The job America can't fill fast enough

The aide was supposed to come at eight. By nine my neighbor was still helping his wife to the bathroom himself, at seventy-nine, the way he had all week.

The agency was short again. It is short every week now.

This is not an isolated problem. The shortage is built into the demographics.

About 4.1 million Americans turn 65 every year now. The oldest boomers just turned 80, the age when help stops being a choice.

More than nine in ten people past 65 already live with a chronic condition. The need for daily care is growing every year, and the workforce is struggling to keep up.

The work that answers that need is home health and personal care aides. The people who help with the plain things when the body stops cooperating.

Millions already do it. The government keeps projecting more, around 765,800 openings a year through the decade.

So why the shortage? Look at the pay.

The job pays about $16.78 an hour. Call it $34,900 a year, for lifting, bathing, and driving to the doctor.

Three in four home-care workers leave within the year. The demand climbs a staircase you can read in advance. The workforce keeps draining out the bottom.

 

Hold that gap in your head. The need is printed years out. The hands to meet it keep shrinking.

A need this certain, unmet for a decade, sends people looking for another way to do the work.

For the first time, that other way is walking into rooms. A wave of machines built to help older people through the day.

The ones out today mostly keep company, watch, and remind. The ones on the drawing board are meant to lift a body and steady it on the stairs.

A generation that watched the personal computer and the smartphone turn into fortunes is watching the next machine arrive. This time it is pointed at their own care.

Set the machines aside for a minute and follow the money the way this letter always does.

In a gold rush the steady fortune sits with whoever sells the shovels. The same rule holds when the shovel walks and blinks.

Whichever robot ends up on the magazine cover, they all run on the same guts. The motors, the sensors, the joints that let a machine move without knocking a lamp off the table.

The demo videos leave out the hard part.

Most of these machines cannot do the thing families actually need. They keep company and watch the clock. They cannot lift a grown adult out of a tub.

They cost between twenty thousand and a hundred thousand dollars. Medicare pays for none of it, so the bill lands on the family.

The rules for a machine that touches a frail body are not written yet. So this is early. The pull is real and dated. The tools are still crude, and the price is nowhere near reach.

The arithmetic

The caregiver workforce, the projected openings, and the pay are from the Bureau of Labor Statistics. About 4 million home health and personal care aides, roughly 765,800 openings a year, and about 820,500 more jobs by 2033. The median pay was $34,900, or $16.78 an hour, as of May 2024. The three-in-four turnover in home care is PHI, 2024. The five long-term-care workers per 100 people over 65, flat since 2013, is the OECD. The oldest boomers turning 80 in 2026 is Pew; the 4.1 million turning 65 a year is the Census Bureau and the Alliance for Lifetime Income. That more than nine in ten people over 65 live with a chronic condition is the CDC. The eldercare-robot capabilities and prices are from 2025 and 2026 industry and company reports. The read on who profits, and the gold-rush framing, are Boomers Trade’s own.

 

My neighbor found someone in the end. A niece of a friend, three mornings a week, some of it paid in cash. It held for a month. Then it did not. That is the gap, in one kitchen. Watch the hands. The robot on the magazine cover is the easy part of the story. The first company to make the shortage easier to bear is the one that gets paid. I will see you back here tomorrow, one aisle further down the list.

Andrew

Boomers Trade is written by someone getting older right alongside you, and watching who profits from it.