By Claudia Tanner
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Low wages, limited benefits and demanding working conditions may be contributing to high turnover among home care aides, new research suggests, worsening staffing shortages that leave older Americans struggling without critical support in their own homes.
A recent Brookings Institution analysis found that fewer than half of direct care workers remained in long-term care roles the following year. Home care workers saw greater movement into and out of employment (16 to 17 percent annually) than residential care workers (11 to 12 percent).
With 7.3 million Americans receiving care at home or in their communities, demand is set to grow as the population aged 65 and older rises from 59.7 million in 2024 to a projected 72.5 million by 2034.
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Competition for workers is growing, too, and fully understanding the quality of care that can be offered to your loved one is important.
Medicaid covers nearly 70 percent of U.S. home care spending, raising concerns that estimated federal cuts of $911 billion to the broader program over a decade could further increase waiting lists.
The consequences are being felt by older Americans who depend on help with everyday activities, including bathing, dressing and eating.
An August report by USAging found that 89 percent of surveyed local aging agencies said staffing shortages had reduced care visits for some older adults, while 81 percent reported some going without essential services altogether.
Meanwhile, 84 percent reported older adults entering nursing homes when adequate support could have allowed them to remain at home.
Jason Lee, CEO of the Home Care Association of America, which represents more than 5,300 nonmedical home care agencies, told Newsweek that staffing shortages can mean “longer waits for services, fewer hours of care than needed or difficulty accessing care altogether.”
“Caregiving is demanding, meaningful work, but compensation often doesn’t reflect the responsibility and importance of the role,” he said, citing unpredictable schedules, limited career advancement and the physical and emotional demands of the job as contributors to turnover.
Brookings researcher Krista Ruffini told Newsweek that better pay and benefits elsewhere may be luring home care workers away, saying, “Among those who leave home care for jobs in other industries, hourly wages increase by nearly $3 and they are more likely to work full-time and have benefits.”
Ruffini said Medicaid reimbursement policies could help improve staffing, pointing to an Illinois initiative that linked payments to staffing levels in residential care facilities and increased direct care employment.
“Wage pass-through provisions could be another strategy,” she said, referring to policies requiring providers to direct part of their Medicaid payments toward workers’ pay.
Newsweek, in partnership with Statista, recently presented the America's Best Nursing Homes 2027 ranking. It highlights high-performing facilities nationwide using a range of quality measures and groups results by small, medium and large bed counts to enable fair comparisons.
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