Field Notes: Overcoming the Caregiver Crisis

Through 60 Caregiver Issues, Paraprofessional Healthcare Institute (PHI) confronts the shortage of caregivers to meet growing demand amidst an aging population.


In early 2017, the Paraprofessional Healthcare Institute (PHI), a Heron grantee, announced a solution-oriented education campaign to address the caregiver crisis: By 2024, we will need 5 million paid caregivers for our loved ones, yet home care providers across the country increasingly struggle to supply enough aides to care for the nation’s elderly and disabled.

Why do promises of consistent employment and an expanding market not attract more workers to the field?  Basic laws of supply and demand suggest that the fierce competition for workers would raise wages and improve conditions, but so far this isn’t the case:

The typical home care worker makes $10 an hour, works part-time and irregular hours, and relies on public benefits to manage her health and remain financially secure.  Perhaps as a result, she will likely leave her job within a year, exacerbating the workforce shortage that looms heavy over older people, people with disabilities, and their families.  In turn, millions of people are left without proper care.

The home care profession will need to become a more supportive one in order to attract and retain the caregivers needed by an increasing number of patients.  As the nation’s leading expert on the direct care workforce, PHI is uniquely positioned to conduct research, in partnership with state and local leaders, and publish its findings to inform policy makers about how to address employment challenges to meet the demand for home care aides, nursing aides, and personal care aides.

From improving wages and benefits, to creating advanced roles and improving training opportunities, to reconfiguring how we finance and structure the entire long-term care system, and much more, PHI has committed itself to finding solutions that can gradually improve the quality of care we receive as elders and people with disabilities—and the quality of jobs for people who provide that care.   

The project considers sixty ways to address the shortage through a series of briefs, videos, and slideshows that are being released over the course of the next two years.  The series approaches issues in the home care industry by considering the hallmarks of quality jobs, the provision for training and career advancement, and planning for the future of home care, all informed by facts, trends and stories from the field.

PHI assesses how healthcare and labor policies and reforms impact the direct care workforce through a framework evaluating compensation, opportunity, and support. 

Already, PHI's Quality Care through Quality Jobs (QCQJ) Training Collaborative has found that investing in training and support for home care workers improves care and increases job satisfaction:

Through participation in the QCQJ training program, personal care aides were more satisfied with their training, more confident in their abilities, and more likely to stay on the job for at least one year. When QCQJ-trained workers applied their training to their jobs, consumers were satisfied with the person-centered care they received.

Stay tuned to the 60 Caregiver Issues website for more releases this year.

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