Seniors are thriving. Caregiving is struggling to keep up

In November 2022, Beth Pinsker’s 76-year-old mother began getting sick.

Anne Pinsker, a healthy woman, chose to have spinal surgery to preserve her ability to walk after developing back problems. What Anne and Beth thought would be a straightforward recovery process, instead led to complications and infections, resulting in Anne arriving at one assisted living facility after another as her daughter navigated her care.

Ultimately, by July of the following year, Anne died.

“We thought she would bounce back after a few weeks of hospitalization, rehab, and going home, but she had complications, and it was a lot harder than she thought,” Beth Pinsker, a certified financial planner and financial planning columnist for MarketWatch, who wrote a book about caregiving, told CNBC.

This wasn’t Pinsker’s first time navigating senior care. Five years before her mother died, she took care of her father, and before that her grandparents.

But during each of these operations, Pinsker said she saw a significant shift in the senior caregiving sector.

“From the level of care my grandparents received to the level of care my mother received, prices have gone up dramatically and services have gone down,” she said.

It evokes a larger trend across the sector as America’s aging population booms and the workforce struggles to keep up.

Recent data from the U.S. Census Bureau found that the nation’s population ages 65 and older rose from 12.4% in 2004 to 18% in 2024, and the number of seniors has outnumbered children in 11 states — up from just three states in 2020.

Along with this demographic change have come other shifts, including increased demand for care for the elderly.

According to the US Bureau of Labor Statistics, prices for elder care services are rising faster than inflation. In September, the Consumer Price Index rose 3% annually, while prices for nursing homes and adult day services rose more than 4% over the same period.

But the workforce has not necessarily kept pace with the increase.

Demand for home care workers is growing as the gap widens, with 4.6 million unfilled jobs expected by 2032, according to Harvard Public Health estimates. McKnight’s Senior Living, a trade publication that caters to senior care companies, found that the employment gap in long-term care is steeper than any other health care sector, down more than 7% since 2020.

Experts say the shortage is driven primarily by a combination of low wages, poor job quality and difficulty rising through the ranks.

“This is coming for us, and we are going to let this create an enormous 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 “severe labor shortage.”

Moreover, jobs in nursing homes are often strenuous and vary in skills depending on each senior’s specific needs, he said, leading to nursing assistants being placed in challenging jobs that often pay little more than a retail job, even though they require more training.

According to the most recent wage data from the BLS as of May 2024, the average base salary for home health and personal care aides was $16.82 per hour, compared to $15.07 per hour for fast food and office workers.

“If we could create a better care system with the right to all care for those who need it, that would free up millions of workers to make our economy grow, so that’s a drag on economic growth,” Gruber said.

Pinsker said she has seen this shortage firsthand. At one nursing facility she toured with her mother, she observed nurses transporting residents to the dining hall for lunch at 10:30 a.m., an hour and a half before lunch was served, because the home did not have enough caregivers to get them back at noon.

“They would bring them out one by one, whatever was available, seat them in rows at their tables, and leave them there to sit and wait,” Pinsker said. “This was their morning activity for these people in this nursing home. … They don’t have enough people to pay them. This is what staffing shortages look like in real time.”

Pinsker said her mother was placed in a nursing rehabilitation facility because she is unable to walk or get out of bed, and that her facility does not have any doctors on the premises. For the most part, she said the facility was staffed only with business-level caregivers who changed bed linen and clothing.

“They don’t have enough doctors and registered nurses and physical therapists and occupational therapists and people who come in and check blood pressure and take blood samples and that kind of thing,” she said. “They are understaffed at all ends of the staffing spectrum.”

Gruber said there are three directions he believes the country could take to solve the employment gap: paying more for these jobs, allowing more immigration to fill the jobs or creating better career ladders within the sector.

“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 take care of our seniors at the wages we’re willing to pay, and we just have to let them in,” Gruber said.

He’s also part of an initiative in Massachusetts focused on making training affordable for nurses so they can climb the career ladder and pipelines to fill the gap, which he said helps hire more people.

For Care.com CEO Brad Wilson, the overwhelming demand for senior care made it clear to the staffing company that it needed to create a separate category of job offerings. Care.com, which is known for listing child care jobs, has met the demand and offered senior care options, as well as being a tool for families trying to navigate what would be best for their situation and their family.

The company sees senior care as a $200 billion to $300 billion business annually, Wilson said. Now, this is the company’s fastest growing segment.

“We’ve heard from families that it’s a huge stressor as they go through the senior care aspect of these things, because child care can be a little more planned, but sometimes an adult or senior care situation is surprising, and there’s a lot to navigate.”

Care.com is also seeing a surge in demand for “home managers,” who can help multiple people in a household, as caregiving situations evolve, Wilson said.

“I can’t stress it enough… this is the unexpected part of the caregiving journey, and it’s increasingly common,” he added.

As the number of seniors increases, the so-called sandwich generation, whose members are caring for their elderly parents and young children, is also thriving. Wilson said his family is in the midst of caring for older family members while also raising three children.

“By 2034, there will be more seniors in this country than children,” Wilson said, citing Census Bureau statistics. “Senior care is in crisis. It’s actually a largely invisible part of today’s caregiving crisis, and we’re really trying to highlight it and share that we have solutions that can help people.”