Have you ever asked yourself, “Will I need long-term care someday?” The odds make it extremely likely that the answer is yes: some of the articles we’ve read for the Blog estimate that between 70 and 80 percent of us will require at least some long-term care as we age. 

But here’s another question: with so many needing care, have you ever asked yourself where the long-term care workers will come from?  The reality is that the number of long-term care workers is declining just as the aging population is soaring. What we’re witnessing is the beginnings of a crisis in long-term care. 

This week here on the Blog, we’re looking at this issue from two angles. First, we’re focusing on the problem, as described in this article we recently discovered in the Seattle Times, originally written for the New York Times by reporter Mark Miller. Miller’s article lays out the worker shortage issue in stark terms.  

Second, we’re exploring an idea that is gaining credence in the home care industry – the suggestion that virtual healthcare might be able to bridge the gap and bring more affordable care to seniors whose needs might otherwise go unmet. Could technology help address the in-home care shortage? We’ve tapped multiple sources for the answer. 

Storm Clouds Gathering for Seniors Needing Long-Term Care  

“Samir Shah is a forecaster,” Miller’s New York Times article begins — “but he’s an expert on the U.S. long-term care industry, not the weather. Right now, he is seeing storm clouds gathering for the Americans who will need help with basic living needs in the years ahead.” 

“Demand is rising at the same point that supply is decreasing, and both are happening at a very rapid pace,” Shah, who is CEO of CareScout, told the New York Times. CareScout is a company that publishes an annual study on the cost of long-term care. 

The Demand for Care Meets a Serious Shortage of Caregivers 

As Miller explains, a rapidly-aging U.S. population is driving demand for care higher and higher. “In 2026,” he writes, “the oldest baby boomers will start turning 80, an age when the odds of needing care grow. The U.S. Census Bureau forecasts that the number of people 85 and older will nearly double by 2035 (to 11.8 million people) and nearly triple by 2060 (to 19 million).” 

On the supply side, the situation appears bleak.  

“At the same time, the care industry has a shortage of workers that is driven partly by low wages,” Miller notes. “The median hourly wage for all direct care workers was $16.72 in 2023 — lower than the wage for all other jobs with similar or low entry-level requirements, according to an analysis by PHI, a nonprofit research and policy organization.” 

Immigration Crackdown Exacerbates Worker Shortage  

In an industry that is so reliant on foreign-born workers, the current political climate is making things worse, says the article.  

“Experts fear that shortage will be exacerbated by the Trump administration’s immigration crackdown,” Miller writes. “Immigrants make up 28 percent of the long-term-care workforce — a figure that has been rising in recent years, according to KFF, a health policy research group.”  

The inevitable result has been higher care costs. Miller quotes data from CareScout to show that, last year, the price of some long-term-care services rose as much as 10 percent, three times the rate of inflation. 

Nearly Half of Seniors Expect Medicare to Pay for Long-Term Care 

In spite of efforts to educate the public about the need for long-term care, millions of people remain staggeringly ill-informed about the issue. Nowhere is that fact more obvious than in the confusion over Medicare. 

“Much of your medical care in retirement will be covered by Medicare,” Miller explains. However, long-term care, which refers to help with daily living for people who are frail or disabled, falls into an entirely different category. When it comes to assistance with bathing, dressing, using the toilet, preparing meals, shopping, walking and taking medications, with few limited exceptions Medicare will not pay for care. And most Americans, even seniors, have done little if any planning in this arena. 

“KFF polling shows that 23 percent of all adults — and 45 percent of those age 65 or older (emphasis added) — incorrectly believe that Medicare will cover their time in a nursing home if they have a long-term illness or disability,” Miller states. “Fewer than half of adults said they’ve talked seriously with loved ones about how they would obtain or pay for long-term care. And among near-retirement individuals, just 28 percent say they have set aside money for it.” 

Will You Need Care – and How Much Will You Pay? 

In his article, Miller boils the issue down to two central questions: “Will I need care?” and “How much will it cost?” 

“Looking at the risk for people age 65 and older,” says Miller, “the Center for Retirement Research at Boston College concluded that about one-fifth of retirees will require no long-term-care support, and that 20 percent are likely to experience a severe need. Between these extremes, 25 percent will have low needs and 37 percent will have moderate needs.”  

That’s roughly four out five retirees who will need at least some care, although, as the Times points out, individual likelihood is tough to predict. 

Care costs also vary widely. Assisted living communities have an average median cost of $5,900 per month, compared with in-home care at $6,292 per month and a room in a private nursing home costing $10,646 per month. CareScout reports that some of these costs rose by 10 percent in 2024. Costs will also vary widely depending on location and level of need. 

More Than 800,000 New Jobs – but Who Will Fill Them? 

It’s not surprising that – driven by relentless demand – some 817,000 new jobs for home and residential care providers are going to be generated between now and 2032. That, the article reports, is the largest number of new positions of any job category across the U.S. economy.  

But filling those jobs will be a problem. Reporter Miller spoke with Mollie Gurian, a vice president at the nonprofit LeadingAge. Gurian said flatly, “We’re simply not going to have enough people to take care of everyone” who needs care.  

Gurian told Miller she also worried about possible Congressional cuts for Medicaid funding, which covers 61 percent of all long-term care, according to KFF. “Providers would have to either reduce the number of Medicaid patients they accept, increase private pay rates or close facilities,” she stated.  

Virtual Caregiving Will Be Part of the Long-Term Care Solution 

Miller’s article goes on to explore various ways to cover the costs of long-term care – but we’re saving that discussion for another time. Instead, we’re shifting gears to explore the role of technology – specifically what’s often called telehealth or telemedicine – in helping to fill the need for more long-term care in light of the looming shortage of in-person caregivers. 

Most of us are familiar with telehealth, and specifically telehealth for seniors, as described in this article from the Medispress website.  The article explains how technology can allow for timely medical support for aging patients when mobility issues, transportation problems, or chronic health conditions make in-person doctor visits impractical if not impossible. 

Telehealth Services for Seniors Driven by Technology 

Simply put, says the Medispress article, telehealth for seniors uses a computer, tablet, or phone to connect patients with doctors or nurses remotely. “Instead of going to a clinic, seniors can have video or phone calls with their healthcare providers,” says the article. “This helps them manage their health more easily and safely, especially for those who live alone or have trouble traveling.” 

Seniors can chat face-to-face (or at least over the phone) with a healthcare provider, get prescriptions filled, follow up on lab results, and even have therapy sessions, from the security of their own home. It’s a way to access care with far less stress, advocates say. 

Pros and Cons of Telehealth for Seniors 

The advantages of telehealth are clear. It’s convenient. It’s readily available. Seniors using telehealth can easily have a loved one or trusted adviser with them on the call. Telehealth doesn’t require a ride to the doctor’s office or a convenient bus schedule, and appointments are accessible rain or shine. 

However, there’s clearly a downside to healthcare that depends on technology. For one thing, many seniors are not tech-savvy: talking on the phone is simple, but a video call using Zoom or some other program requires an internet connection and a PC or tablet. Some older users either aren’t comfortable with this type of digital technology or else they mistrust it. 

Then there’s the power of an in-person connection. Will a generation that is accustomed to meeting their physician in his or her office readily give up the ritual of the office visit in favor of screen-time over a remote connection? That shift may take time. 

How Will Telehealth Meet the Need for Long-Term Care? 

For our final portion of this article, we were curious if there has been much research about telehealth as it specifically relates to in-home long-term care. This article from a Canadian website called The Conversation gave us some helpful insight. It was published last fall and was the work of researchers from Simon Fraser University. 

“Seventy-five per cent of health care in Canada is provided at home by unpaid family caregivers,” the authors write. “Not only is this essential health-care work often unrecognized and under-supported, it is rapidly changing.”  Sounds a lot like the situation in the U.S. to us. 

Family Caregivers are the Backbone of Long-Term Healthcare 

The Canadian study appeared to focus primarily on how telehealth services might benefit family caregivers. 

“With a growing portion of Canadians opting to age in place at home, family members will increasingly be relied upon to provide care,” the article states. These uncompensated caregivers serve at great personal cost, most notably the need to take time away from their workplace in order to provide care. As in the United States, women make up the major share of caregivers in Canada, the article notes. 

Here’s one area where telemedicine might have a significant positive impact. “Virtual care has reduced the economic costs of attending [medical] appointments by lessening the need for caregivers to take time off work,” the article points out. “It has also expanded caregiver networks, allowing those living at a distance to be involved in a loved one’s care, and opened new avenues for caregivers to find supportive communities and services online.” 

In other words, remote access to healthcare can make a caregiver’s life considerably easier. 

“Digital Divide” Limits Access to Care 

But the telehealth landscape isn’t free from roadblocks. “Caregivers also report encountering challenges with virtual care,” says the article. “Among these are experiences overcoming the ‘digital divide’” – the fact that not all seni0rs have easy access to digital devices combined with the knowledge of how to use them. 

“Although technology and internet usage have become increasingly ingrained in the day-to-day lives of Canadians, individuals living with limited incomes, or who live in remote areas, still face barriers to reliable internet,” The Conversation reports. “Our research suggests this limits options for accessing virtual forms of health care. Meanwhile, some patients who have more limited knowledge of digital technology rely on a caregiver to facilitate virtual appointments.” 

Virtual Healthcare Can Actually Increase Caregiver Stress 

The article in The Conversation points out that, even with the benefits of convenience, these new virtual healthcare tools can create stress for caregivers.  

“For instance,” say the researchers, “uncertainty as to where and how to follow up with a clinician, or concerns related to privacy and confidentiality” can trigger unease. “These concerns, amidst other barriers, can compound feelings of anxiety for caregivers already grappling with the stress of their loved one’s care.” 

The Canadian study concludes with another salient observation: most caregivers surveyed were seniors themselves, caring for a spouse or aging parent. For these users, the smartphones, tablets, laptops, and reliable internet connections may pose both a technological barrier and a financial one.  

Telemedicine Will Impact Long-Term Care Over Time 

As we wrap up this quick look at an important issue, we realize we’ve just scratched the surface. But there are important take-aways for just about all of us, we think. 

First, the odds are high that each of us will need long-term care. But there’s a growing labor shortage that promises to limit access while driving up costs. 

Second, telemedicine can provide access to healthcare, even in a long-term care setting, but the advent and adoption of this technology comes with major new challenges. 

Third, virtual care can make life far easier for family caregivers. However, if we as a society are serious about controlling healthcare costs, it seems to us that we’ll need to find ways for more seniors to have better, cheaper, more reliable digital access to the medical services they need.  

Can telehealth be the panacea to solve the long-term care labor shortage?  No – but it appears to be a vital part of the solution. 

(originally reported at www.seattletimes.com and other sources)