https://www.nytimes.com/2025/12/02/health/seniors-aging-home-care.html?smid=nytcore-ios-share
summary:
The U.S. home care system is in crisis. The aging population is surging while facing severe labor shortages. Home care aides—who earn less than $17 per hour on average despite consumers paying $34 per hour—face unstable, low-paying jobs with an 80% annual turnover rate. Three promising innovations are emerging: worker-owned cooperatives that pay $2 more per hour and have half the turnover of traditional agencies; registries that connect workers directly with clients, allowing better matches and higher wages by cutting out agencies; and enhanced training programs that equip aides to spot early warning signs in patients with complex conditions like heart failure. These approaches show potential to improve both job quality and patient care, though they don’t solve the fundamental affordability problem—middle-class families often must spend down their assets to qualify for Medicaid or go without care entirely. The nation will need 740,000 additional home care workers over the next decade.
But the nation will need about 740,000 additional home care workers over the next decade, according to the Bureau of Labor Statistics, and recruiting them won’t be easy.
These remain unstable, low-paying jobs. Of the largely female work force, about a third of whom are immigrants, 40 percent live in low-income households and most receive some sort of public assistance.
I am certainly trying to brace myself and not waste oxygen griping about the wrong things. I am 60 and my mother is 80.
For the long term health of planet earth, I think the contracting birth rate is a good thing, but for the current and next several generations of old and infirm or disabled, plus daycares for kids, it’s going to be very tough going to get help. Including my generation for sure.