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In November 2022, Beth Pinsker’s 76-year-old mother began falling ill.
Ann Pinsker, an otherwise healthy woman, had chosen to have spinal surgery to preserve her ability to walk after back problems. What Ann and Beth thought would be a simple recovery process instead led to complications and infections, landing Ann in one assisted living facility after another as her daughter navigated her care.
Finally, in July of the following year, Ann died.
“We thought she would get back into her groove within a few weeks of her stay in the hospital, in rehab and at home, but she had complications, and it was all a lot harder than she thought,” Beth Pinsker, a certified financial planner and financial planning columnist at MarketWatch who wrote a book about caregiving, told CNBC.
This wasn’t Pinsker’s first time accessing aged care. Five years before her mother died, she was caring for her father and, before that, her grandparents.
But through each of these processes, Pinsker said he noticed a significant change in the senior care industry.
“From the level of care my grandparents received to the level of care my mother received, prices have skyrocketed and services have decreased,” she said.
This speaks to a broader trend in the sector, as the elderly population in the United States is booming and the working population struggles to keep pace.
Recent data from the United States Census Bureau found that the nation’s population of people aged 65 and older increased from 12.4% in 2004 to 18% in 2024, and the number of seniors exceeded that of children in 11 states, up from just three states in 2020.
This demographic shift has been accompanied by other changes, including increased demand for care for older people.
According to the U.S. Bureau of Labor Statistics, prices for senior care services are increasing faster than the price of inflation. In September, the consumer price index rose 3% annually, while prices for care homes and adult day services rose more than 4% over the same period.
But the active population has not necessarily followed this increase.
Demand for home care workers is skyrocketing as the gap widens, with 4.6 million jobs going unfilled by 2032, according to Harvard Public Health. And McKnight’s Senior Living, a trade publication that caters to senior care companies, found that the labor shortage in long-term care is more severe than in any other health care sector, down more than 7% since 2020.
“A serious labor shortage”
This shortage is mainly due to a combination of low wages, poor job quality and difficulty moving up the ladder, experts say.
“It’s coming for us, and it’s 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 entering a period of “peak demand” for aging baby boomers, creating a situation in which rising demand and wages are not adequately matched, leading to a “critical labor shortage.”
On top of that, nursing home jobs are often strenuous and their skills vary depending on the specific needs of each senior, he said, leading nursing assistants to work in tough positions that often pay only slightly more than a retail job, although they require more training.
According to the most recent BLS wage data from May 2024, the average base pay for home health and personal care aides was $16.82 per hour, compared to $15.07 per hour for fast food and counter workers.
“If we can create a better health care system with a right to all care for those who need it, that will free up millions of workers to grow our economy, which will dampen economic growth,” Gruber said.
Pinsker said she has seen this shortage manifest firsthand. At one of the assisted living facilities she visited for her mother, she noticed nurses taking residents to the dining room for lunch at 10:30 a.m., an hour and a half before lunch, because the home didn’t have enough caregivers to pick them up at noon.
“They would bring them in one at a time, whichever one was available, sit them in rows at their tables and just leave them there to sit and wait,” Pinsker said. “This was their morning activity for these people in this nursing home. … They just don’t have enough people to hustle them. This is what a staffing shortage looks like in real time.”
Pinsker said her mother was placed in a nursing rehabilitation center, unable to walk or get out of bed, and her facility had no doctors on site. Most often, she said, the facility was staffed only by professional-level guards who changed bedpans and clothing.
“They don’t have enough doctors, registered nurses, physical therapists, occupational therapists and people to come in and check blood pressure and take blood samples and that sort of thing,” she said. “They are missing at all ends of the personnel spectrum.”
Fill the void
Gruber said he thinks there are three directions the country could take to solve the labor gap: pay more for these jobs, allow more immigration to fill the jobs, or implement better career ladders within the sector.
“It’s not complicated: Either you have to pay more, or you have to let a lot more people in. … There are wonderful, caring people all over the world who would love to come and take care of our elderly at the wages we are willing to pay, and we just have to let them in,” Gruber said.
He’s also part of a Massachusetts initiative to make training more affordable so nurses can move up the career ladder and fill shortages, which he says helps recruit more people.
For Brad Wilson, CEO of Care.com, overwhelming demand for senior care made it clear to the company that it needed to create a separate category of job openings. Care.com, which is best known for listing child care jobs, responded to the demand and rolled out additional senior care options, as well as a tool for families trying to determine what would work best for their situation and household.
Wilson said the company sees senior care as a $200 billion to $300 billion a year category. It is now the fastest growing segment of the company.
“Families have told us it’s a huge pressure when going through the elder care aspect because child care can be a little more planned out, but sometimes the adult or elderly situation is sudden and there’s a lot to deal with,” he said.
Care.com is also seeing an increase in demand for “home managers,” Wilson said, who can help multiple people in a single household as care situations evolve.
“I can’t emphasize it enough…it’s the most unanticipated part of the care journey, and it’s becoming more and more prevalent,” he added.
And as the elderly population explodes, the so-called sandwich generation, whose members care for both their aging parents and their young children, is also booming. Wilson said her family was in the process of caring for older family members while also raising three children.
“By 2034, there will actually be more seniors than children in this country,” Wilson said, citing Census Bureau statistics. “Aged care is in crisis. It’s actually the most invisible part of the care crisis today, and we’re really trying to bring some visibility to it and make it known that we have solutions that can help people.”