American families shouldered an enormous burden caring for family members even before the pandemic, and a shortage of professional caregivers now is only likely to make that burden heavier.
The big picture: Nursing homes and other long-term care settings have seen a staff exodus both during and after the pandemic, especially when they've imposed vaccine mandates — poking new holes in a system that was already full of them.
"We have this terrible tradeoff right in a lot of parts of the country where we can either have staff working who aren't vaccinated and put our older adults at risk, or we can be short-staffed and that also puts older adults at risk," David Grabowski, a health policy professor at Harvard, told Axios.
By the numbers: Health care employment is down by 524,000 jobs since February 2020. Nursing and residential care facilities account for about 80% of the losses. Last week's jobs report showed another 38,000-job decline in nursing and residential care.
Between the lines: The kind of care delivered in nursing homes and assisted-living facilities has long been a patchwork in the U.S.
- "We are losing more people than we can recruit," Gayle Kvenvold, CEO of industry trade group LeadingAge Minnesota told the Minneapolis Star Tribune about concerns in her state. Seven in 10 nursing homes and 29% of assisted-living facilities have limited new admissions as a result.
- It's expensive, it's hard for all but the poorest patients to get insurance coverage for it, and facilities offer widely differing levels of care. It's mostly been family members that have filled in the gaps.
- Unpaid caregiving is a burden that has traditionally fallen disproportionately on women — as has child care, which is facing its own pandemic crunch.