The Coming Caregiver Shortage May Change the Look of Future Long-Term Care

Did you know family caregivers provide $500 billion dollars of cost-free care to seniors in the United States each year? That’s about three times the annual Medicaid budget for professional care. Changing family dynamics, however, are painting a new picture. And it’s one that includes a family caregiver shortage in our future.


Not only are family caregiver numbers waning, but the phenomenon is coinciding with an exodus of professional in-home caregivers. According to the Wall Street Journal, “Demand for private home health aides is expected to exceed supply by more than three million in the next decade.”



Caregiver to Care Recipient Ratio Drops
More Americans who find themselves in need of long-term care, will also find fewer caregivers.


This leaves us wondering – who will care for me, if I can’t care for myself?


Changing Family Dynamics Change Expectations

Traditionally, seniors’ adult children have been their caregivers. It has allowed many to remain in their homes and keep their cost of care low. But fewer seniors see this as an option today for a number of reasons.


  • 45% of the adult population in the U.S. are single, divorced, or widowed
  • 6% of multi-person households don’t include family members
  • Shrinking family size leaves many seniors without children or siblings
  • A growing number of women are opting not to have children
  • These days, children often live hundreds or thousands of miles away


Smaller, more scattered families mean fewer familial caregivers for those who want to remain independent at home. The AARP Public Policy Institute estimates that 14% of frail seniors currently don’t have children. They predict that by 2014, the percentage will be twice that. Adult children who are able to care for their parents often have do it on a part-time basis, and from miles away.


The National Institute on Aging found that in the U.S. about 15% of all caregivers are long-distance caregivers, a number that is expected to double by 2020. This long-distance care can be for stressful for the adult caregivers and their aging parents. It poses unique communication and care coordination challenges.


Consequently, seniors may need to look for alternatives. Some are able to rely on friends, volunteers, or even ex-spouses to provide a minimal level of in-home care. Others, particularly those with long-term care insurance, are able to afford private home health aides. But with a shortage of professional in-home caregivers too, that may not be an option for long.


Factors Prompting the Exodus of Professional Home Health Aides

As anyone who’s ever provided long-term care for a family member knows, it’s hard work. Remember that to qualify for long-term care, a person has to be incapable of performing two of six activities of daily living. These include: dressing, bathing, eating, toileting, continence, and transference (walking, moving from bed to chair, etc.). So caregivers have their work cut out for them.


Now, imagine doing that difficult work that requires so much from a caregiver both physically and emotionally, and being paid an average of $10.66 an hour. That’s a real number from the U.S. Bureau of Labor Statistics. Also, benefits are almost unheard of in the caregiver industry. It’s no wonder trained professionals are abandoning the field for jobs in other sectors. Costco employees, for example, earn an average $21 per hour with hourly pay starting at $11.50.


Howard Gleckman is the author of Caring for Our Parents and is a senior fellow at the Urban Institute. He points out in a Forbes article that veterinary technicians make one-third more than home health aides. He says, “In other words, we pay people $5-an-hour more to care for our cats than to care for our mothers.”


Eventually, many more seniors may have to leave their homes for long-term care in expensive assisted living facilities or nursing homes to get the care they need. Those without long-term care insurance or substantial cash-on-hand will have to limit their assets and income to qualify for Medicaid. That may put heirs on the hook to pay Medicaid back, a risk some parents don’t want to take.


Possible Solutions to the Looming Caregiver Shortage

One move some states are making to address the caregiver shortage is training home health aides to administer routine medications. Trained home health professionals spend the most time with care recipients and are an integral part of the healthcare team. Respecting their role on the team, instead of treating them as glorified babysitters, is good for everyone involved.


Caregiver co-ops where the employees own the business is another way of encouraging caregivers to stay in the profession. There are about a dozen of these organizations across the country now. As they continue to grow, their ability to deliver an increased number of well-trained, well-paid caregivers is promising.


Planned, multi-generational neighborhoods where seniors play a vital role offer another innovative solution. Hope Meadows in Rantoul, Illinois, addresses multiple social issues at once this way. The neighborhood is designed to support families who adopt children from foster care. “Informal grandparents” support adoptive parents and preserve relationships between kids and their elders. The community also provides an alternative for seniors who can’t afford to age in place alone anymore.


What Seniors Can Do to Prepare for the Caregiver Shortage

Planning is the key to independence in your senior years. Even seniors who can rely on their children for help are reluctant to do it. The demands of long-term care put emotional, physical, and financial stress on family caregivers. Seniors who can afford it, often opt not to put those burdens on their children.


Having long-term care insurance in place affords seniors the luxury of choices. Many policies now allow you to use benefits not only for professional home health aides, but for family caregivers too. This, in turn, allows seniors to stay in their own homes longer, which is what a majority prefer.


The federally supported state Partnership Program long-term care insurance gives seniors a way to protect assets and qualify for Medicaid. Flex-Plan Advantage is another long-term care insurance option. It pays cash for in-home long-term care whether from families, friends, or professionals. Hybrid Long-term Care Insurance protects your estate, stays liquid, and pays out if you use it or not.


Not sure which long-term care insurance program is right for you? Contact us here or give us a call at 844 805 3557.

Experts Advise Senior Singles

For those without family caregivers, experts in aging suggest seniors start building a network of potential helpers before they’re needed. Seniors living alone in a home with multiple bedrooms could bring in renters, or a roommate, for added income. Another idea would be to offer room and board in exchange for defined caregiving services and hours.


New technologies like in-home monitoring, wearable health monitors, simplified smart phones, medication dispensers, and emergency response systems can be invaluable. Ride-sharing services like SilverRide and Lift Hero specialize in senior transportation. Groceries can be ordered online and delivered to your home. CVS and Walgreens have home delivery services for prescriptions.


All of these options can be put in place before they’re needed. Most are covered with the right long-term care insurance.


Are you prepared for the impending caregiver shortage? Don’t wait.


The best time to buy long-term care insurance is when you’re young and healthy. The younger you are, the better price you’ll get. Prepare yourself for the coming caregiver shortage, call 844 805 3557.


(Sources: The Wall Street Journal and National Institute on Aging)


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