A Catastrophe is Coming: As America Ages, We Face a Severe Worker Shortage

America is aging rapidly, with projections showing that by 2030, 20% of all Americans will be 65 or older. Longer life expectancy due to modern medicine, coupled with a decreased birth rate among American families, has caused a sharp rise in this percentage in a relatively short period of time (13% in 2010). Meanwhile, America is facing a severe worker shortage in care workers, with a projected 7.8 million job openings by 2026, as millions of current care workers retire or find new professions, all while demand in the field skyrockets. The total cost of caring for America’s elderly will double from $2.8 trillion to $5.6 trillion by 2047.

Other countries have responded to their aging populations with government-provided care, and many have increased their number of aides and providers, to combat their worker shortage. America and England are the only economically developed nations in the West that do not provide a universal long-term-care benefit.

‘This will be catastrophic’: Maine families face elder boom, worker shortage in preview of nation’s future

Maine Worker Shortage

Maine is the “oldest” state in the country, with over a fifth of its population older than 65, meeting the definition of “super-aged,” according to the World Bank. With its 65-and-older population expected to grow by 55% by 2026, Maine needs more nurses, more home-care workers and more physicians than ever to keep pace with demand for long-term-care services.

Maine’s largest long-term-care provider, North Country Associates, has been forced to temporarily close admissions in each of its 26 nursing homes because of staffing shortages, sometimes for as long as several months, in an unprecedented change from a few years ago. Staffing agencies cannot fill more than 6,000 hours of direct care that have been pre-authorized by the state and will be paid for by Medicaid, because there simply are not enough workers to fill those hours.

Care workers in Maine were paid about $11.37 an hour in 2017, according to an AARP report, with a 2019 minimum wage of $11 an hour. Noted one care worker, “Even Dunkin’ Donuts pays you more”.

“The U.S. is just starting this journey, and Maine is at the leading edge,” said Jess Maurer, executive director of the Maine Council on Aging. “As we are living longer, all the systems that have always worked for us may have to be changed.” Congress created a commission to study the long-term-care problem. In 2013, it issued dozens of recommendations, including a “national strategy” to help family caregivers, but “a fair number of these things have not been implemented. Those that have been implemented are being implemented far too slowly,” said Bruce Chernof, co-author of the commission’s report. “Left unaddressed, this will be catastrophic. We as a country have not wrapped our heads around what it’s going to take to pay for long-term care,” Chernof said.

Housekeepers Face a Disaster Generations in the Making

The pandemic has had devastating consequences for a wide variety of occupations, but housekeepers have been among the hardest hit. Seventy-two percent of them reported that they had lost all of their clients by the first week of April, according to a survey by the National Domestic Workers Alliance. The fortunate had employers who continued to pay them. The unlucky called or texted their employers and heard nothing back. They weren’t laid off so much as ghosted, en masse.

The ordeal of housekeepers is a case study in the wildly unequal ways that the pandemic has inflicted suffering. Their pay dwindled, in many cases, because employers left for vacation homes or because those employers could work from home and didn’t want visitors. Few housekeepers have much in the way of savings, which means they are scrabbling for dollars as the wealthiest of their clients are prospering courtesy of the recent bull market.

Housekeepers have long had a uniquely precarious foothold in the U.S. labor market. Many people still refer to them as “the help,” which makes the job sound like something far less than an occupation. The Economic Policy Institute found that the country’s 2.2 million domestic workers — a group that includes housekeepers, child care workers and home health care aides — earn an average of $12.01 an hour and are three times as likely to live in poverty than other hourly workers. Few have benefits that are common in the American work force, like sick leave, health insurance, formal contracts or protection against unfair dismissal.

Why Aren’t More Women Working? They’re Caring for Parents

Family Care Worker Shortage

The burden of care for aging relatives is reshaping the lives of millions of others. About 15 percent of women and 13 percent of men 25 to 54 years old spend time caring for an older relative, according to the Labor Department. Among those 55 to 64, the share rises to one in five Americans. And 20 percent of these caregivers also have children at home.

We are witnessing a decline in the participation of prime-age women in the work force. This is partially due to the lack of family-friendly policies like parental leave and child care subsidies, but economists say the virtual absence of support for eldercare is a major reason why the share of women taking part in the labor force has stalled in the last 20 years.

If Immigrants are Pushed Out, Who Will Care for the Elderly?

Immigrant Care Worker Shortage

One in four of the direct-care workers in the nation’s nursing homes, assisted living facilities and home care agencies are foreign-born, according to an analysis of census data by PHI, the New York research organization.

“The population of working-age women, who typically provide care both paid and unpaid, has shrunk — and they have more career options than they once did.”

Providing care for older people, in their homes or in facilities, has become the classic example of a job native-born Americans would rather not take, and instead rely on immigrants to do. It is generally physically demanding work that pays poorly (the median wage for home care workers was $10.49 an hour in 2016), and rarely comes with benefits .

Additional Resources

On the Job, 24 Hours a Day, 27 Days a Month
New York Times

Home health care is the fastest growing major job category in the country, one of the most emotionally and personally demanding, and one of the worst paid.

Immigrants Contribute Greatly to U.S. Economy, Despite Administration’s “Public Charge” Rule Rationale
Center on Budget and Policy Priorities

A low birth rate combined with the aging of the baby boom generation means that immigrants are vital to helping us improve our ratio of workers to retirees and support the baby boom generation in their retirement years.

Auditor general warns of dwindling nursing home workers
The Times (Pennsylvania)

Estimates are that by 2030, Pennsylvania will be short more than 4,000 registered nurses, the auditor general said, and in 2026, the state will be short 37,000 direct-care workers. Pennsylvania is facing a worker shortage.