 2024, the average base wage for home health and personal care aides was $16.82 per hour, compared to $15.07 per hour for fast food and counter workers.
“This is a drag on economic growth, because if we could build a better care system that gives people who need care the right to full care, we could free up millions of workers and boost economic growth,” Gruber said.
Pinsker said she has seen the shortage in action firsthand. At one of the assisted living facilities she inspected for her mother, she noticed nurses driving residents to the cafeteria for lunch at 10:30 a.m., an hour and a half before lunch. This was because the home did not have enough caregivers to pick up the resident at noon.
“They just brought in the available people one at a time, lined them up at a table, sat them down, and sat there and waited,” Pinsker said. “This was the morning activity of the people in this nursing home. … We don’t have enough people to push them around. That’s the real-time situation of understaffing.”
Pinsker said her mother was in a nursing care rehabilitation facility, unable to walk or get out of bed, and there were no doctors on site. In most cases, facilities are staffed only by business-level caretakers who change toilets and clothing, she said.
“They don’t have enough doctors, registered nurses, physical therapists, occupational therapists and people to take blood pressure and take blood samples,” she said. “They are short on all aspects of staffing.”
fill the gap
Gruber said he believes there are three directions the country can take to resolve workforce disparities. That could be paying more for these jobs, allowing more immigrants to fill them, or creating better career ladders in this field.
“This is not rocket science. We either have to pay more or we have to bring in more people. … There are wonderful, caring people all over the world who want to take care of the elderly at the wages we can pay them. We have to let them in,” Gruber said.
He’s also joining efforts in Massachusetts focused on making training more affordable and providing a pipeline to help nurses climb the career ladder, which he said will help fill more jobs.
For Care.com CEO Brad Wilson, the overwhelming demand for senior care made it clear the company needed to create another category of jobs. In response to demand, Care.com, best known for listing child care jobs, has rolled out additional senior care options and tools for families looking to find out what’s best for their situation and family.
Wilson said the company views senior care as a $200 billion to $300 billion annual category. This area is currently the company’s fastest growing area.
“We hear from families that it takes a lot of strain when going through these aspects of elder care, because while childcare can be a little more planned, adult and elder care situations can come on suddenly and there are a lot of things to deal with,” he said.
Care.com also said that as the caregiving landscape evolves, “house managers” who can support multiple people in one household are increasingly in demand.
“I cannot stress this enough…this is the most unexpected part of the caregiving journey and it is becoming more and more prevalent,” he added.
And as the elderly population rapidly grows, so too does the so-called sandwich generation, whose members care for both aging parents and young children. Wilson said her family is busy raising three children and caring for an elderly family member.
“By 2034, there will actually be more seniors in this country than children,” Wilson said, citing Census Bureau statistics. “Aged care is in crisis. In fact, this is a largely invisible part of today’s care crisis and we are really working to make it visible and share that there are solutions that can help people.”
