Memory Care Sector Needs 1 Million More Direct Care Workers by 2031

The memory care sector requires one million new direct care workers by 2031, a need greater than in any other occupation in the U.S.

That’s according to the latest Alzheimer’s Association 2024 Facts and Findings report, released earlier this month. The annual report details national and state statistics related to Alzheimer’s prevalence, mortality, cost of care and caregiving.

According to the report, between 2012 and 2021, the number of direct care workers increased from 3.2 million to 4.8 million. But more than 1 million additional direct care workers are needed between 2021 and 2031 to meet future care demands, according to the report.

That is despite an anticipated 30% to 40% increase in the number of workers in 21 states, and a 50% increase in Arizona and Nevada. And the report indicates this will likely still not meet the demand for dementia and Alzheimer’s caregiving services.

“Although more direct care workers will be needed in the years ahead, the long-term care field is already struggling to fill existing direct care positions,” the report states.

The total cost for providing dementia care services in the U.S. is staggering, with a projected $360 billion price tag in 2024 for families and other unpaid caregivers alone. Without new treatments or care advances, that total could reach nearly $1 trillion in 2050, according to the report.

Alzheimer’s workforce worries

That challenge for operators is highlighted through high turnover rates in the workforce, with a 77% rate in direct care workers providing home care services and 99% for nursing assistants in nursing homes, which are exacerbated by “low wages and poor job conditions.” The median wage for direct care workers is $15.43 per hour, and due to a large number of part-time positions, has median annual earnings at $24,000 or less.

More than half of primary care physicians caring for people living with Alzheimer’s said there are not enough dementia care specialists in their communities. There are also 20 states that have been deemed “dementia neurology deserts,” which are projected to have fewer than 10 neurologists per 10,000 people with dementia in 2025.

There are an estimated 6.9 million people aged 65 or older living with Alzheimer’s, and an additional 200,000 people under 65 estimated to have a younger-onset version of the disease. However, the report’s authors noted that estimate is likely low, and a large portion of Americans may have a form of Alzheimer’s but not yet know it.

“Even fewer people living with mild cognitive impairment [MCI], a precursor to dementia, receive a diagnosis despite this being a stage where treatment and planning may be most effective,” the report’s authors wrote. “One recent study estimates that only 8% of older Americans living with MCI receive a diagnosis.”

By 2060, it is estimated that 6.7 million people age 85 and older are expected to have Alzheimer’s, making up almost half of all people 65 and older who have it.

Efforts are currently underway to attempt to bolster the workforce. In 2023, the National Institute on Aging funded the National Dementia Workforce Study to “build a data infrastructure to inform efforts to strengthen the workforce of clinicians and other care providers.”

The five-year study is part of an $81 million grant and is meant to survey caregivers in homes, hospitals, clinics, assisted living communities and nursing homes. It’s being headed up by researchers with the University of Michigan and the University of California, San Francisco.

Additionally, the American Public Health Association identified the need to strengthen the dementia care workforce as a public health priority in 2020.

“Continued failure to strengthen the dementia care workforce will increasingly limit the ability of people living with dementia to access quality services and supports, adding to health, social and economic burdens for individuals, families and society,” the report cites from the APHA.

More training, care navigation needed

Another pain point for the future of the dementia care workforce in the U.S. is training and navigation services, both of which are lacking in the industry.

Care navigation – the act of arranging medical and other services and other help for people with care needs – has been identified as an important resource for managing Alzheimer’s and other dementias. Even so, care navigation is an unfamiliar term, with three-fourths of dementia caregivers reporting little or no familiarity with it.

The vast majority of workers providing care navigation services, 93%, said they were at least “somewhat knowledgeable about mild cognitive impairment, Alzheimer’s disease, and other dementias, but just over one-third said they were “very knowledgeable.”

The report noted that three-fourths of dementia caregivers in the U.S. hadn’t received any formal training in dementia care navigation. Professionals who did receive training worked in non-medical positions and got a median of 30 hours of formal training, according to the report. Trained Medical professionals got a median of 20 hours of formal training by contrast.

According to the report, the most frequently provided care navigation services are community support and service referrals (75%), emotional and cultural support (68%) and screening for safety needs (66%).

Nearly three-quarters of those surveyed in the report said that coordinating care is stressful, while another 53% said doing so was difficult. Two-thirds of dementia caregivers said it is hard to find resources and support to care for someone living with Alzheimer’s.

Still, just half of the surveyed caregivers said they have talked with a healthcare professional to help address those challenges.