Understanding America’s Caregiving Crisis

For the disabled, elderly, and others who require assistance in their daily lives, caregivers are essential for facilitating everyday tasks – like dressing, eating, using the restroom, and more. While caregivers boost patient quality of life by enabling independent and comfortable lifestyles, a shrinking caregiver workforce is raising concerns for the hundreds of thousands of Americans who need them. Caregivers were already in short supply well before the pandemic, and coronavirus-related restrictions have only made it harder for patients to access the care they need.

Why is the caregiving workforce shrinking?

The caregiver workforce has been experiencing extremely high turnover rates, jumping as high as 81.6% in 2018 and settling to around 65.2% in 2020 [1]. This is due to a variety of factors, including salary, the difficulty of the job, and lack of support and funding from the government.

The average hourly rate of a caregiver in Wisconsin is $12/hour [2], and a broader look at median salaries for caregivers across the country shows a range from $19-$27k. [3] Because long-term care is not covered by Medicare, the financial burden rests on the and/or their families, who may not be able to afford the high cost of in-home care or expensive nursing facilities.

In addition to financial concerns, caregivers can also experience emotional and physical strains, with the Family Caregiver Alliance reporting a conservative 20% of family caregivers suffer from depression — twice the rate of the general population.[4] A recent report by the CDC found that about 10 percent reported serious suicidal ideation. [5]

With the AARP reporting that there will only be a ratio of 4 potential caregivers to 1 person aged 80 or older in 2030 — a sharp decline from the 7 to 1 ratio reported in 2010 — the caregiving workforce is shrinking rapidly, with a growing responsibility falling on informal caregivers such as family members who may not be adequately trained to provide proper care. [6] For the family members who are waiting for government aid in caregiving, the waiting list is running at over 800,000, and the average wait is about 5 years. [7]

The Pandemic’s Affect on Caregiving 

Because states did not recognize home care workers as “essential workers,” caregivers were delayed access to personal protective equipment, coronavirus testing, and even vaccines, pushing many into crisis. The lack of proper equipment and safeguards pushed many caregivers out of the workforce because of alarming concerns of contracting the virus, spreading it to their families, or spreading it to their patients. By the end of 2020, the AARP found that 6% of caregivers gave up working entirely and another 5% retired early. [8]

Due to the decreasing availability of caregivers during the pandemic, a rising 47.9 million adults in the United States reported providing informal care to an adult with physical or mental health needs in 2020. Many stated difficulty coordinating care, financial setbacks, and worsening personal health, all due to the overwhelming tasks of finding ways to work their jobs, run their everyday lives, and care for elderly family members. [9]

The COVID-19 pandemic demonstrates how reliant we have become on family members to provide care or support during illness, and exposes the fragility of America’s caregiving infrastructure. Caregivers face a new set of difficult health care decisions, while the unprecedented growth of older adults with serious illness necessitates widespread changes to our health care system.  [10]

The Cost of Care

Caregiving is not generally covered by Medicaid or insurance plans, which means that families or patients may spend a significant amount of money per year on caregiving services. In 2021, the annual total per family for in-home caregiving was around $7,242, and families who take on caregiving responsibilities can expect to spend about 26% of their income on caregiving activities and 17% on health care and medical equipment. [11]

For those who want to look into a separate long-term care insurance, policies can cost a pretty penny. In 2020, a 55-year-old man in the United States can expect to pay a long-term care insurance premium of $1,700 per year on average, while a 55-year-old woman averages $2,675, and a couple can cost a combined $3,050. [12]

As minimum wages are being raised to $15/hour as employers struggle to fill jobs, we may see some caregiving positions being filled in the near future. However, due to the skills required to be a caregiver, a raise to $15/hour may simply not be enough. [13]

Biden’s Infrastructure Bill and More

There are several government bills that have recently passed or are in the works that are expected to make significant changes to America’s caregiving infrastructure. The Credit for Caring Act, introduced in Congress in 2021, would give eligible family caregivers up to $5,000 per year to help pay for care costs. If passed, this bill would help cover a significant amount of in-home care costs, including adult daycare, respite care, and even home modifications like ramps and smart-home technology. [14]

The Biden administration has additionally announced the American Families Plan, which would provide up to 12 weeks of annual paid family leave, greatly alleviating the financial burden on caregiver families. [15]

Lastly, President Joe Biden’s $1T infrastructure bill was recently passed in the Senate, pledging 400 billion to “expand access” to home care in a way that would also support “well-paying caregiving jobs. “The proposal would include hiring an additional 150,000 community health workers, along with expanding caregiving support for underserved communities, from veterans to Native Americans, and fund enough caregiving services to eliminate the long waitlists for in-home care. [16] 

Benefits of Case Management

If you or someone you know is in need of in-home care and are wondering how to best use available resources for maintaining quality of life, case management may be a good option for you.

The CRC Case Managers, help find the appropriate care relating to you or your condition and help assess whether you would benefit from in-home or residential facility care. With our vast network of resources and team members, we can explore public and private sources to help pay for long-term care, while ensuring you receive the care according to your health and wellness goals. We help respond to every obstacle that may arise through the healthcare system, and tailor each care plan to your medical, rehabilitative, and psychological needs.

To learn more or to speak with a CRC representative, contact us at info@crcmiami.com.






[1] https://homehealthcarenews.com/2021/05/a-huge-victory-home-care-turnover-remains-stable-at-65-2/