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#60CaregiverIssues to Address Workforce Shortage

February 7, 2017

NEW YORK—Today, PHI, the nation’s leading authority on the direct care workforce, launched a national public education campaign at to tackle the growing paid caregiving crisis.

Increasingly, families are facing stark choices when it comes to finding support for their loved ones. Because of the challenge in finding professional home care aides, adult children reduce working hours or leave work altogether to manage care for their parents, costing hundreds of thousands of dollars in lifetime earnings. Area Agencies on Aging, which provide assistance to seniors, from Michigan to New York, report growing waitlists of individuals who need assistance with dressing, bathing, and preparing meals. The agencies cannot find home care aides to ensure these seniors are safe and well cared for in their homes.

Over the next three decades, according to the U.S. Census Bureau, the population of adults over age 65 will nearly double, from 48 million to 88 million. As this population grows, so will the need for care—at home, in community settings, and in nursing homes. But already there is a significant shortage of direct care workers—the home health aides, personal care aides, and nursing assistants who provide the majority of paid, hands-on care across the country.

How will we, as a nation, find solutions to this serious and growing problem?

Caregiving Crisis Demands Multiple Solutions

To ensure quality care for millions of older Americans—as well as people living with disabilities—will require stakeholders to come together to design multiple solutions. Among the most critical needs is attracting sufficient numbers of skilled direct care workers to provide ongoing supports and services.

“PHI works closely with home care providers and nursing homes around the country,” says PHI President Jodi M. Sturgeon. “Today, the number one challenge everyone faces is finding and keeping direct care workers. There are multiple reasons, from insufficient public funding that keeps wages low to poor training that undermines workers’ success and increases turnover. This campaign represents our best thinking on how to address this shortage from all angles.”

PHI has been the leading expert on the direct care workforce for 25 years, providing research, training and policy solutions directed at improving the quality of direct care jobs and the quality of care for older adults and people living with disabilities. Among its many accomplishments, PHI led efforts in New York to raise wages for home health aides, and nationally, to extend the Fair Labor Standards Act to the home care workforce. PHI is nationally recognized for its adult learner-centered approach to training direct care staff and its efforts to develop viable career paths for this workforce.

#60CaregiverIssues Public Education Campaign

The caregiving crisis is evident not only in the stories of America’s families but also in the numbers (PHI 2017):

  • Direct care is creating the greatest number of jobs in our economy, but many are going unfilled. Nursing homes have over 50,000 vacant positions.
  • By 2024, we will need an additional 1.1 million direct care workers.
  • One in two direct care workers leaves her job annually. 
  • As a result of low wages, over half of direct care workers live in households that rely on public assistance to make ends meet.

To elevate the national conversation around these issues—and to find solutions that work—PHI’s #60CaregiverIssues public education campaign will explore 60 ideas that can help policymakers and long-term leaders strengthen the direct care workforce and build a vibrant, sustainable system of long-term services and supports. This campaign will release a new issue every few weeks until the end of 2018. 

Over two years, the campaign will address five themes:

  1. Facts and Trends. By 2024, we will need more than 1 million new direct care workers. What does the latest research say about occupational trends, and the staggering mismatch between supply and demand?
  2. Future of LongTerm Care. In many states, long-term care is being delivered through managed care organizations. What should we know about the how this impacts quality of jobs and quality of care? How can we finance the long‐term care system in a way that supports both workers and consumers?
  3. Quality Jobs. One in five direct care workers lives in poverty. How do direct care worker wages compare to other occupations? What percentage of direct care workers are covered by health insurance? Are there other factors that impact the ability of employers to attract and keep these workers?
  4. Stories from the Field. Nearly 5 million direct care workers support over 8 million older Americans and people living with disabilities. Who are these workers, and who are the people they support? What can we learn from these stories about improving our systems of care?  
  5. Training and Advanced Roles. At most direct care workers get a few weeks of training. Is this adequate to meet the needs of millions of consumers with conditions that vary from physical disability to dementia? Could “advanced roles” that provided career paths improve the quality of direct care jobs and the care we receive?

Joining Together to Find Solutions

“Our campaign is intended to deepen the public conversation around caregiving,” says Robert Espinoza, PHI Vice President of Policy. “We want policymakers, long-term care leaders, consumers, and the public to take this opportunity to learn about the issues, to share their experiences, and to join together to propose solutions that work.

“All of us will one day grapple with the challenges of finding accessible long-term care, either as a caregiver, someone managing care, or someone who needs care,” says Espinoza. “This is truly a universal problem.”

To find out more about the #60CaregiverIssues campaign, visit our website at You can also follow the campaign on Facebook and Twitter


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