Caregiver crisis impacting LTC services
The caregiver workforce crisis may be the biggest constraint on access to long-term care services. And family caregivers are feeling the emotional and financial pressure of ensuring the well-being of their loved ones.
OneAmerica’s 2026 Long-Term Care Market Outlook called for an interconnected model to provide care, which includes:
- The rise of preventive long-term care.
- The deepening caregiver/workforce crisis.
- The mounting pressures that fall to family caregivers, especially those in Generation X.
“Families remain the backbone of care. But they can’t shoulder the responsibility alone,” said Jeff Levin, vice president of OneAmerica’s care solutions distribution. “Insurers are being called to innovate with products that support not just the care recipients but also the caregivers themselves.”
The home care industry hasn’t been the same since the COVID-19 pandemic, said Tafa Jefferson, founder and CEO of Amada Senior Care.
“COVID taught us a lot about the health care infrastructure, taught us a lot about how fragile the health care structure is for hospital stays, but most importantly for post-hospital stays,” he said.
Jefferson said there are not enough caregivers to meet the demand for post-hospital care that is required immediately after discharge to home.
Competition for care is one driver of the caregiver shortage, he said. Nearly 90% of caregivers polled said they are seeking a more skilled position. More caregivers want to train to become nurses or physical therapists, while competition from other businesses – particularly fast-casual dining – is syphoning off the caregiver labor pool.
The best approach to providing care is to take a holistic approach, realizing care is not one size fits all, Jefferson said.
“It comes down to: Is there a care need? How do we plan for this episode of care? Do we have the financial tools to pay for it? Where should care best be delivered? We want to provide a holistic approach that deals with the clinical and the financial aspects of care.”
Family caregiving under extreme pressure
Caregivers have so much that they juggle on a day-to-day basis, said Jody Hirst, licensed clinical social worker with Pike Medical Consultants.
“Stress is a given in our lives; being a caregiver adds another layer of responsibility, and it can be a complex layer,” she said.
Gen X is the sandwich generation and is especially impacted by the caregiving role, Hirst said. Focusing on their own health is the most important way Gen X caregivers can deal with caregiving stress.
“Because we need to manage our own emotional and physical wellness,” she said. “It’s finding that level of acceptance, just like that saying about putting our oxygen mask on ourselves first.”
Many families discover the need for long-term care for a loved one only after a crisis or unexpected care event. Hirst said planning for care and having the care conversations with family members early on are crucial to managing a care event.
“Nobody wants to talk about end of life and family members’ wishes; it’s uncomfortable and we want to avoid it,” she said. “But the best thing we can do is lean into it with a little bit of kindness and love and grace. “
Hirst advised asking parents what they want for their lives over the next 10-15 years. Do they want to stay in their home? Do they want to downsize? Do they want to live closer to one of their children?
When you begin to understand their wishes, you can begin to understand their psychosocial and financial profile, and begin to see what a plan to carry out their wishes and be cared for will look like.
“It’s about having those conversations first with our parents and then making sure the siblings unit and can have conversations together,” she said.
The rise of preventive long-term care
Early detection tools can help screen for cognitive impairment while giving families more time to plan for a loved one’s future care.
Donna Wilcock, professor of neurology at Indiana University School of Medicine, said the challenge is getting these cognitive assessments to the right people at the right time so that treatments can be administered early.
IU is attempting to establish a statewide program that trains registered nurses, whom it refers to as brain health navigators, to administer brief cognitive assessments. They can order blood tests to determine brain changes indicative of Alzheimer’s disease and begin talking with patients and families about the care path that is best for each patient.
Gen Xers and millennials should act now to decrease their risks of developing cognitive impairment later in life, Wilcock said. Maintaining a healthy blood pressure is one example of something that can keep the brain functioning in later years.
Wilcock also urged the families of those experiencing cognitive decline to keep their loved ones socially engaged.
Social disengagement is one of the quickest factors of decline when someone begins to show impairment,” she said. “People often withdraw after a diagnosis of impairment, but it increases the rate of that cognitive decline.”
Wilcock predicted that more tools to detect and treat impairment in its early stages will soon be available.
“We’re just on the first prong of treatment – there’s more coming down the pike.”
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