Posted On July 29, 2022.

December blurred to January, and the night shift blurred into the day shift, as Momah Wolapaye, 53, rotated warm towels beneath the bedridden at the nursing care wing for the Covid-positive. Repositioning the residents every two hours prevented bed sores, and normally took two aides, but now only one was permitted in rooms. Straws were also forbidden, so after giving sponge baths, Wolapaye spoon-fed sips of water to the elderly, checked their breathing and skin coloration, and calmed the anxious who called into the night silence.

Most didn’t understand why they were suddenly in new rooms, sealed with painter’s plastic, and why they needed masks. Some wanted to leave, and Wolapaye spent 20 of the 30 minutes inside each room calming them and explaining “the virus.” It was December 2020, the pandemic’s second wave, and all but three staff on his team had caught Covid. His supervisor asked if he could work 16-hour shifts. He agreed. He tied his blue uniform in a plastic bag when he got home in the morning, told his sons not to touch it, and returned to work that evening to Goodwin Living, a long-term care community in D.C.’s suburbs.

Wolapaye stands out: He genuinely loves his job, one known for burnout, mistreatment and injury. “It’s my responsibility, being there with the residents. I take them to be like my own people.”

Since January 2020, 400,000 nursing home and assisted living staff have quit, citing pandemic exhaustion as well as the low pay and lack of advancement opportunities typical of the field. The job losses arrive when America already faces an elder caregiver shortage, as 10,000 people daily turn 65 and birth rates decline. The labor shortage gripping America’s workforce across industries is felt most acutely in home health care. According to the Bureau of Labor Statistics, home health and personal care aides are actually the fastest growing industry, projected to grow 33 percent in the next decade, much faster than all occupations. But there still simply aren’t enough workers to fill the demand.

“The numbers alone suggest we’re going to need a lot more people in the caregiving sector than we have now,” says Tara Watson, a fellow at the Brookings Institution and professor of economics at Williams College. “We need to make some changes in order for that to happen.”

A reflection of Momah Walopaye cleaning the floors of Goodwin House during his overnight shift.

America’s immigration policies have not kept pace with its aging demographics, and the country now faces a caregiver shortage.

For decades, elder care in the U.S. has been bolstered by an immigrant workforce. As a new immigrant from Liberia, Wolapaye found his first job in America at Goodwin Living 11 years ago. Immigrants occupy nearly 70 percent of jobs at the Alexandria, Va., facility, and are 40 percent of home health aides. But today, international migration to the U.S. is at record-lows. And with native-born Americans apparently reluctant to take elder care jobs, economists like Watson are raising alarm bells: Who will care for America’s elderly?

It’s a particularly important question as the crisis we’re in now is nothing compared to what’s coming: The percentage of people over the age of 85 — the group that most needs care — is predicted to double to 14 million by 2040, in part because Americans are living longer. In 2050, 84 million elderly people will live in America. Virginia alone is projected to be short 23,000 nurses in the next decade.

“The demand for this isn’t going to go away because the demand is being driven by an aging population,” says Dan Kosten, assistant vice president of policy and advocacy at the National Immigration Forum.

Still, despite the challenges that have pushed so many away from elder care work, immigrants, like Wolapaye, continue to seek and have remained in these difficult jobs. Wolapaye has stayed at Goodwin Living and — with good pay, benefits and advancement opportunities — has no plans to leave. His favorite residents are the ones who are quick with a story, like one resident nicknamed (for his time in the U.S. Army) General. Goodwin Living has been home to hundreds of retired government officials, including CIA agents, Navy admirals, and, at one time, former National Security Advisor Brent Scowcroft and former President Ronald Reagan’s press secretary, Jim Brady. (Disclosure: My mother-in-law also lived there, before dying of Covid.)

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Read more in the original post: The Crisis Facing Nursing Homes, Assisted Living and Home Care for America’s Elderly