1. Anthony, Maureen PhD, RN

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When asked, most older individuals say they want to remain in their homes as long as possible. In fact, when 2,287 older adults were surveyed, 76% said they prefer to age in place (AARP, 2019). But aging in place requires resources, particularly human resources. The global pandemic has upended employment patterns. In the first year of the pandemic, 2.4 million women left the labor force compared with 1.8 million men. More than half of the 2.4 million women who left the workforce were Black or Hispanic, and workers in low-wage jobs were disproportionally represented (World Economic Forum, 2021). This is the very population that has been the backbone of the home care industry.

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As more older adults chose to age in place, nursing home utilization is predicted to decrease, suggesting a surge in the need for direct care workers in homes. By 2029, there will be an additional 1.3 million direct care jobs, offset only slightly by losses of 10,000 nurse assistant jobs in nursing homes (PHI, 2021). During the first year of the pandemic, many workers in all areas quit due to fear of contracting the virus or because of childcare issues. This helped raise pay in other sectors as employers tried to get reluctant workers to return to restaurants and grocery stores. These jobs are now understandably attracting former direct care workers.


Very few people can afford to private pay for home care at the current rates, let alone the well-deserved increase that will be required to entice direct care workers back to home care. President Biden has recently proposed aid in the form of 400 billion dollars for the Better Care Better Jobs Act, helping to expand eligibility for Medicaid and to improve benefits, including wages, for direct care workers (KFF, 2021).


The good news is that direct care workers are finally recognized for the important work they do. Urge your legislators to support the Better Care Better Jobs Act. The ability to age in place, as so many chose to do, depends on it.




AARP. (2019). 2018 home and community preferences: A national survey of adults ages 18+.[Context Link]


KFF. (2021). How Could $400 Billion New Federal Dollars Change Medicaid Home and Community-Based Services?[Context Link]


PHI. (2021). Will COVID-19 change direct care employment? New data offer clues.[Context Link]


World Economic Forum. (2021). 6 things to know about the pandemic's impact on US employment. [Context Link]