How To Tackle The Caregiver Crisis — Once And For All

More than 15 million U.S. adults require some degree of personal care, whether it’s from a friend, family member or paid caregiver.

But factors such as the worsening caregiver shortage and the fragmentation of services are making formalized care harder to receive. 

That’s according to a new report from New York-based direct care workforce advocacy organization PHI. The goal of the report is to identify ways to strengthen the home care workforce and improve home care access in the years to come.


The report was compiled using information from the U.S. Census Bureau, the Bureau of Labor Statistics, academic journals, policy documents and various other industry reports.

Strengthening the home care workforce and improving home care access will require a multi-pronged approach focused on at least six areas, the report’s authors argue. Those include job quality, training, payment, value maximization, technology and data. 

The recommendations can be boiled down into two main takeaways.


First, home care interventions need to be adopted on a larger scale, specifically by leaders on the state, regional or national level to address the issues that currently exist, according to the report.

“The HCBS sector has seen considerable innovation within recent decades,” the report reads. “However, many efforts have necessarily been undertaken on a small scale and for limited duration, and often without robust evaluation or lasting impact.”

But with 10,000 baby boomers turning 65 every day, now is the time to come up with a larger-scale intervention to address issues such as financing care, as well as standardizing and professionalizing caregiving, the authors argue. 

Secondly, there should also be a national push to improve workforce conditions for caregivers, with priorities being pay, training and job quality. 

To make it happen, the report’s authors suggest national policy leaders need to promote best practices in recruiting and retaining quality workers. Suggested topics include outreach, recruitment, screening, hiring, orientation, onboarding, training, supervision, support, compensation, engagement, recognition and strategies for supporting career advancement.

Currently, such efforts are handled on an agency-by-agency basis with less than optimal results.

In fact, recruiting and retention issues are only worsening.

In 2018, home care turnover reached an all-time high of 82%. 

“Just as action is needed to implement collective knowledge at the policy level, dissemination of lessons learned to the employer level will also help move the field forward,” the authors of the report wrote.

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