When it comes to the subject of elder care and senior living options, the numbers matter. According to the U.S. Census Bureau, 1 in 6 Americans are 65 or older as of 2020. The rate of growth in the demographic category was unprecedented, up 39% from 2010. The senior population is expected to reach 80 million by 2040, per The Senior List.com, putting strains on industry segments from health care to housing.
Much of this is not news as the baby boomer aging phenomenon — known colloquially as the “Silver Tsunami” — has been in the headlines for some time. What isn’t as well-known, and what is keeping everyone from service providers to elders up at night, especially in-home care and residential communities, is the number 2035. That’s the year when the number of older adults will surpass the number of children under 18 in the United States for the first time in history.
“The 2035 problem is coming,” said Mark Goetz, president of the HomeCare Advocacy Network. “There’s already a national shortage of caregivers.”
Reform Needed
Goetz said while the nation’s nursing shortage tends to get the headlines when talking about elder issues, the dearth of caregivers overall to provide services is an even bigger issue. He said a combination of technology and legislative reform is required to adequately address the situation.
“There’s no doubt that tech will play a greater role in senior care in general over the next 20 years,” he said. “We are going to see better reimbursement for remote patient monitoring.
“We’ll move into what I believe will be remote client monitoring where services that tech companies provide will be the far front end of the care continuum. That’s already happening. However, we also need innovation coupled with government and policy support in every aspect of home health care. What’s needed is immigration reform, targeting those who want to serve our aging population, whether that’s nursing or home caregivers. And, in this state, we need to normalize senior caregiving for our youth, as some states have already done. In the state of Iowa, for instance, you can become a certified nursing assistant at the age of 16, and they have been doing this very successfully for the last 30 years.”
Within the home care industry, companies are challenged to provide ever-more robust training for their front-line employees, Goetz said. He said one of the most important measurements by which such companies will be judged in the marketplace will be a measurable quality of care delivered in the patient’s place of residence.
“We’re going to see more of the home care and home health companies driving outcomes, benefitting their clients by not having to go back into the hospital after a health event because they are effectively and efficiently being taken care of at home,” he said.
Group Solution
Nate Underwood, president of Heritage Communities, agreed, saying governmental leaders need to join hands with the senior care industry as a matter of public health.
“As the owner of senior living communities, we recognize that not all seniors have access to quality care,” he said. “There may not be suitable housing options in their community that can provide the level of support they require and affordability can also be a major concern.
“Inadequate housing and care options can have detrimental effects on seniors’ health and impact their overall happiness and sense of fulfillment. All of this can place a significant burden on family caregivers, affecting their own well-being and ability to provide care effectively. We see it every day.”
He said a multi-faceted approach with policymakers, health care providers, caregivers and community organizations is needed.
As for communities themselves, Underwood said the public will continue to demand more and more amenities and on-premises expertise to meet their needs. Some areas of service he mentioned in particular include a shift toward more person-centered care models, more wellness and lifestyle amenities and especially innovations in memory care.
This last point is an increasingly important segment of operations, given the number of seniors needing these services. In its 2024 annual report, the Alzheimer’s Association noted that 7 million Americans live with some form of dementia, yet per the Centers for Disease Control, only 4 in 10 assisted living facilities nationwide offer memory care to residents.
“With the rising prevalence of Alzheimer’s and other forms of dementia, there will be increased focus on specialized memory care programs, therapeutic environments and innovative technologies,” Underwood said. “At Heritage Communities, we are rolling out an in-room technology solution for memory care with dashboards that flag health changes and AI-driven safety alerts that will help us improve resident health and safety.”
Wider Net
Lakelyn Eichenberger, gerontologist and caregiving advocate with Home Instead, said part of the solution for growing workforce and providing quality elder care in part lies with the industry’s ability to think outside of traditional labor demographic pools to find workers.
“We see people from 18 years old up into their 80s that can be really great providers of care in the home,” she said. “It really depends on if they have the heart for service and will they be willing to learn the skills needed. We see college students who are wanting to get some experience; maybe they’re going into a health care field or social work. Experience in home care is a really great thing to have on their resume. We also see teachers working in the summer or on the weekends and they make great home care professionals.
“And then there are retirees themselves. A lot of times people retire from their profession and they want to do something, maybe not full-time. The role in home care is quite flexible, so you can set your schedule. We’re trying to appeal to those individuals that have a heart to serve and draw them into our field.”
Beyond expanded recruitment, Eichenberger said home care is following the lead of other industries in doing more with less thanks to technology.
“Looking into the future, we’re trying to better utilize technology to create more efficiencies in the way that we staff and schedule to hopefully make the most of the workforce that we currently have,” she said. “I think we’re going to see more and more of those types of innovations and utilization of technology for the operational efficiencies of these types of service lines so that we can continue to meet the growing need and demand.”
As experts also note, home care and residential options aren’t mutually exclusive; senior community ownership groups have diversified into the in-home space and home care companies routinely deliver their services to clients living in a community. For that reason, both industries have a vested interest in working collaboratively to meet clients where they are as they age.
“As we see the baby boomers continue to age, they have a focus on holistic care,” Eichenberger said. “We are seeing them be a little more active and even proactive in their care. As we explore this, there are opportunities for active aging, healthy aging and getting people to stay active both physically and mentally.”
