Recently, Olera’s CEO and co-founder, TJ Falohun, was featured in a QUESTPress publication - a collection from the acclaimed QUEST Honors Program at the University of Maryland. For those who don’t know, QUEST is an interdisciplinary program where students combine their knowledge in business, engineering, and science to tackle real-world problems, creating innovative business solutions. It turns out, our very own TJ Falohun is a distinguished alumnus of this program.

The article primarily focused on TJ Falohun as an innovator, entrepreneur, and proud QUEST alumnus. It delved into his journey, from his time in the coursework-filled lecture halls of UMD, to becoming the co-founder of not one, but two companies focused on human health - Olera and Ai-Ris.

In the course of the interview, Falohun shared an essential piece of advice that he believes in and has followed throughout his journey - find a domain where you naturally excel and feel passionate about. His rich experiences and undeniable passion for improving human health are evident in Olera and Ai-Ris. His companies are a testament to what can be achieved when personal strengths are synergized with the desire to make a difference.

It's heartening to see Olera and Ai-Ris get such attention and recognition. This feature acknowledged the incredible work that TJ and his teams are doing, their commitment to improving human health, and the positive impact they've made so far.

While this recognition is definitely appreciated, it isn’t the end goal. We hope this acknowledgement encourages us to go further, to innovate more, to refine our processes, and to always strive for improving human health.

To get more on Falohun's journey, insights, and his approach to innovation, check out the full article in the 

. Stay connected for more updates and achievements from Olera.

Join us in celebrating Olera CEO and co-founder, TJ Falohun's recent feature in the QUESTPress. Learn about his entrepreneurial journey and his insights on innovation.

CEO Spotlight: TJ Falohun of Olera Features in QUESTPress

Co-Founder Spotlight: Olera's TJ Falohun in QUESTPress

Dr. Logan DuBose, MD and co-founder of Olera, has recently been making waves in the healthcare industry with his insightful discussions on the challenges and opportunities in the senior care landscape. In a series of podcast guest appearances in 2023, Dr. DuBose shared his expertise and experiences, shedding light on the complexities of long-term care infrastructure, hospital discharges, and the barriers to effective chronic management and proactive care strategies.

Introduction

 with Michele Magner, Dr. DuBose emphasized the significance of enhancing the long-term care infrastructure in the United States to break free from the relentless cycle of re-hospitalizations. He discussed Olera's mission to empower families by providing comprehensive information on available senior care industry providers, both public and private, including home care, assisted living, memory care, skilled nursing, and other services.

Enhancing Long-Term Care Infrastructure

 with Christoph and Ginger, Dr. DuBose shared personal experiences from his intern year as an internal medicine doctor, highlighting the challenges faced in hospital settings, particularly in discharging patients to the community. He discussed the complications stemming from the difficulty of securing adequate home caregiving arrangements, establishing connections with local home care services, and transitioning patients to long-term care facilities or assisted living homes. The discussion also addressed the consequences of rising unaffordable senior care costs in the US, with Olera's vision aligning with addressing these complexities.

Challenges Faced in Hospital Settings

 with Savy Makalena, Dr. DuBose delved into the significant hurdles encountered in facilitating lifestyle changes aimed at reducing the risks, severity, and recovery challenges associated with dementia, stroke, and long-term care. He highlighted the prevalent barriers, encompassing difficulties in accessing necessary resources due to a cumbersome eldercare ecosystem that requires a high level of technical and literacy skills to navigate. Olera's vision, as discussed, aligns with addressing these access barriers, striving to empower individuals and families by providing tailored information and support in more caregiver-centric ways, ultimately fostering more effective chronic management and proactive care strategies.

Facilitating Lifestyle Changes for Chronic Management

 with Amy A. Palmer, Dr. Logan DuBose, discusses the current state of the eldercare system and the challenges of providing good care for elderly loved ones. He shares guidance and resources for navigating this season, including finding good care, addressing financial challenges, and seeking support.

Challenges with the Eldercare System in America

 with Dr. Kiplee Bell, Dr. Logan shares his journey through medicine and clinical practice and his experience with caring for patients with dementia and Alzheimers disease.

Sharing his Journey

Through these podcast guest appearances, Dr. DuBose has shared his expertise and Olera's vision, contributing to a deeper understanding of the complexities and opportunities in senior care. This positions Dr. Logan DuBose as a thought leader in the intersection of healthcare, research, and medical technology. He is committed to revolutionizing senior care services with 

 and empowering individuals and families to navigate the challenges of long-term care more effectively.

Main image credit - Image by Studio_Iris from Pixabay.

Conclusion

Join Dr. Logan DuBose as he delves into the challenges and opportunities in the senior care landscape. Gain valuable insights into the complexities of long-term care, hospital discharges, and proactive care strategies.

Dr. Logan DuBose's Podcast Guest Appearances 2023

Dr. Logan DuBose Podcast Appearances Roundup 2023

The senior populace has become one of the most vulnerable populations due to several factors. Senior populations can be defined as those individuals who are age 65 and older, and they currently comprise 17.34% of the population in 2022.[1] Factors that may affect them are: general aging maladies, related disabilities that often accompany aging, Alzheimer’s, dementia, and other health issues. As a result of these factors, the senior population will stand in need of long term care. The level and duration of long term care varies from individual to individual, however, there are some statistics provided by LongTermCare.gov to consider: [2]

Individuals turning age 65 have almost a 70% chance of being in need of some type of long-term care services and support in the years they have remaining.

Women need longer care (3.7 years) than men do (2.2 years).

One-third of today’s 65-year-olds may never find themselves in need of long-term support, however, 20 percent of individuals will need it for longer than 5 years.

In addition, recent research has shown that the senior population will need long-term services due to:[3]

Living arrangements: Those who live alone will likely need paid care due to the absence of a partner or spouse.

Disability: 69% of people aged 90 or more have a disability.

Age: The older you are, the more likely long-term care will be needed.

According to Genworth, a financial solutions company, “Every day until 2030, 10,000 Baby Boomers will turn 65 and 7 out of 10 people will require long term care in their lifetime.”[4] Long term care has several associated costs for seniors. This care can either be provided as home-based or it can be provided outside of the home. According to Genworth, the following are estimated national monthly median costs for senior care in 2023: [4]

The homemaker services’ cost is $5,259.00, and the home health aide cost is $5,462.00.

The adult day health care cost is $1,793.00, and the assisted living facility cost is $4,774.00.

 A semi-private room costs $8,390.00, and a private room costs $9,584.00.

The current cost structure in senior care is multi-faceted and as evidenced above can be quite costly. The elements involved in this cost structure are further delineated according to home health care (medical home care) versus non-medical home care. Home health care, according to Olera, is “in-home skilled nursing care that is provided to older adults, either temporarily or long-term, to manage an ongoing health condition.[5]

This type of care is often the most expensive due to the quality and complexities of the individual's care and is due to the fact that it’s a more “personal touch” as it relates to individuals receiving medical care in the comforts and confines of their own homes. Although the costs vary by location, at-home skilled nursing care can range from $40 to $80 per hour.

Non-medical home care is a type of care that provides individuals with the assistance they need to carry out daily living tasks.

The following assistance that’s provided is: meal preparation, light housekeeping, companionship, personal care (such as bathing and dressing), transportation, and medication reminders.6 The cost of non-medical home care greatly varies from medical home care because this form of care can be carried out by less-skilled professionals. The average rate for a home health aide is about $17 per hour.[6]

Overview of the Current State of Senior Care

Inflation has had a tremendous impact on senior care costs. Inflation can be defined as, “The general upward price movement of goods and services in an economy.”[7] The present effects and future residuals of inflation have often thrown this generation into a panicked frenzy. This is not a new conundrum, as inflation has heavily impacted individuals over 40 years ago as well, as is evidenced by an article produced by The ANNALS of the American Academy of Political and Social Science. In this article, we see that inflation causes problems for the elderly, a group that has special characteristics that cause difficulty for them to cope, such as:[8]

They have differing expenditure patterns.

Their income is reduced to half upon retirement.

The period of retirement is lengthened quickly and significantly.

Each of the problems listed above has a direct impact due to inflation. The effects of aging cause the senior population to be less flexible in their dealings. Many view their past and current situation as unchangeable, thus maintaining the same mindset. As a result of receiving less income due to retirement, they may change their spending habits.

Senior populations shoulder the costs of long-term care through personal funds, private financing options, and government programs such as Medicaid or Medicare.[9] Rates at long-term care providers, which consists of assisted-living and independent-living facilities, surge as providers deal with the growing costs of utilities, food, insurance, supplies, and wages.[10]

Everything flows downhill as inflation continues to grow at an astronomical rate. A recent study concluded that by 2033, more than 11 million middle-income seniors aged 75 and above might find themselves unable to pay for assisted living and are also unlikely to qualify for Medicaid, according to research provided by NORC at the University of Chicago.[10]

Impact of Inflation on Senior Care Costs

The escalating costs of services and items directly impact both seniors and their families. According to key findings by AARP in 2020, more than one in five Americans (21.3%, or an estimated 53.0 million adults) are caregivers.[11]

19% (1 in 5) of caregivers provided unpaid care to an adult with health or functional needs.

26% of Americans are caring for someone with dementia or Alzheimer’s disease.

26% of Americans are having difficulty coordinating care.

Family caregiving isn’t singular and it spans all generations, including Gen-X, Gen-Z, Boomers, Silent, and Millennials.

61% of family caregivers continue to work.

With the landscape of the caregiver now being established, we can now delve in and see the consequences that rising costs have on these caregiving families. Families provide care to their senior loved ones often unpaid. In 2021, the estimated economic value of family caregivers’ unpaid contributions was approximately $600 billion dollars, which was based on 38 million caregivers who provide on average 18 hours of care per week.[12]

Due to many caregivers being unpaid, they shoulder the financial burden of costs associated with the care they provide. As costs rise on commodities, food, and other personal items, their accounts are lowered due to meeting the demand of those needs. Caregivers can also be impacted by losing income, reductions in savings and career opportunities, and the receipt of lower retirement benefits and Social Security due to the unpaid care they provide.[12]

Escalating costs, such as food and healthcare costs, are causing dire consequences for seniors. According to Gallup, many older adults are severely sacrificing essentials to accommodate rises in healthcare costs. The following findings demonstrate this impact:[13]

African-American women aged 50-64 are more apt to cut back on the basics.

Well over 1 in 3 adults age 50 and above have forgone the basics, such as food, in order to pay for their healthcare needs.

Some older Americans are skipping medication and care that is needed in order to reduce costs.

As we can see, rising costs are not only affecting the incomes of the senior population, but their health as well. Costs are also significantly rising for senior care as well. According to the Washington Post, “Long term care costs represent the single largest financial risk facing seniors and their families.”[14]

Consequences for Senior Citizens and Families

The Consumer Price Index (CPI) of the Bureau of Labor Statistics (BLS) measures the change in prices over time for a fixed market basket of goods and services for two population groups, CPI for All Urban Consumers and CPI for Urban Wage Earners and Clerical Workers.[15] CPI also calculates an experimental price index for Americans ages 62 and older, our senior population. The market basket is expenditure items that are lumped into more than eight major groups which include: food and beverages, housing, apparel, transportation, medical care, recreation, education and communication, and other goods and services. [16] In the consumer price index, it is estimated and indicated that there is a higher overall inflation rate for older Americans compared to other population groups that they study. [15]

The CPI’s prediction provides a high-level look and estimation into the rising costs of housing, food and goods and services for the senior population. CPI tracks the change of U.S. inflation over time and the percentage change in CPI over a period of time is referred to as the inflation rate.[13] It seems as though the rise in cost is outpacing senior’s income, more notably those who rely on Social Security for their monthly retirement incomes. About 66 million seniors rely on Social Security, and the cost-of-living adjustment that was provided to them is lagging due to the highest inflation seen in 40 years. 14 The effects that it’s having on seniors is:[17]

Seniors are cutting back on medications, which can lead to major health complications.

Seniors are cutting down on the amount of food they are getting.

Seniors have rising housing costs that are causing stress levels to elevate.

Gasoline and energy prices are also putting a major strain on their finances.

An example of just how high CPI inflation is, $100.00 in 2013 has the same buying power as $133.66 in 2023.

Consumer Price Index and its Effect on Seniors

In our 2022 study of the challenges associated with senior care among family caregivers in Houston Texas, participants mentioned that the overall expenses for care, especially professional assistance, were too high, preventing them from initiating or maintaining such services.

One participant shared that finding affordable care was the primary challenge regarding eldercare, saying, 

She needs someone with her pretty much most of the time. It’s something that we’re not sure we can afford yet. That’s the biggest thing is not being able to afford it” (PID022).

Another participant shared the high cost of constant care for an elderly parent, saying, “We have 24/7, 365 care for him. It’s costly, but he can’t be left alone for any real period of time” (PID021). Some caregivers immediately recognize their inability to pay for professional caregiving services, with one participant saying, “I know that I financially could not pay for the cost of nursing home care” (PID058).

Another participant shared the difficulties of obtaining financial assistance due to specific qualifying parameters, saying, “Medicare doesn't step in and won't help even with the in-home health unless she has a broken hip. And then they'll help with that. But for dementia alone, they don't want you to put them in a nursing home, but they also won't let you keep them [at] home or [give] help” (PID064).

Another financial challenge was caregivers’ or care recipients’ inability to qualify for certain financial healthcare benefits. One participant shared their difficulty utilizing benefits, saying, “He is a veteran. I’ve contacted the veteran association (VA), but you have to have a 70% or higher disability to gain access to their homes… He could eventually go on a waiting list, but the waiting list is long” (PID058).

Family caregivers can find managing property, estate, and funds stressful and confusing. For many, understanding the process of setting up financial documents is a daunting task; as one participant said, "For me, the most challenging has been finding out what I needed to do, getting the right paperwork done" (PID109).

One participant expressed the difficulties of navigating the financial aspects of caregiving, saying, “That was hard. There's just a lot of paperwork with being a power of attorney, the financial power of attorney, because every bank, every medical office, everything wants a copy of all this stuff... It's just very daunting and time-consuming for a person that doesn't know that going into it” (PID003).

For many family caregivers, navigating insurance or other benefits that cover some caregiving costs was also challenging. One participant mentioned insurance policies, saying, “Understanding the insurance and health things is overwhelming for me. I don't like sitting down trying to read insurance policies... Trying to navigate through that is overwhelming” (PID093). Many participants expressed difficulties completing the necessary steps to qualify for financial assistance programs.

One participant shared their experience with such difficulties, saying, “I guess the biggest thing is I'm having some issues with her [Social] security. My father passed away in March. And when he passed away, she was supposed to get his social security automatically, and they haven't done that yet. And I'm still in the process of working on that… But with all the COVID and nobody having offices open, it's been tough” (PID034).

Family caregivers are usually responsible for providing additional financial support and paying for needed resources if the care recipients' resources (savings, benefits, insurance, etc) do not cover these expenses. One participant expressed the financial burden of caregiving, saying, “[We pay] all out of pocket. There's no help that I know, and I have to pay for this kind of stuff... You know, you're always trying to calculate… What are we going to do if he lives beyond his money? It's not a great position to be here” (PID021). Another participant discussed the high out-of-pocket costs, saying “We don’t have any long-term care insurance, and the costs are pretty high. It’s going to go into our savings” (PID027).

Challenges with Paying for Dementia Care

Measures can be put in place in order to mitigate the rising costs associated with senior care. These measures can be enacted in order to help support the financial well-being of many unpaid familial caregivers. Creation of policies that will focus on the following key areas:[15]

Strengthening of the federal Family and Medical Leave Act (FMLA) and state (FMLAs). This would include, but is not limited to the expansion of protections that apply to all caregivers and all workplaces.

Provision of financial relief and financial assistance to caregivers through federal and state tax credits.

Utilization of the National Strategy to Support Family Caregiver’s plan for the implementation of coordinated support for family caregivers across the areas of social support, economic support, and healthcare.

The creation of these policies and their usage will help mitigate escalating costs because it will hopefully give caregivers more financial backing. With this extra money, they will be able to alleviate the burden of higher costs, and not have added stress of trying to make ends meet.

State and federal initiatives are in place currently that family caregivers can avail themselves of at the state and federal levels. Some major federal initiatives:[12]

Expanded Supports for caregivers of veterans: The VA MISSION act, which was enacted in 2018, provided the expansion of the Department of Veteran Affairs (VA) Program of Comprehensive Assistance for Family Caregivers (PCAFC). This expansion now included caregivers of veterans who served prior to September 11, 2001.

American Rescue Plan Act of 2021: In this Act, a temporary increase was included for certain Medicaid home- and community-based services expenditures. These expenditures were used to expand service capacity and address HCBS workforce issues.

The National Strategy to Support Family Caregivers: This act was enacted in 2018 and provides a unified approach to the improvement of recognition of and support for caregivers.

Supplemental benefits under Medicare Advantage: These Medicare Advantage plans provided beneficiaries with expanded and new supplemental services, such as support services for family caregivers of Medicare enrollees.

Spousal impoverishment protections: Ensures that the spouse of a person receiving Medicare HCBS isn’t required to spend all of their assets in order for their spouse to receive supportive services.

Public Health Emergency (PHE) Acute Hospital Care at Home (AHCaH) Waiver: This is a CMS waiver that provided expansion of the Hospital at Home initiative. This initiative is a long-standing United States care model that provides individuals with acute hospital care in their homes.

The state initiatives that are currently in place are:[12]

Paid sick leave: 14 states now require paid sick leave.

Paid family leave: 11 states and the District of Columbia now have paid family leave programs.

Caregiver Advise, Record, and Enable Act (CARE Act): 45 states and territories have CARE Act laws in place that support family caregivers during their hospital stay and following discharge home.

Seniors have measures in place as well that can help them mitigate the costs of rising healthcare, services, and commodities. Some of the common suggestions include: retiring later, unifying portable indexed pension plans, reverse annuity mortgages, revision of the tax code in order to slow down condominium conversions, better usage of housing stock, and changes in behavior to cope with higher energy and cost demands.[7] These suggestions can help stave off some of the rising costs, but they are not all-encompassing.

Seniors can utilize government programs in order to mitigate rising costs. These programs can be provided on the state or federal level and can be used to help defray healthcare costs. Medicare is a federal government health insurance plan. This federal plan helps pay some medical costs for individuals age 65 and over.[13]

Medicare can comprehensively ease the burden of rising costs.

In addition to Medicare, the senior population can avail themselves of Medicaid. The Medicaid program is a combined state and federal program that is available for low-income people.[12] Medicaid also covers the cost of long-term care for seniors. Some of the benefits of Medicaid are:

Assistance in the cost of prescription drugs

The following are additional programs that seniors can use to help curb rising costs. These programs are:[12]

Program of All-Inclusive Care for the Elderly (PACE): PACE is a combined Medicaid and Medicare program that provides services and care to people who would otherwise need nursing home care. This program is offered by some states and it covers social service, long-term care costs, and medical services. Individuals can also receive coordinated care from a team of healthcare professionals.

State Health Insurance Assistance Program (SHIP): This is a national program that is offered in each of the states. SHIP provides one-on-one counseling and assistance with Medicare, Medicaid, and Medicare supplemental insurance.

Department of Veteran Affairs: This department provides coverage for long-term care at home or in a facility for some veterans.

Supplemental Security Income (SSI): This program provides monthly payments to adults 65 and over who have a disability. In order to qualify, however, your resources and income must be under certain limits.

Possible Measures to Mitigate Escalating Costs

The future seems to be trending upward in some instances and downward in some others. According to Insider Intelligence, “The United States home care market is expected to grow from $100 billion in 2016 to $225 billion by 2024.”[13]

The home care pricing growth is sure to cause some further issues with the senior population and those who service them. As evidenced, and currently, seniors are having issues keeping up with pricing demands as is. In addition, this increase will cause a shortage of United States home health aides and physicians.[13] Insider Intelligence also predicts that new digital technologies will help bring down costs, improve quality, and create a more sustainable business model for senior care.[13]

This future prediction is predicated upon technologies being leveraged in senior care. Emerging technologies will drive the future of senior care and involve several changes needed in the future.[14] This will produce the following as it relates to senior care.[14]

Better patient outcomes in senior and post-acute care.

Future Implications and Predictions

The current state of senior care is multi-faceted and contains several dimensions. Inflation and rising costs have placed the senior population in often dire straits. These factors are continually rising providing little to no leeway for seniors to remain above water financially. The factors not only impact the senior population but their caregivers as well.

As evidenced in the paper, we saw where most caregivers were unpaid and felt the pinch of inflation both personally and as it relates to the care provided. Strategies and measures were provided in order to mitigate these rising costs and hopefully place both seniors and their family caregivers on the path to financial stability. There is a pressing need for seniors to have adequate long-term care that will not break the bank.

Organization for Economic Co-operation and Development. (n.d.). 

Inflation and the Elderly: A Housing Perspective.

Another Inflation Stress: Rising Costs of Senior-Living Homes Strain Families.

.). Attachment F: Experimental CPI for Americans 62 Years of Age and Older.

U.S. Bureau of Labor Statistics. (n.d.). 

Inflation is slamming U.S. seniors. "It's a scary time," one disabled widow said.

Valuing the Invaluable 2023 Update: Strengthening Supports for Family Caregivers.

Older Adults Sacrificing Basic Needs Due to Healthcare Costs.

Future demand for elderly care services like assisted living & in-home care are rife for digital disruption.

LeadingAge 2022: 3 Emerging Technologies Driving the Future of Senior Care.

References

Discover how inflation and escalating labor costs are reshaping the landscape of senior care. Understand the challenges and explore effective strategies. Our comprehensive analysis.

Inflation & Labor Costs: The Changing Face of Senior Care

How Inflation and Rising Labor Costs are Increasing the Costs of Senior Care

In 2023, there are an estimated 38 million caregivers, giving roughly 36 billion hours and $600 billion dollars worth of care to their aging relatives.[1] As the population struggles to keep up with rising healthcare needs not being met by the medical system, the costs are crippling families across the nation. Read on to learn how everyday Americans are facing the aging crisis and what can be done to help family caregivers in the US.

For the first two hundred years of American history, families stayed with their nuclear units throughout the duration of their lifetime, with grandparents helping to raise children and adult children caring for their aging grandparents. At the onset of the Industrial Revolution, the manufacturing of goods increased, with many Americans leaving their home to help drive domestic production.

Over time, household compositions shifted to a more national reliance on public health care instead, with older adults living independently more often. Between the years 1940 and 2020, the number of households comprised of only one person tripled. The greatest shift occurred between 1970 and 1980 when a 5% increase in single-person households occurred.[2]

Independent Seniors Still Rely on Families for Help

As the American family dynamic shifted, so did the nation’s reliance on outsourced home and health care. However, the burden of cost has always remained on the individual for the most part, and so families are reunited when aging needs become too much to handle. By 2011, over 14.7 million caregivers helped older relatives with their daily needs,[3] with over half of them receiving no payment for their services.[4]

In response to the heightened reliance on unpaid family caregivers, the Family Caregiver Alliance was created in 1977. To further support older adults as the gray tide swept over the nation, the National Center on Caregiving was formed in 2001. These and other programs have been able to craft legislation to assist family caregivers, such as serving as a model for the Older Americans Act’s National Caregiver Support Program.[5]

Brief History of America's Aging Care System

As of the writing of this report in 2023, the crisis has shown no signs of slowing down. In fact, between 2010 and 2020, the percentage of adults over age 65 in America rose by 15.5 million, the largest such increase in history. While the number of elders in the country was about 1 in 20 in 1920, the senior population has grown at a rate of 1,000%, about five times faster than any other age group.[6] Additionally, life expectancy has risen significantly in recent years, to an average age of 73.4 globally,[6] a 56% increase since the average age of 47 in 1950, with people living much longer in developed countries. In the US, people live an average of 78.5 years.

Consequently, the number of people who rely on family members for help with activities of daily living (ADLs) and medical needs has risen dramatically in the past few decades. Currently, there are an estimated 38 million family caregivers, most of whom receive no pay and use their own money to pay for relatives’ medical care.[7]

Another group at a categorical disadvantage is those who care for minor children as well as older relatives. Dubbed “sandwich caregivers,” these family caregivers face significantly more challenges than those without children. In 2015, there were about 2.5 million sandwich caregivers, representing nearly 25% of all caregivers in the country.[8]

The number of individuals providing care to both children and older family members grew to an estimated 11.5 million by 2019, a mere four years later. The added stress is only compounded by the fact that over half, 60%, of two-parent households have work outside the home as well, with 76% of individuals being employed while providing care. Furthermore, only 44% of caregivers have flexible work hours, 31% have sick leave, and only 13% have employee support programs.[9]

The Current State of the Caregiving System

While the aging population continues to outpace younger generations, the healthcare system is facing its own population crisis. Namely, the shortage of healthcare workers, particularly those in the senior care field. There are several reasons behind this shortage:

The fact that the number of people retiring dramatically passes the number of people entering the healthcare field each year means there are simply not enough people to provide care.

COVID-19 has reduced the number of people trained in healthcare who are available for senior care, as many hospitals and clinics have had to re-organize staff to care for the people affected by the virus.

Insufficient funding in the social services that help pay for medical care combined with rising medical costs has led to a national crisis of people who need aging care but simply can’t afford it.

There Simply Isn’t Enough in Families Budgets to Meet Care Needs

Despite being aware of the impending “Gray Tide," the country has remained woefully unprepared for the real-life implications. The consequences for care recipients and providers are quite dramatic, and rising—the cost of food has risen 4.3% in 2023 alone, medical costs have risen an average of 4.5% across the board of medical industry,[10] and wages have remained stagnant.

While this might not seem like much, the reality is that families are bearing the weight of the nation’s inability to handle the aging crisis. A recent AARP study shows that the typical family caregiver devotes one quarter of their income to paying for their older relatives care[11], 25% more than in 2016[12]. Furthermore, only a quarter of workers in the country have access to paid family leave, and less than half can take advantage of short-term disability options through their employer[13]. As a result, family caregivers often have to take on multiple jobs just to pay bills, and many seniors are forced to find work after retirement.

According to the Bureau of Labor, in 2022, over 100 million Americans worked one-quarter past the age of 65[14], an increase of 13,632% in only two decades[15]. To put it into perspective, you can probably see the results in your local community. For example, the number of workers over age 30 entering the fast food industry has nearly doubled in the past two years[16]. You may have even noticed this shift in workers at the grocery store and other retail outlets. There were 1,137,000 workers over the age of 65 in the retail industry in 2022, about one-tenth that of the “retired” workforce and 7% of total retail workers[14].

Aging services have been increasing in cost over recent years, whatever the means of retirement you choose. Private-room nursing facility stays rose 2.4% in 2021, and 1.96% for a semi-private room, for a total average of $94,900. Assisted living facilities costs rose 4.65% to a national median cost of $54,000 per year in 2021.

Lastly, the cost of in-home care rose much more dramatically, at 12.5%, with personal health assistants costing a median of $61,776 in 2021 and homemakers (which provide less medically intensive care services, such as cleaning and cooking) costing $59,488.17 Medications have also risen in price. Studies indicate that we can expect an increase between 6-8% in the cost of prescription drugs in 2023, which will likely be passed directly onto consumers.[18]

One reason for the shortage of qualified care providers is the low wages being offered for the high-stress position. This issue is worsened by the fact that by 2029, an estimated 1 million more home caregivers will be needed to meet the nation’s need for aging services. Currently, the average wages for home health aides across the nation range from $12 per hour in the lowest paying states and max out at $18 per hour in the highest paying states.[19]

New Reliance on Family Caregivers Causes Strain on Working Households

Family caregivers across the country are picking up the slack where the retirement and healthcare systems have failed. According to a recent AARP study, 78% of caregivers pay out-of-pocket costs for the care of their older relatives, at an average of $7,242 annually per caregiver.[20] The average caregiver spends just over a quarter of their annual income on caregiving expenses. This number varies across groups[21]:

41% of African-American family caregivers were under annual financial strain due to caregiving costs.

When considering income, Hispanic and African-American caregivers experience the highest financial burden.

Asian Americans have the highest out-of-pocket expenses on average, as well as the highest mortgages, and relatives' medical costs—though they also have the highest incomes.

Women are more likely to live in poverty due to prioritizing caregiving duties over working out of the home, and Hispanic and Asian American women tend to incur higher out-of-pocket costs than men.

People with dementia incur higher caregiving costs; caregivers of dementia patients have out-of-pocket costs of $8,978 on average.

The disparities grow when you include gender. A recent study shows that mothers in the workplace tend to face lower wages (5% lower for each child they care for, to be precise) and less incentive to work outside the home altogether.[22] To add to the financial instability, workers are often forced to leave their jobs because of insufficient time to care for their families.

Many older Americans have had to seek employment after retirement to help make up for lost wages by the primary breadwinners in the house who have had to sacrifice work hours to fill care needs. A recent study by the National Council on Aging shows that nearly a quarter of the workforce in 2022 is comprised of retirees. Only thanks to Social Security benefits (which average $511 a month[23])are 16.1 million adults living above the poverty line, while about a third of retirees in the country are living below it.[24]

Understanding the Issues with the Aging Care System

Financial instability is one major cause of high turnover, as families lose access to affordable help with their aging issues. People paying for private help out of their pockets may need to take up an extra job or simply go without extra help if they can’t afford it. Caregivers may be forced to leave a family if they are able to find better-paying work, having their own needs to pay for.

People fortunate enough to have private long-term care insurance coverage, or those with Medicare and Medicaid, may face changes each year as their plans change providers. Furthermore, caregivers are less incentivized to stay with a family when their wages are too low to afford their own needs.

The impact of high turnover is twofold, affecting both caregivers economically, and care receivers personally. In order to provide consistent care, it’s necessary to spend time and form a bond, particularly in cases where your loved one is diagnosed with dementia or Alzheimer’s disease. These people might be especially susceptible to confusion and agitation, and having to form a relationship with a new caregiver could pose a challenge.

Impact of Low Wages and High Turnover Rates

One such potentially successful model would be the addition of long-term care insurance to the healthcare marketplace. This is how the Netherlands’ government[25] has been able to tackle the issue, with their country being second best for healthcare in 2021.[26] This is also a solution that has been posed by numerous states across the U.S.

Technology could also serve as a way to bridge the gaps in care, using AI and robotics to bring specialized aging care services into the home. Companies such as Nationwide have begun researching the possible use of AI robotics for in-home senior care. A recent survey from the insurance giant shows that one-third of older adults would be happy to integrate a robotic helper within their household, talking to them to appease loneliness, save medical information, and to rely on them to get help if they experienced a fall or accident.[27]

Countries identified in a Pew Research study[28] as having the fastest-aging populations have found ways unique ways to deal with their national crises’:

The Netherlands became the first country to create long-term care laws in 1968. The country’s 2015 Long Term Care Act reforms those policies to better serve the needs of people who want to age in place, as well as expand long-term care coverage and improve support with more specifically structured service systems.[29] The country invests heavily in long-term care, family caregiver support, and social assistance, 4% of its GDP, more than any other country.[30]

Germany, which had 15 million citizens aged 55 or older in 2000[31] and whose older population is estimated to double by 2050, adopted a long-term care law in 1995. The compulsory Long Term Care Insurance Act[28] has been strengthened twice since then to provide better structure for differing levels of ability and expanded assistance packages, especially for those diagnosed with dementia or Alzheimer’s disease.

Japan is expected to have significantly more senior citizens than any other population group by 2050. The country has instituted a mandatory insurance program to help offset the costs for individuals entering long-term care, called the Long-Term Care Insurance (LTCI) system. After a risk-prevention campaign was adopted and failed, the government changed strategies to a community-based care model. Citizens begin contributing to their insurance fund at age 40, and anyone over age 65 can utilize the program and access care.[32]

Potential Solutions

While these approaches have been helpful in other countries, the USA has yet to formally adopt any compulsory aging insurance programs outside of social security, or offer family caregiver protection outside of FMLA. However, some bills have been passed at federal and state levels to protect aging adults and their families when facing long-term care needs. Many states have created aging councils and regularly examine new ways to address the needs of their aging populations. For example:

The RAISE (Recognize, Assist, Include, Support, Engage) Caregiver Act of 2017 was enacted to give rights to the millions of family caregivers in the USA. Rights such as being on the patients' healthcare contact list, workplace solutions, and financial security.[33]

The American Rescue Plan Act was enacted in 2021, and increased Medicare funding for Home and Community Based Services (HCBS). These programs are offered in most states, though funding may be lacking and there is usually a long waiting list (several years).[34]

Washington state hosts the WA Cares Fund, a long-term care insurance program that is set to go into effect in July of 2026, though workers can make contributions to their accounts as of 2023. Similar to Medicare, the program offers services for individuals who qualify based on qualifying contributions of .58% of their earnings during their working years, and by needing care services.[35]

Florida’s Home Care for the Elderly program, created for low-income adults over the age of 60 with in-home caregivers and other qualifications, offers a small monthly stipend ($160 in 2023) for care costs.[36]

In Hawaii, the Kupuna Care Program assists those who fall in the “gap group”, or people who don’t quite qualify for government assistance, but don’t have private resources to fund home care.[37]

The California Partnership for Long-Term Care[38] creates a network of highly-vetted long-term care insurance companies. In addition to trustworthy insurance options, the partnership strives to educate consumers on the need for long-term care insurance.

How the USA Handles the Aging Crisis

The issues faced by family caregivers are far-reaching and affect people in every corner of the globe, increasing each year as the world continues to grow older. Compounded with a bearish economy and increasing medical needs, the challenges family caregivers and their loved ones face need sustainable solutions.

If you’re a family caregiver, reach out and build a network of support in your life to help you handle the challenges you face. Browsing Olera’s family caregiver forum, you’ll see stories from people just like you, struggling to balance the needs of your life and the needs of your loved one. With cutting-edge AI technology, Olera can help you manage your numerous responsibilities. Visit the 

 family caregiver support network now to find answers to your everyday problems.

Family Caregivers Can Find Support with Olera

Horovitz B. New AARP report finds family caregivers provide $600 billion in unpaid care across the U.S. AARP. July 14, 2023. Accessed September 28, 2023. 

https://www.aarp.org/caregiving/financial-legal/info-2023/unpaid-caregivers-provide-billions-in-care.html

Anderson L. Share of one-person households more than tripled from 1940 to 2020. Census.gov. June 8, 2023. Accessed September 28, 2023. 

https://www.census.gov/library/stories/2023/06/more-than-a-quarter-all-households-have-one-person.html

Wolff J.L., Spillman B.C., Freedman V.A., Kasper J.D. (2016). A National Profile of Family and Unpaid Caregivers who Assist Older Adults with Health Care Activities. JAMA Intern Medicine, 176(3): 372-79. 

https://pubmed.ncbi.nlm.nih.gov/26882031/

Spillman B.C., Favreault M., Allen E.H. (2020). Family Structures and Support Strategies in the Older Population: Implications for Baby Boomers (Issue Brief). Washington, DC: Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services. 

https://aspe.hhs.gov/system/files/pdf/264806/SnapshotIB.pdf

1977–2017: Caregiving then and now. 1977–2017: Caregiving Then and Now - Family Caregiver Alliance. January 3, 2018. Accessed September 28, 2023. 

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