The Caregiver Shortage

Breaking · 2025 Home Care Crisis Alert

America's Caregiver Shortage:
What PA Families Must Know Now

By Gabrielle, Founder — Gilgal Home Care & Registry  |  9-minute read  |  April 2026

The home care workforce crisis is no longer a warning on the horizon. It is here — today — affecting families across Pennsylvania and the entire country. If you are caring for an aging parent, supporting a family member with a disability, or planning for your own future needs, this is something you need to understand right now.

This is not meant to alarm you without purpose. Understanding what is happening — and why — gives you the power to act before a crisis forces your hand.

1.2M

Additional caregivers needed in the U.S. by 2030 — the gap is widening

77%

Annual caregiver turnover rate nationally in 2024 — agencies restart constantly

59%

of home care agencies report being understaffed right now — today

⚠️ Why this matters to your family

When agencies are understaffed, they cannot guarantee coverage. Shifts get cancelled. Caregivers get pulled to other clients. Families who waited to plan find themselves with no options — and a loved one who urgently needs support. The families who plan ahead have choices. Those who don't often don't.

What Is Driving the Crisis?

The caregiver shortage is the result of three powerful forces colliding simultaneously — and none of them are going away soon.

1. The Demographic Tsunami

The numbers are relentless. With the number of people in the U.S. 85 years and older expected to more than double from 6.5 million in 2022 to 13.7 million in 2040, the demand for home care services is also growing. Every day, 10,000 Baby Boomers turn 65. The oldest Boomers are entering their 80s now — the age when care needs typically intensify. The demand side of the equation is growing with no ceiling.

2. The Wage and Retention Crisis

The median hourly wage for home care aides is $15.14, far below the national living wage threshold. At that wage, caregiving struggles to compete with retail, food service, and warehouse work — jobs that are less physically demanding and emotionally taxing. The result is caregiver shortage concerns affecting 59% of agencies, with high turnover rates remaining over 60% annually. Agencies are constantly recruiting, training, and losing caregivers in a cycle that never stabilizes.

3. Immigration Policy and Workforce Vulnerability

A significant portion of the U.S. caregiver workforce consists of immigrant workers. Workforce shortages have beleaguered the home-based care industry, and recent legislative moves have worsened the outlook. Providers have lost workers due to the Trump administration's immigration crackdown, creating significant problems for workers as well as home-based care companies and clients. For Pennsylvania families, this has translated into sudden caregiver losses mid-placement — disrupting continuity of care for some of the most vulnerable clients.

"The shortage is not theoretical. I have worked with families who had to scramble for care because their agency couldn't staff. That experience is preventable — but only if families plan ahead."

— Gabrielle, Founder, Gilgal Home Care & Registry · Stage 4 Breast Cancer Survivor · PA Chapter 611 Licensed Home Care Agency & Registry

What This Means for Pennsylvania Families

Expect longer wait times

Families who call a home care agency expecting placement within a week may find the reality is very different. High-demand areas — including Montgomery County, Chester County, and the greater Philadelphia region — have waitlists that can stretch weeks or longer for certain schedules and care types.

Continuity of care is not guaranteed through large agencies

When agencies have high turnover, they cannot guarantee that your loved one will have the same caregiver week to week. For individuals with dementia, autism, or strong routine-based needs, this inconsistency can cause real distress. Building a direct relationship with a caregiver through a registry model addresses this problem directly.

Costs are rising

The increasing cost of home care to consumers has emerged as the primary concern, with 64% of respondents believing it is a hindrance. As agencies compete for a shrinking workforce, they pass wage increases on to families. Private-pay rates have increased significantly in recent years and will continue to rise.

Technology is not yet the solution

AI solutions will aid agencies in automating paperwork, streamlining scheduling, and enhancing compliance monitoring — but AI cannot bathe, dress, or sit with your parent. Technology will improve operational efficiency, but it cannot replace human touch in personal care. The workforce gap cannot be tech-solved.

The Gilgal Advantage in a Shortage Environment

Gilgal is licensed under 28 Pa. Code Chapter 611 as both a home care agency and a home care registry. That dual model is exactly what helps during a shortage — if one arrangement cannot be staffed, the other often can.

• Direct placement: Gilgal connects families with pre-screened caregivers directly, building a genuine 1:1 relationship rather than relying on agency rotation pools
• PA clearance verification: Every caregiver placed through Gilgal has verified PA State Police, FBI, and Child Abuse clearances on file before placement
• Flexibility: Registry placement gives families more flexibility in scheduling and caregiver selection than large agency models
• Cost efficiency: Registry rates are typically $5–$8/hr lower than comparable agency rates — and because Gilgal offers both models, families can weigh the trade-off directly
• Consultation first: Gilgal's consulting model helps families identify their actual needs, funding options, and care plan before placement begins

What You Should Do Right Now

You cannot control the workforce shortage. You can control whether you are prepared for it. Here are five concrete actions to take in the next 30 days:

01

Start the conversation before you need to

Have an honest family conversation about your loved one's current capabilities and what the trajectory looks like. The best care plans are built before a crisis forces the issue.

02

Apply for Medicaid benefits now, not later

PA Medicaid waivers (OLTL, ODP, MAWD) have application and processing timelines that can stretch months. If your loved one may qualify, apply as soon as possible — benefits cannot be backdated.

03

Build a caregiver shortlist before you need one

Identify and vet 2–3 caregivers through a trusted registry so you have a relationship before the urgent need arises. Families with an existing network have options when coverage gaps occur.

04

Get a home safety assessment done this month

Falls are the leading cause of injury-related hospitalizations for older adults. A professional home safety assessment identifies every preventable risk — before an accident creates an emergency care need.

05

Work with a care consultant who knows the system

Navigating the home care system alone in a shortage environment is harder than it has ever been. A 60-minute consultation with Gilgal can give you a clear roadmap — funding, placement strategy, care planning, and what to expect.

💡 Download our Family Care Planning Workbook ($22.97): A complete care organization system — 30-day daily logs, appointment tracker, medication management, emergency contacts, and care team worksheets. Available at gilgalhomecare.org/resources.

The Bottom Line

The home care workforce crisis is real, it is significant, and it is going to affect more Pennsylvania families over the next decade than at any point in history. The U.S. home care market is projected to reach $225 billion by 2025, reflecting a significant growth trajectory — but that growth means nothing to a family that can't find a caregiver when they need one.

The families who will navigate this well are the ones who plan early, understand their funding options, build relationships with trusted providers, and don't wait for a crisis to force their hand. That's exactly what Gilgal is here to help you do.

Don't wait for the crisis.

Book a free 15-minute intro call with Gilgal. We'll listen to your situation and point you toward the right next step — whether that's a consultation, a resource, or simply knowing what questions to ask.

📞 Book a Free Intro Call 📚 Family Care Resources

Statistics referenced from PHI, AxisCare 2025 Home Care Industry Survey, Home Health Care News 2025 Survey, Family & Nursing Care 2025 Trends Report, and the North American Community Hub. All information is for educational purposes. Gilgal Home Care & Registry · care@gilgalhomecare.org · gilgalhomecare.org · King of Prussia, PA 19406