Home Care Aid Part 1: Addressing the Challenges


Part one of a three-part series by Nancy Verdin, Graduate Assistant, SDSU Social Policy Institute

Our personal autonomy ebbs and flows throughout our lives. The first steps of a child signify the emergence of newfound independence, yet even in those moments, the reach for a reassuring guiding hand accompanies each wobbly step. This process of self-discovery and interdependence continues throughout our life. Moments arise when leaning on others becomes not just a choice but a natural part of our evolving nature. A recent finding from a longitudinal study delving into autonomy sheds light on a significant reality – among individuals who reached the age of 65, a substantial 70% found themselves relying on the indispensable support provided by Long-term Services and Supports (LTSS). Long-term Services and Supports serve as pillars and reassurance throughout the aging process when a guiding hand is essential. 

In California, one of the LTSS services provided is In-Home Support Services. Currently serving 630,792 recipients, this number is expected to grow. By 2030, the state anticipates a population of 10.8 million individuals over the age of 60, constituting a quarter of its population. Simultaneously, the projections also indicate that there will be a shortage of between 600,000 and 3.2 million direct care workers within the same timeframe. These workers play a crucial role in ensuring that older adults receive essential support, including vital home care aid. The challenge lies in addressing this growing gap to sustain home care aid and the well-being of the aging population.


How does this widening disparity between a diminishing workforce and a growing aging population impact both caregivers and those receiving care?

Impact on Caregivers: 

  1. Increased Workload: A potential shortage of caregivers could increase the workload, leading to an increase in burnout and fatigue. 
  2. Challenges in Meeting Demand: Given the increase in individuals requiring care, caregivers may encounter difficulties in accommodating and meeting needs in a timely manner, resulting in potential details in delivering essential services.  
  3. Recruitment and Retention Issues: The shortage of direct care workers may create difficulties in recruiting and retaining qualified individuals, impacting the overall quality of care provided.

Impact on Care Recipients: 

  1. Limited Access to Services: Shortage of skilled care workers limits access to vital services, potentially resulting in service gaps, unmet needs, delays or reduction in care.
  2. Increased Dependence on Family: With a potential shortage in professional caregivers, family members must navigate ways to offer support.  
  3. Quality of Care Concerns: The strain on the caregiving workforce may raise concerns about the quality of care provided, potentially affecting the overall well-being and satisfaction of care recipients.

Acknowledging the widening gap between the rising number of care recipients and the limited availability of caregivers prompts an exploration into the potential barriers that hinder closing the home care aid gap. In the upcoming series, the focus will delve into current trends in home care aid, highlighting indicators that suggest an unsustainable trajectory. And the final series will shed light on proactive measures already underway, inspiring optimism for the future. The series aims to address the trends in home care aid and collective efforts dedicated to ensuring everyone ages with the essential support.