Understanding America’s Caregiving Crisis - Comprehensive Rehabilitation Consultants (2025)

For the disabled, elderly, and others who require assistance in their daily lives, caregivers are essential for facilitating everyday tasks – like dressing, eating, using the restroom, and more. While caregivers boost patient quality of life by enabling independent and comfortable lifestyles, a shrinking caregiver workforce is raising concerns for the hundreds of thousands of Americans who need them. Caregivers were already in short supply well before the pandemic, and coronavirus-related restrictions have only made it harder for patients to access the care they need.

Why is the Caregiving Workforce Shrinking?

The caregiver workforce has been experiencing extremely high turnover rates, jumping as high as 81.6% in 2018 and settling to around 65.2% in 2020 [1]. This is due to a variety of factors, including salary, the difficulty of the job, and lack of support and funding from the government.

The average hourly rate of a caregiver in Wisconsin is $12/hour [2], and median salaries across the country range from $19,000 to $27,000 [3]. Because long-term care is not covered by Medicare, the financial burden falls on the patients and/or their families, who may not be able to afford the high cost of in-home care or expensive nursing facilities.

In addition to financial concerns, caregivers often experience emotional and physical strains. The Family Caregiver Alliance reports that approximately 20% of family caregivers suffer from depression—twice the rate of the general population [4]—and a recent CDC report found that about 10% of caregivers reported serious suicidal ideation [5].

According to AARP, there will only be a ratio of 4 potential caregivers to 1 person aged 80 or older in 2030—a sharp decline from the 7 to 1 ratio reported in 2010 [6]. With over 800,000 families on waiting lists for government aid in caregiving, and an average wait of about 5 years [7], the caregiving workforce is shrinking rapidly, placing an increasing burden on informal caregivers such as family members.

The Pandemic’s Effect on Caregiving

Because many states did not recognize home care workers as “essential workers,” caregivers experienced delays in accessing personal protective equipment, coronavirus testing, and even vaccines. This lack of proper equipment and safeguards led many caregivers to leave the workforce out of fear of contracting or spreading the virus. By the end of 2020, the AARP found that 6% of caregivers had left their jobs entirely, with another 5% retiring early [8].

With fewer caregivers available during the pandemic, 47.9 million adults in the United States reported providing informal care to an adult with physical or mental health needs in 2020. Many of these caregivers faced difficulties coordinating care, financial setbacks, and worsening personal health due to the overwhelming demands of managing their jobs, daily lives, and caregiving responsibilities [9].

The COVID-19 pandemic has highlighted how reliant we have become on family members to provide care during illness, exposing the fragility of America’s caregiving infrastructure. As the number of older adults with serious illnesses grows, the challenges facing caregivers are driving the need for widespread changes in our health care system [10].

The Cost of Care

Caregiving is typically not covered by Medicaid or insurance plans, meaning that families or patients may spend a significant amount of money annually on caregiving services. In 2021, the average annual cost per family for in-home caregiving was around $7,242, with families spending about 26% of their income on caregiving activities and 17% on health care and medical equipment [11].

For those considering long-term care insurance, the costs can be substantial. In 2020, a 55-year-old man could expect to pay an average of $1,700 per year, a 55-year-old woman about $2,675, and a couple roughly $3,050 combined [12].

Although minimum wages are rising to $15/hour as employers struggle to fill jobs, this increase may not be sufficient to meet the specialized skills required for caregiving positions [13].

Biden’s Infrastructure Bill and More

Several government initiatives are poised to make significant changes to America’s caregiving infrastructure. The Credit for Caring Act, introduced in Congress in 2021, would provide eligible family caregivers with up to $5,000 per year to help cover care costs, including adult daycare, respite care, and home modifications like ramps and smart-home technology [14].

The American Families Plan, announced by the Biden administration, would provide up to 12 weeks of annual paid family leave, easing the financial burden on caregiving families [15].

Additionally, President Joe Biden’s $1 trillion infrastructure bill, recently passed in the Senate, allocates $400 billion to expand access to home care and support well-paying caregiving jobs. The proposal includes hiring an additional 150,000 community health workers, expanding caregiving support for underserved communities, and funding enough caregiving services to eliminate long waitlists for in-home care [16].

Benefits of Case Management

If you or someone you know is in need of in-home care and are wondering how to best use available resources to maintain quality of life, case management may be a good option.

The CRC Case Managers help identify the appropriate care for your condition and assess whether in-home or residential facility care is best. With our extensive network of resources and team members, we explore public and private funding sources to help cover long-term care costs while ensuring that you receive care aligned with your health and wellness goals. We address every obstacle within the healthcare system, tailoring each care plan to your medical, rehabilitative, and psychological needs.

To learn more or to speak with a CRC representative, contact us at info@crcmiami.com.