DOVER-FOXCROFT, Maine – Janet Flaherty got an alarming call last October from the agency tasked with coordinating in-home care for her 82-year-old mother. It could no longer send her mom’s home caretaker. It knew of no other aides who could care for her mother, either.
Flaherty’s mother, Caroline, has for two years qualified for in-home care paid for by the state’s Medicaid program. But the agency could not find someone to hire amid a severe shortage of workers that has crippled facilities for seniors across the state.
With private help now bid up to $50 an hour, Janet and her two sisters have been forced to do what millions of families in a rapidly aging America have done: take up second, unpaid jobs caring full time for their mother.
“We do not know what to do. We do not know where to go. We are in such dire need of help,” said Flaherty, an insurance saleswoman.
Across Maine, families like the Flahertys are being hammered by two slow-moving demographic forces — the growth of the retirement population and a simultaneous decline in young workers — that have been exacerbated by a national worker shortage pushing up the cost of labor. The unemployment rate in Maine is 3.2%, below the national average of 3.7%.
The disconnect between Maine’s aging population and its need for young workers to care for that population is expected to be mirrored in states throughout the country over the coming decade, demographic experts say. And that’s especially true in states with populations with fewer immigrants, who are disproportionately represented in many occupations serving the elderly, statistics show.
“We have added an entire generation since we first put the safety net in place but with no plan whatsoever for how to support them,” said Ai-jen Poo, co-director of Caring Across Generations, which advocates for long-term care. “As the oldest state, Maine is the tip of the spear — but it foreshadows what is to come for the entire country.”
Last year, Maine crossed a crucial aging milestone: A fifth of its population is older than 65, which meets the definition of “super-aged,” according to the World Bank.
By 2026, Maine will be joined by more than 15 other states, according to Fitch Ratings, including Vermont and New Hampshire, Maine’s neighbors in the Northeast; Montana; Delaware; West Virginia; Wisconsin, and Pennsylvania. More than a dozen more will meet that criterion by 2030.
Across the country, the number of seniors will grow by more than 40 million, approximately doubling between 2015 and 2050, while the population older than 85 will come close to tripling.
Experts say the nation will have to refashion its workforce, overhaul its old-age programs and learn how to care for tens of millions of elderly people without ruining their families’ financial lives.
The results of not doing so fast enough are already visible in Maine. At the Hibbard Nursing Home in a rural slice of the state, Beth Lagasse cried softly as her father recovered down the hallway in Room 113.
Lagasse’s mother broke her back in May and died in June. Her father suffered a stroke in July. The nursing home near her has no open beds, so she drives an hour every day to care for her ailing father after spending months caring for her mother.
Lagasse has not been able to read a book, go canoeing or take care of her 1-year-old Shetland puppy, Paddy, since her mother first got sick. Lagasse, a physical education teacher, and her three siblings cannot afford the cost of 24/7 care, although Medicare temporarily covered her father’s hospitalization.
“I love them. I love them dearly,” Lagasse, 55, says of her parents. “I just wish this weren’t so hard.”
With its 65-and-older population expected to grow by 55% by 2026, Maine needs more nurses, more home-care workers and more physicians than ever to keep pace with demand for long-term-care services.
But the rising demand for care is occurring simultaneously with a dangerously low supply of workers. About one-third of Maine’s physicians are older than 60. In several rural counties in the state, close to half of the registered nurses are 55 or older and expected to retire or cut back their hours within a decade.
Care workers in Maine were paid about $11.37 an hour in 2017, according to an AARP report, with a 2019 minimum wage of $11 an hour. As Kristi Penny, a home care worker, noted over the phone: “Even Dunkin’ Donuts pays you more.”
Maine’s largest long-term-care provider, North Country Associates, has been forced to temporarily close admissions in each of its 26 nursing homes because of staffing shortages, sometimes for as long as several months, in an unprecedented change from a few years ago.
It has also permanently shut down two of its nursing homes over the past year, while about a dozen nursing homes across the state have closed their doors over the past several years.
Betsy Sawyer-Manter, president of the SeniorsPlus agency responsible for placing care workers with Medicaid enrollees, said she was not surprised by Flaherty’s story of failing to find a worker for her mother, despite qualifying for care. Sawyer-Manter said that every week her agency cannot fill more than 6,000 hours of direct care that have been authorized by the state, because of worker shortages.
“If there aren’t any workers in that area, there’s nothing we can do,” Sawyer-Manter said. “As people retire, we just don’t have enough workers to do all the jobs we need done.”