Why America Is in Danger of Running Out of Caregivers

Senior woman with walker and caregiver
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With the oldest baby boomers now age 67, it will not be long before the generation begins needing old-age care. Even a healthy 80-year-old is likely to need assistance. Due in part to America's rising obesity problem, baby boomers are not as healthy as the generation before them. They may live longer as a result of advances in medical care and pharmaceutical breakthroughs, but they will need ever-increasing amounts of care.

At the same time, the traditional family pool of caregivers is drying up. Families have been getting smaller for a long time. More people are living alone, and large numbers of boomers currently providing family care to their loved ones will wind up becoming large numbers of boomers needing care themselves. When that happens, the baby bust generation will be hard-pressed to provide the help that's needed.

The last part of what could be a perfect storm for caregiving is that we are coming off an extended period when people have not moved into nursing homes. Instead, aided by those large numbers of boomer caregivers, they have stayed in their homes.
While there are many terrific nursing homes, the industry as a whole has been languishing for years and is so starved for capital that a quick response to increased demand for caregiving would be nearly impossible.

AARP wove these trends together in a recent report that provides projections of future caregiver shortages that at best can be described as serious and challenging: "The departure of the boomers from the peak caregiving years will mean that the population aged 45 to 64 is projected to increase by only 1 percent between 2010 and 2030," the report states. "During the same period, the 80-plus population is projected to increase by a whopping 79 percent."

"In just 13 years, as the baby boomers age into their 80s, the decline in the caregiver support ratio will shift from a slow decline to a free fall," the report continues, adding that between 2030 and 2050, the shortage will become more acute before population trends balance again.

AARP also notes that caregiving has become more difficult than in the past because many health care services have shifted into the home from institutional settings. Family members often must care for wounds, give injections and perform other medical tasks "with little training of professional support," AARP says.

If the statistical projections are correct, families with frail older members needing care will either need to forego help, hire more professional caregivers (assuming they are available at any price) or place their loved one in an institution. At the end of the line, Medicaid is obligated under current law to provide long-term care for those who are financially unable to afford private care.

As previously noted, institutionalized care for frail seniors has been declining, and AARP says it fell by 37 percent from 1984 to 2004. "Medicaid costs for institutional care would have been an estimated $24 billion higher in 2004 had utilization rates remained unchanged after 1984," AARP says. "By 2010, the number of older people who received Medicaid assistance for nursing home services had declined by 26 percent from its peak in 1995."

The nation's bill for Medicaid is already projected to rise substantially due to the expansion of health insurance under Obamacare. Imagine what a caregiving crisis would do.

AARP says most caregivers are people ages 45 to 64, and most people needing care are age 80 and older. The caregiver support ratio reflects the relative sizes of these groups. The ratio peaked at 7.2 in 2010 – meaning there were 7.2 people ages 45 to 64 for each person age 80 and older. In 2010, there were many baby boomers in the caregiving group and a relatively small number of people age 80 and older.

Over the next 40 years, however, the sizes of these groups will move in opposite directions. AARP projects that the support ratio will drop to only 4.1 in 2030 and then plummet further to 2.9 by the year 2050.

AARP also looked at trends within individual states. Here are the states with the best and worst projected caregiver support ratios in 2030:

District of Columbia: 6.4
Utah: 5.8
Alaska: 5.3
Illinois: 4.9
Georgia, New York and Texas: 4.8
Colorado: 4.5
California, Louisiana, Massachusetts and Washington: 4.4

Arizona: 2.6
Florida and Hawaii: 2.9
New Mexico: 3.2
Iowa: 3.3
Maine, Nevada, Vermont and West Virginia: 3.4
Delaware and Montana: 3.5

Here are the states with the best and worst projected caregiver support ratios in 2050:

District of Columbia: 4.0
New York: 3.5
Louisiana and Utah: 3.4
Illinois, Michigan, Mississippi, Ohio and Pennsylvania: 3.3
Alabama, Arkansas, Indiana, Massachusetts and Tennessee: 3.2

Arizona: 1.8
Nevada: 2.0
Hawaii: 2.1
Florida and Iowa: 2.3
New Mexico: 2.5
Wyoming: 2.6
California, Colorado, Kansas, Minnesota and North Carolina: 2.7

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December 02 2013 at 3:48 PM Report abuse rate up rate down Reply

Simple answer why... Crappy Wages, Long hours, Abuse both verbal and in some cases physical from patients family and even the patient to the care giver, no respect from most Md.'s. .

September 10 2013 at 1:48 PM Report abuse rate up rate down Reply

Welcome to Obamacare !!!
AND AARP was a HUGE supporter of this boondoggle....
Keep THAT in mind when it's time to renew you memberships....

September 10 2013 at 7:47 AM Report abuse +1 rate up rate down Reply

When I said move on, I meant move on to the higher power of your choice (not a nursing home).

September 06 2013 at 7:03 PM Report abuse -2 rate up rate down Reply

I agree if you need oxygen impotence or caregiver or cane for back or knee or taking stong meds for chronic pain you should be in a facilitiy where you are protected and life is made bearable

September 06 2013 at 6:59 PM Report abuse rate up rate down Reply

You know when it is time to move on when:
1. You need a walker.
2. You need oxygen.
3. You need a caregiver
4. You have had a surgery that leaves you impotent.
5. Or any of the above..
If most people had any dignity and followed these three rules financial crises resolved. One man's opinion which I plan to practice.

September 06 2013 at 6:27 PM Report abuse -2 rate up rate down Reply

What happens is that so-called family members get subsidies to provide care to their infirmed and elderly "loved ones". This just adds to their subsidies for food stamps, having kids, not working, for cell phones, for education and for health care so in my mind we will evolve to running out of money for legitimate caregivers and everyone will suffer-especially the taxpayers who fund all of this!

September 06 2013 at 6:12 PM Report abuse +1 rate up rate down Reply

AARP is pushing obamacare which will eventialy explain to the elderly how they don't need to live any longer. Read it. You'll find out.

September 06 2013 at 4:59 PM Report abuse +1 rate up rate down Reply

SROs are the answer! Single Room Occupancy buildings with a couple kitchens on each floor is the only way to go. That's what we have been saying about the homeless issue. Many of these people could end up homeless if we don't start thinking ahead.
Fortunately, my husband has been thinking ahead, and we will figure something out if need be.

September 06 2013 at 1:23 PM Report abuse -1 rate up rate down Reply

That's why I lived my life like a rockstar, minus the fame and fortune I did a great job at it but damn, somehow I lived through it???

September 06 2013 at 4:51 AM Report abuse rate up rate down Reply