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In November 2022, Beth Pinsker’s 76-year-old mother became ill.
Ann Pinsker, a healthy woman, decided to have spine surgery to preserve her ability to walk after back problems. What Ann and Beth thought would be a straightforward recovery process instead resulted in complications and infections, sending Ann to one assisted living facility after another as her daughter cared for her.
Eventually, by July of the following year, Ann died.
“We thought she would be on the mend again after a few weeks of hospital stays, rehab, staying at home, but she had complications, and it was all much more difficult than she thought,” Beth Pinsker, a certified financial planner and financial planning columnist at MarketWatch, who has written a book on the care, told CNBC.
This wasn’t Pinsker’s first time visiting senior care. For five years before his mother’s death, he took care of his father and, before that, his grandparents.
But during each of those processes, Pinsker said he has seen a significant change in the senior care sector.
“From the level of care my grandparents received to the level of care my mother received, prices have skyrocketed and services have diminished,” she said.
This is indicative of a larger trend across the region as the senior population in the US continues to age rapidly and the labor force struggles to keep up.
Recent data from the U.S. Census Bureau showed that the country’s population of people age 65 and older is projected to grow from 12.4% in 2004 to 18% in 2024, and older adults outnumber children in 11 states – up from only three states in 2020.
Population change was accompanied by other changes, including increased demand for care for older people.
According to the U.S. Bureau of Labor Statistics, the prices of senior care services are rising faster than inflation. In September, the consumer price index rose 3% annually, while nursing home and adult day services prices rose more than 4% over the same period.
But the labor force has not necessarily kept up with growth.
The demand for home care workers is increasing as the gap widens, with an estimated 4.6 million unfilled jobs by 2032, according to Harvard Public Health. And McKnight’s Senior Living, a trade publication that caters to senior care businesses, found that the labor gap for long-term care is more severe than any other sector in health care, having decreased by more than 7% since 2020.
‘Severe labor shortage’
According to experts this decline is mainly driven by a combination of low pay, poor job quality and difficulty climbing the ranks.
“It’s coming for us, and we’re going to see it create a massive need for long-term care,” Massachusetts Institute of Technology economist Jonathan Gruber told CNBC.
Gruber said the country is entering a period of “peak demand” for aging baby boomers, creating a situation where rising demand and pay are not adequately matched, leading to a “severe labor shortage.”
Additionally, jobs in nursing homes are often difficult and vary in skills depending on each senior’s specific needs, she said, which has led nursing assistants to be assigned to difficult jobs that often pay slightly more than retail jobs despite requiring more training.
According to the BLS’s most recent wage data from May 2024, the average base wage for home health and personal care aides was $16.82 an hour, compared to $15.07 an hour for fast food and counter workers.
“If we can create a better care system with the right to care for all those who need it, that will free up millions of workers to grow our economy, which is a drag on economic growth,” Gruber said.
Pinsker said he has seen that shortage firsthand. At one of the assisted living facilities she visited for her mother, she noticed that nurses were taking residents to the dining room for lunch at 10:30 a.m., an hour and a half before lunch was to be served, because the home did not have enough caregivers to bring them back at noon.
“They were bringing them in one by one, using whatever was available, sitting them in rows at their tables, and just leaving them there to sit and wait,” Pinsker said. “For these people in this nursing home this was their morning activity. … They don’t have enough people to push them around. This is what understaffing looks like in real time.”
Pinsker said his mother was placed in a nursing rehabilitation facility, unable to walk or get out of bed, and there were zero doctors on the premises of her facility. Often, she said, the facility was staffed only by business-level caregivers who changed bedpans and clothes.
“They don’t have enough doctors and registered nurses and physical therapists and occupational therapists and people to come and check blood pressure and take blood samples and things like that,” he said. “They have shortages at all levels of the workforce.”
gap filling
Gruber said he thinks the country can go in three directions to solve the labor gap: pay more for these jobs, allow more immigration to fill the jobs or establish better career ladders within the field.
“It’s not rocket science – you either have to pay more, or you have to let more people in. … There are wonderful, caring people all over the world who want to come take care of our seniors at the wages that we’re willing to pay, and we just have to let them in,” Gruber said.
She is also part of an initiative in Massachusetts focused on making training more affordable for nurses so they are able to climb the career ladder and pipelines to fill the shortage, which she said helps more people in the workforce.
For Care.com CEO Brad Wilson, the huge demand for senior care made it clear to the company that it needed to establish a separate category of job offering. Care.com, best known for listing child care service jobs, responded to demand and introduced additional senior care options, as well as created a tool for families who are trying to figure out what will work best for their situations and households.
Wilson said the company sees senior care as a $200 billion to $300 billion per year range. Now, it is the fastest growing segment of the company.
“We’ve heard from families that it’s a huge stress when they go through the senior care aspect of these things, because child care may be a little more planned, but sometimes your adult or senior care situation happens suddenly, and there’s a lot to navigate,” he said.
Care.com is also seeing a growing demand for “house managers,” who can help multiple people in the same home as caregiving situations evolve, Wilson said.
“I can’t emphasize this enough…it’s the most unexpected part of the care journey and it’s becoming increasingly prevalent,” he said.
And as the senior population grows, so does the so-called sandwich generation, whose members are caring for both their aging parents and their young children. Wilson said her family is juggling raising three children while also taking care of older family members.
“By 2034, there will actually be more seniors in this country than babies,” Wilson said, citing Census Bureau data. “Senior care is in crisis. It’s really a very overlooked part of the care crisis today, and we’re really trying to bring some visibility to it and share that we have solutions that can help people.”